Virtual Reality-based Training Research Articles

Feasibility study on virtual reality-based training for skin cancer screening: Bridging the gap in dermatological education

AbstractDespite growing interest in the inclusion of virtual reality (VR) in medical education, its full potential for immersive and interactive training remains underutilized, particularly in dermatology. As part of a multidisciplinary project, we tested the feasibility of integrating a VR training scenario for a complete skin cancer screening into the curriculum with 58 medical students. The evaluation focused on simulation usability, cognitive task load, immersion, change in perceived competence, suitability, and cybersickness using established and adapted questionnaires. Participants reported rather high levels of system usability and immersion and medium cognitive task load. Self-assessed competence in performing a skin cancer screening increased significantly after the training simulation.Prior skin cancer screening experience correlated positively with self-assessed competence and theoretical knowledge, which themselves were neither related to gender nor age. Age correlated negatively with perceived usability and immersion, enjoyment of learning during the simulation and assessed appropriateness of the simulation to learn a dermatological full-body examination while being positively correlated with perceived cybersickness. Gender was significantly associated with the need for technical help during the simulation and openness to new technologies.As a blueprint of a feasibility evaluation, this study can contribute to further refinement of the presented and relatable VR applications in medical curricula.

Insights into virtual reality-based training for unexplained disease outbreaks: A qualitative exploration of Chinese standardized training nurses' experiences

BackgroundAn unexplained disease outbreak refers to a scenario wherein a group of individuals encounters similar health issues within a short timeframe, yet healthcare professionals find it challenging to promptly identify the specific cause or pathogenic factors triggering the outbreak. Emerging as a vital force in China, standardized training nurses can significantly mitigate the impact of unforeseen events. ObjectiveThis study aims to illuminate the experiences of Chinese standardized training nurses engaged in training for unexplained disease outbreaks utilizing virtual reality (VR) technology. DesignA qualitative descriptive research design was employed. ParticipantsThirty Chinese standardized training nurses participated in semi-structured interviews. MethodsData were collected through semi-structured interviews conducted from April 2023 to June 2023. Braun and Clark's thematic analysis method was applied for data analysis. ResultsThe study revealed five prominent themes: Surpassing Expectations, Enjoyable Learning, Self-challenge, Reflective Learning, and Promotion-Worthy. In essence, Chinese standardized training nurses perceived VR training as effective, meaningful, and conducive to reflective opportunities. Nevertheless, they expressed challenges in composing epidemiological reports, particularly when lacking expertise in epidemiology and having limited exposure to simulated training. ConclusionVirtual Reality (VR) technology plays a crucial role in continuing education after graduation (standardized training for nurses) in China, contributing to the enhancement of clinical practice standards and the promotion of teamwork collaboration. Its broader application is considered worthy of promotion.

Comparing Learning Outcomes of Machine-Guided Virtual Reality-Based Training With Educator-Guided Training in a Metaverse Environment: Randomized Controlled Trial.

Virtual reality (VR) modules are commonly used for health care training, such as adult advanced cardiac life support (ACLS), due to immersion and engagement. The metaverse differs from current VR serious gaming by enabling shared social connections, while current VR modules focus on computer-based content without social interaction. Educators in the metaverse can foster communication and collaboration during training sessions. This study aimed to compare learning outcomes of VR-based, machine-guided training with educator-guided, VR-based training in the metaverse environment. A total of 62 volunteered students from Acibadem Mehmet Ali Aydinlar University Vocational School for Anesthesiology were randomly divided into 2 groups of 31 participants each: one group received VR-based training with machine guidance (MG), and the other received VR-based training with educator guidance (EG) in the metaverse. The members of both groups undertook VR-based basic training for ACLS. Afterward, the MG group was trained with a VR-based advanced training module, which provides training with full MG, whereas the EG group attended the VR-based, educator-guided training in the metaverse. The primary outcome of the study was determined by the exam score of the VR-based training module. Descriptive statistics defined continuous variables such as VR exam scores and time spent on machine- or educator-guided training. The correlation between training time and VR exam scores was assessed with the Spearman rank correlation, and nonnormally distributed variables were compared using the Mann-Whitney U test. Statistical significance was set at P<.05, with analyses executed by MedCalc Statistical Software (version 12.7.7). Comparing the VR test scores between the MG and EG groups revealed no statistically significant difference. The VR test scores for the EG group had a median of 86 (range 11-100). In contrast, the MG group scores had a median of 66 (range 13-100; P=.08). Regarding the correlation between the duration of machine-guided or educator-guided training and VR-based exam scores, for the MG group, =0.569 and P=.005 were obtained. For the EG group, this correlation was found to be =0.298 and P=.10. While this correlation is statistically significant for the MG group, it is not significant for the EG group. The post hoc power analysis (80%), considering the correlation between the time spent on training and exam scores, supported this finding. The results of this study suggest that a well-designed, VR-based serious gaming module with MG could provide comparable learning outcomes to VR training in the metaverse with EG for adult ACLS training. Future research with a larger sample size could explore whether social interaction with educators in a metaverse environment offers added benefits for learners. ClinicalTrials.gov NCT06288087; https://clinicaltrials.gov/study/NCT06288087.

Virtual Reality-Based Training Has Potential to Improve Dementia Knowledge, Attitudes, and Sense of Competence of Physical Therapists and Occupational Therapists

Aim (i) Evaluate the perceived effect of the Enabling EDIE Acute workshop on dementia knowledge, attitudes toward dementia, and sense of competence of physical therapists, occupational therapists, allied health assistants, and physical therapy students. (ii) Determine if a greater perceived effect was observed within subgroups of the study population. Methods A pretest–posttest study with a three-month follow-up was conducted with participants who attended a virtual reality-based Enabling EDIE Acute workshop. Results Participants (n = 96) predominately had no previous dementia training, were physical therapists (45%), female (70%), and had a mean age of 32.5 (SD 9.7) years. Total scores for dementia knowledge, attitudes, and sense of competence improved immediately post workshop and/or at the three-month follow-up. Conclusion Virtual reality-based training, such as the Enabling EDIE Acute workshop, appears to be an effective component of dementia education for allied health professionals. Further research is needed to confirm, and expand on, these findings. ANZCTR reference number ACTRN12619001095156

Prenatal affective cognitive training to reduce the risk of postpartum depression (PACT): study protocol for a randomized controlled trial

BackgroundPostpartum depression (PPD) affects 30–50% of women with a history of previous depression or bipolar disorder and 8% of women with no history of depression. Negative cognitive biases in the perception of infant cues and difficulties with emotion regulation are replicated risk factors. Current interventions focus on detecting and treating rather than preventing PPD. The aim of this randomized controlled intervention trial is therefore to investigate the potential prophylactic effects of prenatal affective cognitive training for pregnant women at heightened risk of PPD.MethodsThe study will enrol a total of 292 pregnant women: 146 at high risk and 146 at low risk of PPD. Participants undergo comprehensive assessments of affective cognitive processing, clinical depressive symptoms, and complete questionnaires at baseline. Based on the responses, pregnant women will be categorized as either at high or low risk of PPD. High-risk participants will be randomized to either prenatal affective cognitive training (PACT) or care as usual (CAU) immediately after the baseline testing. The PACT intervention is based on emerging evidence for efficacy of affective cognitive training approaches in depression, including cognitive bias modification, attention bias modification, mindfulness-inspired emotion regulation exercises, and working memory training. Participants randomised to PACT will complete five individual computerised and virtual reality-based training sessions over 5 weeks. The primary outcome is the difference between intervention arms in the incidence of PPD, assessed with an interview 6 months after birth. We will also assess the severity of depressive symptoms, rated weekly online during the first 6 weeks postpartum.DiscussionThe results will have implications for future early prophylactic interventions for pregnant women at heightened risk of PPD. If the PACT intervention reduces the incidence of PPD, it can become a feasible, non-invasive prophylactic strategy during pregnancy, with positive mental health implications for these women and their children.Trial registrationClinicalTrials.gov NCT06046456 registered 21-09-2023, updated 08-07-2024.

Using Digital Twin Technology to Conduct Dynamic Simulation of Industry-Education Integration

The high accident rate in the construction industry has a major impact on how well projects turn out. Despite substantial investments in safety planning and supervision, there has been a marked increase in the construction industry's accident rate compared to other sectors. Serious games based on VR have recently been used in the study, suggesting that workers are now more safety conscious. However, these situations need many resources to create and are not always realistic. Hence this paper, Digital Twin-based Construction Safety Training Framework (DT-CSTF) with Artificial Intelligence (AI), has been proposed to monitor employees' emotional, mental, and physical well-being in real-time. The report sheds light on the significance of DT technology and its function in Industry 5.0. Using the Unity game engine, the proposed DT-CSTF creates a virtual reality-based training environment (VRTE) prototype that incorporates BIM, construction timetables, and safety requirements. Following this, the suggested structure enables gathering user data about risks and providing tailored feedback. Automated virtual reality game training scenarios are created using data given by digital twins on project intent, project status, safety requirements, and history. Both improved digital twins and periodic construction safety monitoring are anticipated to reap the benefits of dynamic virtual reality training. The proposed management system offers effectiveness of VR-based security training, cost-benefit analysis, monitoring,employee behaviour, safety education values are obtained by the ratio of 96,90 %, 98,33 %, 99,25 %, 95,91 %, 98,66 % respectively

Use and Effectiveness of Innovative Virtual Reality Application in Teaching Fetal Development: A Randomized Controlled Trial.

Virtual reality-based training is effective. It is increasingly used by multiple disciplines to develop observation and critical skills, including engineering, education, arts, and health. This study was conducted to determine the effectiveness of the application created with Fetal Development Application Created by Virtual Reality Technology, which was developed to teach fetal development. The study was conducted in a single-blind, randomized fashion. Undergraduate midwifery students who took normal pregnancy lessons and learned fetal development were included. Eighty-four students were included in the experimental (n = 42) and control (n = 42) groups. Before the training, a personal information form and a pretest were applied to both groups. After the pretest, the experimental group received Fetal Development Application Created by Virtual Reality Technology, and the control group received 2 hours of theory training. Posttest was applied to both groups 6 weeks after the application. Preintervention scores were similar for the two groups. The posttest score of the experimental group was statistically significant compared with that of the control group ( P < .05). The mean cognitive load score of the experimental group was 1.09 ± 0.29, and the application did not create a cognitive load. The innovative application of Fetal Development Application Created by Virtual Reality Technology is an effective and applicable method in teaching fetal development in midwifery education.

The Effectiveness of Virtual Reality-Based Training on Cognitive, Social, and Physical Functioning in High-Functioning Older Adults (CoSoPhy FX): 2-Arm, Parallel-Group Randomized Controlled Trial.

Virtual reality (VR) has emerged as a promising technology for enhancing the health care of older individuals, particularly in the domains of cognition, physical activity, and social engagement. However, existing VR products and services have limited availability and affordability; hence, there is a need for a scientifically validated and personalized VR service to be used by older adults in their homes, which can improve their overall physical, cognitive, and social well-being. The main purpose of the CoSoPhy FX (Cognitive, Social, and Physical Effects) study was to analyze the effects of a VR-based digital therapeutics app on the cognitive, social, and physical performance abilities of healthy (high-functioning) older adults. This paper presents the study protocol and the results from the recruitment phase. A group of 188 healthy older adults aged 65-85 years, recruited at the Medical University of Lodz, Poland, were randomly allocated to the experimental group (VR dual-task training program) or to the control group (using a VR headset app showing nature videos). A total of 3 cognitive exercises were performed in various 360° nature environments delivered via a VR head-mounted display; the participants listened to their preferred music genre. Each patient received 3 sessions of 12 minutes per week for 12 weeks, totaling a minimum of 36 sessions per participant. Attention and working memory (Central Nervous System Vital Signs computerized cognitive battery) were used as primary outcomes, while other cognitive domains in the Central Nervous System Vital Signs battery, quality of life (World Health Organization-5 Well-Being Index), health-related quality of life (EQ-5D-5L), and anxiety (General Anxiety Disorder 7-item questionnaire) were the secondary outcomes. The group-by-time interaction was determined using linear mixed models with participants' individual slopes. In total, 122 (39%) of the initial 310 participants failed to meet the inclusion criteria, resulting in a recruitment rate of 61% (188/310). Among the participants, 68 successfully completed the intervention and 62 completed the control treatment. The data are currently being analyzed, and we plan to publish the results by the end of September 2024. VR interventions have significant potential among healthy older individuals. VR can address various aspects of well-being by stimulating cognitive functions, promoting physical activity, and facilitating social interaction. However, challenges such as physical discomfort, technology acceptance, safety concerns, and cost must be considered when implementing them for older adults. Further research is needed to determine the long-term effects of VR-based interventions, optimal intervention designs, and the specific populations that would benefit most. ClinicalTrials.gov NCT05369897; https://clinicaltrials.gov/study/NCT05369897. DERR1-10.2196/53261.

Investigating the Effects of Virtual Reality-Based Training on Balance Ability and Balance Confidence in Older Individuals

Each year, over 25% of adults aged sixty-five years old or older suffer a fall, and three million are treated for fall-related injuries due to lack of balance. Here, we aimed to investigate how virtual reality (VR)-based training affects balance performance and confidence in older adults. To accomplish this goal, we studied 21 healthy, older individuals between 60 and 85 years old, both pre- and post-training (6 weeks of training, twice per week (or 12 sessions)). The VR group donned an Oculus VR headset and consisted of nine participants (aged 75.9 ± 3.7 years old), while the control group (aged 75.1 ± 6.7 years old) performed training without a headset and consisted of eight participants that completed our study. To assess balance ability, we utilized the Balance Error Scoring System (BESS) and the Timed Up and Go (TUG) test. To assess balance confidence, we implemented the Activities-Specific Balance Confidence (ABC) Scale and, to assess fear of falling, the Tinetti Falls Efficacy Scale (FES). Further, we assessed depression (via the Geriatric Depression Scale (GDS)) and cognitive ability (via the Mini-Mental State Examination (MMSE)). The post-training results showed improvements in balance ability for both the VR and control groups, as well as changes in the relationship between balance confidence and balance ability for the VR group only. Further, improvements in cognitive ability were seen in the control group. This study is an indication that older individuals’ balance ability may benefit from several weeks of targeted training.

Virtual reality-based training may improve visual memory and some aspects of sustained attention among healthy older adults – preliminary results of a randomized controlled study

Background/AimsOlder age and cognitive inactivity have been associated with cognitive impairment, which in turn is linked to economic and societal burdens due to the high costs of care, especially for care homes and informal care. Emerging non-pharmacological interventions using new technologies, such as virtual reality (VR) delivered on a head-mounted display (HMD), might offer an alternative to maintain or improve cognition. The study aimed to evaluate the efficacy and safety of a VR-based Digital Therapeutics application for improving cognitive functions among healthy older adults.MethodsSeventy-two healthy seniors (experimental group N = 35, control group N = 37), aged 65–85 years, were recruited by the Medical University of Lodz (Poland). Participants were randomly allocated to the experimental group (a VR-based cognitive training which consists of a warm-up module and three tasks, including one-back and dual-N-back) or to the control group (a regular VR headset app only showing nature videos). The exercises are performed in different 360-degree natural environments while listening to a preferred music genre and delivered on a head-mounted display (HMD). The 12-week intervention of 12 min was delivered at least three times per week (36 sessions). Compliance and performance were followed through a web-based application. Primary outcomes included attention and working memory (CNS-Vital Signs computerized cognitive battery). Secondary outcomes comprised other cognitive domains. Mixed linear models were constructed to elucidate the difference in pre- and post-intervention measures between the experimental and control groups.ResultsThe users performed, on average, 39.8 sessions (range 1–100), and 60% performed more than 36 sessions. The experimental group achieved higher scores in the visual memory module (B = 7.767, p = 0.011) and in the one-back continuous performance test (in terms of correct responses: B = 2.057, p = 0.003 and omission errors: B = -1.950, p = 0.007) than the control group in the post-test assessment. The results were independent of participants’ sex, age, and years of education. The differences in CNS Vital Signs’ global score, working memory, executive function, reaction time, processing speed, simple and complex attention, verbal memory, cognitive flexibility, motor speed, and psychomotor speed were not statistically significant.ConclusionsVR-based cognitive training may prove to be a valuable, efficacious, and well-received tool in terms of improving visual memory and some aspect of sustainability of attention among healthy older adults. This is a preliminary analysis based on part of the obtained results to that point. Final conclusions will be drawn after the analysis of the target sample size.Trial registrationClinicaltrials.gov ID NCT05369897.

The Development of a Virtual Reality-based Training System for Prosthetic Foot Users: Effects on Motion Sickness and Postural Stability

The Development of a Virtual Reality-based Training System for Prosthetic Foot Users: Effects on Motion Sickness and Postural Stability

The effect of gender on emotional reactions and perceptions when individuals meet themselves in immersive virtual reality

Immersive virtual reality-based training and research are becoming more and more popular and are in continuous development. For instance, it is now possible to be trained by one’s virtual self (i.e., doppelganger), meaning that a trainee can participate in a training program in which the trainer resembles the trainee. While past research involving doppelgangers showed promising results, findings revealed gender effects such that doppelganger-based training seems to be beneficial only for male trainees. In the present research, we contribute to this literature by investigating the emotional reactions and perceptions that people have when they meet a virtual human in immersive virtual reality. Specifically, we assess the extent to which the appearance of the virtual human (doppelganger vs. unknown avatar) and an individual’s gender influence these reactions and perceptions. We found that males felt more positive emotions toward their doppelganger than toward the unknown avatar and that females perceived their doppelganger as less competent and warm than the unknown avatar. Our findings have important practical implications in terms of virtual reality-based training and research design such that the use of a doppelganger (unknown avatar) might be recommended in a training program or research setting involving men (women).

Design and development of a personalized virtual reality-based training system for vascular intervention surgery

Background and objectivesVirtual training has emerged as an exceptionally effective approach for training healthcare practitioners in the field of vascular intervention surgery. By providing a simulated environment and blood vessel model that enables repeated practice, virtual training facilitates the acquisition of surgical skills in a safe and efficient manner for trainees. However, the current state of research in this area is characterized by limitations in the fidelity of blood vessel and guidewire models, which restricts the effectiveness of training. Additionally, existing approaches lack the necessary real-time responsiveness and precision, while the blood vessel models suffer from incompleteness and a lack of scientific rigor. MethodsTo address these challenges, this paper integrates position-based dynamics (PBD) and its extensions, shape matching, and Cosserat elastic rods. By combining these approaches within a unified particle framework, accurate and realistic deformation simulation of personalized blood vessel and guidewire models is achieved, thereby enhancing the training experience. Furthermore, a multi-level progressive continuous collision detection method, leveraging spatial hashing, is proposed to improve the accuracy and efficiency of collision detection. ResultsOur proposed blood vessel model demonstrated acceptable performance with the reduced deformation simulation response times of 7 ms, improving the real-time capability at least of 43.75 %. Experimental validation confirmed that the guidewire model proposed in this paper can dynamically adjust the density of its elastic rods to alter the degree of bending and torsion. It also exhibited a deformation process comparable to that of real guidewires, with an average response time of 6 ms. In the interaction of blood vessel and guidewire models, the simulator blood vessel model used for coronary vascular intervention training exhibited an average response time of 15.42 ms, with a frame rate of approximately 64 FPS. ConclusionsThe method presented in this paper achieves deformation simulation of both vascular and guidewire models, demonstrating sufficient real-time performance and accuracy. The interaction efficiency between vascular and guidewire models is enhanced through the unified simulation framework and collision detection. Furthermore, it can be integrated with virtual training scenarios within the system, making it suitable for developing more advanced vascular interventional surgery training systems.

Efficacy of a virtual reality-based cognitive interactive training program for children with traumatic brain injuries: study protocol for a parallel-group randomized controlled trial

BackgroundTraumatic brain injury (TBI) is a leading cause of disability in children. Cognitive rehabilitation for this population is critical for their long-term health outcomes. This trial aims to evaluate the efficacy of a virtual reality-based program (VICT) for training executive functions in children with TBI.MethodsA parallel group randomized controlled trial will be conducted among up to 32 children with TBI. Children in the intervention group will receive the VICT training while children in the control group will play a comparable VR game without executive function training. Each participant will be assessed at baseline, post-intervention, and 1-month follow-up. Outcomes will include core executive functions, attention, and health-related quality of life measured by computerized tasks or standardized questionnaires.DiscussionCognitive rehabilitation is among the top healthcare needs for pediatric TBI patients. Virtual reality-based training is promising due to its versatile content, flexibility, and potential cost savings for both patients and providers. Findings of this trial will provide data on the efficacy of the VICT program on core executive functions, attention problems, and health-related quality of life and serve as the empirical foundation for future larger multi-site effectiveness trials.Trial registrationClinicalTrials.gov NCT04526639. Registered on August 18, 2020.

Learning experience design of verbal prompts in virtual reality-based training for autistic children

This study aimed to explore the design and development of verbal prompts in virtual reality (VR)-based social skills training for autistic children. Autism indicates a category with neurodiversity that influences individuals’ capability to engage in social and cognitive tasks. This complex neurodevelopmental condition manifests in a wide array of patterns, featuring unique experiences of each individual. This study explored both advantages and challenges encountered when autistic children interact with verbal prompts in multi-user, desktop VR-based social skills training. Our explanatory case study involved VR-based learning experiences of four autistic children. We used a qualitative thematic analysis to analyse the study participants’ interaction patterns with verbal prompts in the VR-based training. Our research can contribute to both theoretical knowledge and practical design guidelines for the creation of verbal prompts in desktop VR-based training programmes tailored for autistic children.

Developing Independent Skills Using a Virtual Reality-Based Training Program for Children with Down Syndrome

Children with Down syndrome (DS) have difficulties developing independent skills (IS), which affects their ability to carry out daily tasks and social interaction. To develop these children’s skills and enhance their independence, this study aimed to develop the IS of children with moderate DS through a training program based on virtual reality (VR). The study sample consisted of 18 male students with DS at the “Obour Day Care” Center in Al-Ahsa, Kingdom of Saudi Arabia. Their ages ranged from 8–12 years (mean age = 9.45, standard deviation ± 1.47). The study took a quasi-experimental approach, and the research tools were the Independence Skills Scale (ISS) prepared by Badawi (2018) and a training program developed by the researcher. The results showed a statistically significant difference between the mean ranks of the first experimental group (to which the VR program was applied) on the ISS for the pre- and post-measurements in favor of the post-measurement (z = -2.207, p = 0.027). There was also a statistically significant difference between the mean ranks of the second experimental group (to which the regular program was applied) on the ISS in the pre- and post-measurements in favor of the post-measurement (z = -2.201, p = 0.028). There was no statistically significant difference between the mean ranks of the control group (which was not exposed to any intervention) on the ISS in the pre- and post-measurements (z = -0.647, p = 0.518). In addition, there were statistically significant differences between the mean ranks of the three groups on the ISS in the post-measurement (x2 = 15.284, p &lt; 0.001) in favor of the first experimental group, followed by the second experimental group. Based on the results, it is recommended that a training program based on VR be integrated into various training and educational programs targeting children with moderate DS, in order to enhance their independence and develop their skills.&#x0D; &#x0D; Received: 2 January 2024 / Accepted: 27 February 2024 / Published: 5 March 2024

Impact of Virtual Reality Simulation on New Nurses' Assessment of Pediatric Respiratory Distress.

Children often experience respiratory illnesses requiring bedside nurses skilled in recognizing respiratory decompensation. Historically, recognizing respiratory distress has relied on teaching during direct patient care. Virtual reality simulation may accelerate such recognition among novice nurses. To determine whether a virtual reality curriculum improved new nurses' recognition of respiratory distress and impending respiratory failure in pediatric patients based on assessment of physical examination findings and appropriate escalation of care. New nurses (n = 168) were randomly assigned to complete either an immersive virtual reality curriculum on recognition of respiratory distress (intervention) or the usual orientation curriculum (control). Group differences and changes from 3 months to 6 months after the intervention were examined. Nurses in the intervention group were significantly more likely to correctly recognize impending respiratory failure at both 3 months (23.4% vs 3.0%, P < .001) and 6 months (31.9% vs 2.6%, P < .001), identify respiratory distress without impending respiratory failure at 3 months (57.8% vs 29.6%, P = .002) and 6 months (57.9% vs 17.8%, P < .001), and recognize patients' altered mental status at 3 months (51.4% vs 18.2%, P < .001) and 6 months (46.8% vs 18.4%, P = .006). Implementation of a virtual reality-based training curriculum was associated with improved recognition of pediatric respiratory distress, impending respiratory failure, and altered mental status at 3 and 6 months compared with standard training approaches. Virtual reality may offer a new approach to nurse orientation to enhance training in pediatrics-specific assessment skills.

Virtual Reality-Based Training in Chronic Low Back Pain: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Low back pain is one of the most prevalent pain conditions worldwide. Virtual reality-based training has been used for low back pain as a new treatment strategy. Present evidence indicated that the effectiveness of virtual reality-based training for people with chronic low back pain is inconclusive. This study conducted a meta-analysis to evaluate the immediate- and short-term effects of virtual reality-based training on pain, pain-related fear, and disability in people with chronic low back pain. We searched the PubMed, Embase, Web of Science, PEDro, CENTRAL, and CINAHL databases from inception until January 2024. Only randomized controlled trials assessing the effects of virtual reality-based training on individuals with chronic low back pain were selected. The outcomes were focused on pain, pain-related fear measured by the Tampa Scale of Kinesiophobia, and disability measured by the Oswestry Disability Index. The immediate term was defined as the immediate period after intervention, and the short term was defined as 3 to 6 months after intervention. The Cochrane Risk of Bias tool and the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach were used to evaluate the quality of the methodology and evidence, respectively. In total, 20 randomized controlled trials involving 1059 patients were eligible for analysis. Virtual reality-based training showed significant improvements in pain (mean difference [MD] -1.43; 95% CI -1.86 to -1.00; I2=95%; P<.001), pain-related fear using the Tampa Scale of Kinesiophobia (MD -5.46; 95% CI -9.40 to 1.52; I2=90%; P=.007), and disability using the Oswestry Disability Index (MD -11.50; 95% CI -20.00 to -3.01; I2=95%; P=.008) in individuals with chronic low back pain immediately after interventions. However, there were no significant differences observed in pain (P=.16), pain-related fear (P=.10), and disability (P=.43) in the short term. These findings indicated that virtual reality-based training can be used effectively for individuals with chronic low back pain in the immediate term, especially to reduce pain, alleviate pain-related fear, and improve disability. However, the short-term benefits need more high-quality trials to be demonstrated. PROSPERO CRD42021292633; http://tinyurl.com/25mydxpz.

Efficacy of virtual reality-based training programs and games on the improvement of cognitive disorders in patients: a systematic review and meta-analysis

IntroductionCognitive impairments present challenges for patients, impacting memory, attention, and problem-solving abilities. Virtual reality (VR) offers innovative ways to enhance cognitive function and well-being. This study explores the effects of VR-based training programs and games on improving cognitive disorders.MethodsPubMed, Scopus, and Web of Science were systematically searched until May 20, 2023. Two researchers selected and extracted data based on inclusion and exclusion criteria, resolving disagreements through consultation with two other authors. Inclusion criteria required studies of individuals with any cognitive disorder engaged in at least one VR-based training session, reporting cognitive impairment data via scales like the MMSE. Only English-published RCTs were considered, while exclusion criteria included materials not primarily focused on the intersection of VR and cognitive disorders. The risk of bias in the included studies was assessed using the MMAT tool. Publication bias was assessed using funnel plots and Egger’s test. The collected data were utilized to calculate the standardized mean differences (Hedges’s g) between the treatment and control groups. The heterogeneity variance was estimated using the Q test and I2 statistic. The analysis was conducted using Stata version 17.0.ResultsTen studies were included in the analysis out of a total of 3,157 retrieved articles. VR had a statistically significant improvement in cognitive impairments among patients (Hedges’s g = 0.42, 95% CI: 0.15, 0.68; p_value = 0.05). games (Hedges’s g = 0.61, 95% CI: 0.30, 0.39; p_value = 0.20) had a more significant impact on cognitive impairment improvement compared to cognitive training programs (Hedges’s g = 0.29, 95% CI: -0.11, 0.69; p_value = 0.24). The type of VR intervention was a significant moderator of the heterogeneity between studies.ConclusionVR-based interventions have demonstrated promise in enhancing cognitive function and addressing cognitive impairment, highlighting their potential as valuable tools in improving care for individuals with cognitive disorders. The findings underscore the relevance of incorporating virtual reality into therapeutic approaches for cognitive disorders.

Applying multimodal data fusion to track autistic adolescents’ representational flexibility development during virtual reality-based training

In our study, we harnessed multimodal data to develop a predictive model aimed at assessing the development of representational flexibility (RF) in autistic adolescents engaged in virtual reality (VR)-based cognitive skills training. Recognizing VR's potential to enhance RF through immersive 3D simulation tasks, we addressed the research gap in analyzing learners' digital interactions within this environment. This data mining study integrated diverse data sources—including behavioral cues, physiological responses, and direct interaction logs—collected from 178 training sessions with eight autistic adolescents. This comprehensive dataset, encompassing both audio and screen recordings, was analyzed using advanced machine learning techniques. Through decision-level data fusion, particularly employing the random forest algorithm, our model demonstrated enhanced accuracy in predicting RF development, surpassing single-source data approaches. This research not only contributes to the effective use of VR in educational interventions for autistic adolescents but also showcases the potential of multimodal data fusion in understanding complex cognitive skills development.