Virtual Reality For People Research Articles

Social cognition training using virtual reality for people with schizophrenia: a scoping review

To date, many interventions for social cognition have been developed. Nevertheless, the use of social cognition training with virtual reality (SCT-VR) in schizophrenia is a recent field of study. Therefore, a scoping review is a suitable method to examine the extent of existing literature, the characteristics of the studies, and the SCT-VR. Additionally, it allows us to summarize findings from a heterogeneous body of knowledge and identify gaps in the literature favoring the planning and conduct of future research. The aim of this review was to explore and describe the characteristics of SCT-VR in schizophrenia. The searched databases were MEDLINE, PsycInfo, Web of Science, and CINAHL. This scoping review considered experimental, quasi-experimental, analytical observational and descriptive observational study designs. The full text of selected citations was assessed by two independent reviewers. Data were extracted from papers included in the scoping review by two independent reviewers. We identified 1,407 records. A total of twelve studies were included for analyses. Study designs were variable, most research was proof-of-concept or pilot studies. Most SCT-VR were immersive and targeted interventions. Number of sessions ranged from 9 to 16, and the duration of each session ranged from 45 to 120 min. Some studies reported a significant improvement in emotion recognition and/or theory of mind. However, SCT-VR is a recent research field in which the heterogeneity in methodological approaches is evident and has prevented the reaching of robust conclusions. Preliminary evidence has shown that SCT-VR could represent a feasible and promising approach for improving SC deficits in schizophrenia.

Visual Cues for a Steadier You: Visual Feedback Methods Improved Standing Balance in Virtual Reality for People With Balance Impairments.

Users of head-mounted displays (HMDs) for virtual reality (VR) sometimes have balance issues since HMDs impede their view of the outside world. This has a greater impact on people with balance impairments since many rely more heavily on their visual cues to keep their balance. This is a significant obstacle to the universal usability and accessibility of VR. Although previous studies have verified the imbalance issue, not much work has been done to diminish it. In this study, we investigated how to increase VR balance by utilizing additional visual cues. To examine how different visual approaches (static, rhythmic, spatial, and center of pressure (CoP) based feedback) affect balance in VR, we recruited 100 people (50 with balance impairments due to multiple sclerosis and 50 without balance impairments) across two different geographic locations (United States and Bangladesh). All people completed both standing visual exploration as well as standing reach and grasp tasks. Results demonstrated that static, rhythmic, and CoP visual feedback approaches enhanced balance significantly ($p\lt . 05$) in VR for people with balance impairments. The methods described in this study could be applied to design more accessible virtual environments for people with balance impairments.

Efficacy of an Internet-based intervention with self-applied exposure therapy in virtual reality for people with panic disorder: study protocol for a randomized controlled trial

BackgroundDue to several treatment barriers, many individuals with panic disorder do not receive evidence-based treatment. One promising option to narrow this treatment gap is Internet-based psychotherapy, which has been shown particularly effective in guided formats. Still, there remains room for improvement to make these digital therapies more accessible, cost-efficient, and aligned with best practices for in-person interventions (e.g., exposure). The smartphone app “Invirto – Treatment for Anxiety” offers digitally guided, evidence-based treatment of panic disorders including virtual reality (VR) for exposure therapy. The aim present study is to investigate the efficacy, safety, and acceptance of Invirto in comparison to a care-as-usual (CAU) control group.MethodsWe plan to conduct a randomized controlled trial with two conditions (intervention vs. CAU), three assessment times via online surveys (t0: baseline; t1: 3 months after baseline; t2: follow-up assessment 6 months after baseline), and a total of 128 participants with a clinical diagnosis of panic disorder (symptoms must be experienced ≥ 1 year). Recruitment will take place via email, phone, and the study website. The primary outcome will be the change in anxiety symptoms as measured by Beck’s Anxiety Inventory from t0 to t1. Secondary outcomes will be the change in anxiety symptoms (measured by the Panic and Agoraphobia Scale, PAS; Questionnaire on panic-related Anxieties, Cognitions and Avoidance, ACA), depressive symptoms (measured by the Beck-Depression-Inventory, BDI-II), treatment satisfaction (measured by the Client Satisfaction Questionnaire, CSQ-8; Treatment Adherence Perception Questionnaire, TAPQ-adapt; Positive and Negative Effects of Psychotherapy Scale, PANEPS-I), psychological flexibility (measured by the Acceptance and Action Questionnaire-II, AAQ-II), and dissociation during VR exposure (measured by an adapted version of the Peritraumatic Dissociative Experiences Questionnaire, PDEQ-adapt). Participants in the intervention group will receive access to the intervention (Invirto) right after t0, while the CAU group will receive access to Invirto after t1. We expect a larger change in both the primary and secondary outcomes from t0 to t1 in the intervention group in comparison to the CAU group.DiscussionThis study is one of the first to evaluate an Internet-based intervention for people with panic disorder that includes self-application of VR exposure therapy. The findings are expected to extend the body of knowledge about effective Internet-based treatment options for people with panic disorder. The empirical and clinical implications and the limitations of the study are discussed.Trial registrationDRKS00027585 (www.drks.de/drks_web/), date of registration: 13 January 2022.

Effectiveness of Immersive Virtual Reality in People with Cancer Undergoing Antiblastic Therapy: A Randomized Controlled Trial

ObjectivesThis study aims to assess the effects of immersive Virtual Reality in people with cancer undergoing antiblastic therapy, on anxiety, fatigue and pain. Data SourcesThis is a randomized controlled three-arm trial. Seventy-four cancer patients were recruited from a regional hospital in Italy, and randomly allocated into three groups: a Virtual Reality group (n=25), a narrative medicine group (n=25) and a standard care group (n=24). The primary outcome was anxiety. Secondary outcomes included fatigue and pain. The outcomes were evaluated immediately before and after the interventions. The findings showed that anxiety decreased more in the Virtual Reality group (Δpre-post = 6.24, 95% CI 2.578 to 9.902, p=.001, d = 0.63) than in the narrative medicine group, whereas it did not change for those in the standard care group. Fatigue decreased in the Virtual Reality group (Δpre-post = 0.576, 95% CI 0.246 to 0.907, p=.001, d = 0.23), while remaining stable in the narrative medicine group, and increasing in the standard care group. Average levels of pain did not change before and after the intervention [F(1,71) = 1.06, p=.307, ηp2 = .015]. ConclusionFindings show that virtual reality is effective to reduce anxiety and fatigue in people with cancer undergoing antiblastic therapy. Implications for Nursing PracticeVirtual Reality can be recommended as an complementary intervention to manage anxiety and fatigue in people with cancer during antiblastic therapy. Trial registrationClinicalTrials.gov NCT05629507.

The Potential of using Virtual Reality for People with Disabilities

Virtual Reality (VR) technologies have become a popular area of study in recent years. These technologies were found to be effective in various useful applications to support People with Disabilities (PWD). The present article explores the current trends addressing the role and applications of VR in supporting individuals with disabilities. It presents the advantages of VR, and how they can be used as assistive technologies to minimize the effects of disabilities and increase the independency of PWD. It also explores a range of successful VR applications for PWD and an example of an assistive VR application in Mada center to support people with disabilities.

Effectiveness of Virtual Reality on Balance and Risk of Falls in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis.

The aim of this study was to systematically review the scientific evidence related to the physiotherapy interventions in neurorehabilitation that utilize virtual reality (VR) for balance training and risk of falls in people with multiple sclerosis (MS). A search was conducted in Medline (PubMed), PEDro, and Google Scholar to identify all the relevant studies. Clinical trials assessing the effects of VR in people with MS were included. Risk of bias was evaluated using the Cochrane Risk of Bias Tool and PEDro scale. Qualitative analysis was performed according to the GRADE. In total, 16 studies (n = 663) were included. The meta-analysis showed statistically significant differences for the VR intervention in comparison with conventional treatment for balance, with a moderate clinical effect in eight studies (SMD: 0.63; 95% CI 0.34-0.92; p < 0.05). In addition, the meta-analysis showed statistically significant differences for the VR intervention in comparison with conventional treatment for risk of falls, with a small clinical effect in six studies (SMD: -0.55; 95% CI -1.07-0.04; p < 0.05). VR-based treatments are more effective than non-intervention in improving balance and fall risk in people with MS, with a very low certainty of evidence. In addition, they also show to be more effective than conventional rehabilitation, with a very low certainty of evidence.

An integrated intervention of computerized cognitive training and physical exercise in virtual reality for people with Alzheimer's disease: The jDome study protocol.

IntroductionAlzheimer's disease is a neurodegenerative syndrome characterized by cognitive deficits, loss of daily functions, and mental and behavioral disorders, which cause stress and negatively affect the quality of life. Studies in the field suggest that combining cognitive training with physical activity can reduce the risk of developing the disease and, once neurodegeneration has begun, it slows its progress. In particular, virtual reality and augmented reality administer cognitive stimulation while providing a link to autobiographical memory through reminiscence, enabling the improvement of the person's quality of life. The present protocol aims to evaluate the effectiveness of cognitive and physical treatments, integrated with the addition of virtual reality and reminiscence elements, using the Brainer software, in which people will find cognitive training, and the jDome® BikeAround™ system, which will allow participants to pedal along a personalized path projected on a schematic, using an exercise bike connected to the system.Methods and analysisFor this study, 78 patients with mild Alzheimer's dementia were recruited and divided into the Experimental Group (EG) and Control Group (CG). Sixteen treatment sessions of 60 min each were conducted for both groups (2 training sessions per week, for 8 weeks), including 1 patient at a time. The EG received cognitive treatment with Brainer and physical training with jDome, while the CG received cognitive treatment with Brainer and physical training with a classic bicycle. The evaluation mainly focused on the assessment of the person's cognitive status. Other analyses were conducted on the quality of life, mood, behavioral disorders, and physical function, which were considered secondary outcomes.DiscussionsThe ultimate goal of the present study is to test the effectiveness of a treatment for people with mild Alzheimer's focused on the integration of cognitive training and aerobic physical activity, using an exercise bike, with the addition of virtual reality and reminiscence elements.Ethics and disseminationThe study was approved by the Ethics Committee of the IRCCS INRCA. It was recorded in ClinicalTrials.gov on 2 June 2022 with the number NCT05402423. The study findings will be used for publication in peer-reviewed scientific journals and presentations in scientific meetings.

Using Virtual Reality to Improve Classroom Behavior in People With Down Syndrome: Within-Subjects Experimental Design.

BackgroundPeople with Down syndrome face various learning challenges. Introducing new and enjoyable experiences in learning settings may improve learning outcomes. Immersive and interactive technologies such as virtual reality can be used to deliver rich visual experiences in classrooms.ObjectiveThe aim of this study was to investigate the feasibility and benefits of virtual reality exposure for people with Down syndrome in learning settings.MethodsTo address this aim, we used a within-subjects design to assess the effect of a brief virtual reality drawing experience and conventional drawing experience on subsequent behavior in 16 participants.ResultsLarge positive effects were found for virtual reality drawing (t15=5.020, P<.001) and conventional drawing (t15=3.720, P=.002) in improving subsequent behavior in a learning setting. Irrespective of the intervention, the participant’s mood, attention, and overall behavior significantly improved. No significant differences were found between the interventions (t15=–0.648; P=.53).ConclusionsThis study’s results are encouraging for researchers and educators interested in using virtual reality for people with Down syndrome, as virtual reality was found to be highly feasible. Recommendations are made for researchers and educators interested in providing virtual reality experiences for people with Down syndrome.

An Exploratory EEG Analysis on the Effects of Virtual Reality in People with Neuropathic Pain Following Spinal Cord Injury.

Neuropathic pain in people with spinal cord injury is thought to be due to altered central neuronal activity. A novel therapeutic intervention using virtual reality (VR) head-mounted devices was investigated in this study for pain relief. Given the potential links to neuronal activity, the aim of the current study was to determine whether use of VR was associated with corresponding changes in electroencephalography (EEG) patterns linked to the presence of neuropathic pain. Using a within-subject, randomised cross-over pilot trial, we compared EEG activity for three conditions: no task eyes open state, 2D screen task and 3D VR task. We found an increase in delta activity in frontal regions for 3D VR with a decrease in theta activity. There was also a consistent decrease in relative alpha band (8–12 Hz) and an increase in low gamma (30–45 Hz) power during 2D screen and 3D VR corresponding, with reduced self-reported pain. Using the nonlinear and non-oscillatory method of extracting fractal dimensions, we found increases in brain complexity during 2D screen and 3D VR. We successfully classified the 3D VR condition from 2D screen and eyes opened no task conditions with an overall accuracy of 80.3%. The findings in this study have implications for using VR applications as a therapeutic intervention for neuropathic pain in people with spinal cord injury.

A lower limb rehabilitation platform with mirror therapy, electrical stimulation and virtual reality for people with limited dorsiflexion movement

This paper presents a low-cost portable system for applying a rehabilitation therapy, based on virtual reality, functional electrical stimulation and a training device. This open-hardware system, intended to support a home-made therapy process in people with reduced dorsiflexion ability, contains three main building blocks: an electromechanical platform, an immersive virtual reality interface and the firmware. The electromechanical training platform is the core of the system, which acts as a gateway interface of sensors-actuators for a closed loop system, through an immersive virtual reality application, the patient closes the loop by acting as the controller by means of a “virtual dummy” preforming in mirror configuration.The platform measures and process the dorsiflexion angle described by both ankles, real-time transmitting the information to the mobile phone virtual application to be presented as a mirror. The onboard microprocessor drives the operation of the electric stimulation interface, which is sent through two channels to both, healthy and affected lower limbs. The platform communicates continuously through a USB bidirectional interface with a personal computer, in which the physician enters the rehabilitation protocol and follows the patient performance. A first case study by using this device has been reported in [1].

Developing a virtual reality for people with dementia in nursing homes based on their psychological needs: a feasibility study

BackgroundThe purpose of this study was (1) to develop a virtual reality (VR) intervention program based on the psychological needs of patients residing in nursing facilities in South Korea to alleviate their behavioral and psychological symptoms and (2) to confirm the possibility of utilizing VR in patients with dementia.MethodsIn the first phase, patients with dementia residing in nursing homes and experiencing behavioral and psychological symptoms were recruited. Surveys and questionnaires were used to identify activities that alleviated the behavioral and psychological symptoms of dementia (BPSD) among the patients. These activities were classified into five types of psychological needs. In the second phase, a fully immersive, interactive, easy-to-use VR platform was developed that reflected these psychological needs. Patients with dementia experienced the VR content. The researchers assessed the level of the participants’ immersion, preference, and interaction with the VR using a 5-point Likert scale.ResultsIn the feasibility test, 10 nursing home residents were recruited. The mean immersion score was 4.93 ± 0.16 points, the mean preference score was 4.35 ± 0.41 points, and the mean interaction score was 3.84 ± 0.43 points using a 5-point Likert scale. Higher mean scores indicated a more positive outcome. Six of the 10 participants required assistance while using the VR. The mean VR experience duration was 10.00 ± 3.46 min.ConclusionsThe VR-based intervention program that was developed to reduce BPSD was feasible for the participants and provided them with a high degree of satisfaction and immersion. Furthermore, this study also confirmed the convenience and safety of the program. These findings support the potential use of VR-based BPSD intervention programs to treat patients with dementia.

Exploring the Relationship Between Sleep Quality, Sleep-Related Biomarkers, and Motor Skill Acquisition Using Virtual Reality in People With Parkinson's Disease: A Pilot Study.

Background and Objectives: Despite the fact that sleep disturbances are among the most common and disabling manifestations of Parkinson's disease (PD), no study has investigated the effect of sleep quality and sleep-related biomarkers on motor skill acquisition in people with Parkinson's disease (PwPD).Objective: To examine the relationship between skill acquisition, sleep quality, and sleep-related biomarkers in PwPD using virtual reality (VR) system.Methods: This is a cross sectional study conducted on 31 PwPD and 31 healthy controls. To assess skill acquisition, each participant practiced a VR game 6 times (blocks). The main outcomes from the VR game were the required time to complete the VR game and the recorded errors. Motor skill acquisition was calculated as the difference of scores between block 6 and block 2 for both outcomes. Sleep was assessed subjectively using Pittsburgh Sleep Quality Index (PSQI) and objectively using the Actisleep. To assess sleep related biomarker, plasma serotonin level was examined.Results: PwPD and healthy controls demonstrated a practice-related improvement in performance as shown by the main effect of block for each of the VR outcome measures (p < 0.000, time required to complete VR game; p < 0.000, recorded errors). There was no interaction effect between Block X Group for both outcome measures. There were significant correlations in both groups (p < 0.05) between motor skill acquisition (as indicated by the difference of time required to complete the VR game between block 6 and block 2) and PSQI total score, wake after sleep onset, and sleep efficiency. Additionally, a significant correlation was observed in both groups between motor skill acquisition (as indicated by the difference of time required to complete the VR game between block 6 and block 2) and the plasma serotonin level (p < 0.05). These correlations in PwPD remained significant, even after adjusting for disease motor severity, cognitive status, depression, and daily dose of L-dopa.Discussion and Conclusions: Sleep quality may influence motor skill acquisition in PwPD. Healthcare professionals are encouraged to be aware about sleep quality and sleep assessment tools. Therapies may target improving sleep quality which could result in improving motor skill acquisition.

Effect of Combined Therapy of Virtual Reality and Transcranial Direct Current Stimulation in Children and Adolescents With Cerebral Palsy: A Study Protocol for a Triple-Blinded Randomized Controlled Crossover Trial.

Background: Transcranial direct current stimulation (tDCS) and therapy-based virtual reality (VR) have been investigated separately. They have shown promise as efficient and engaging new tools in the neurological rehabilitation of individuals with cerebral palsy (CP). However, the recent literature encourages investigation of the combination of therapy tools in order to potentiate clinic effects and its mechanisms.Methods: A triple-blinded randomised sham-controlled crossover trial will be performed. Thirty-six individuals with gross motor function of levels I to IV (aged 4–14 years old) will be recruited. Individuals will be randomly assigned to Group A (active first) or S (sham first): Group A will start with ten sessions of active tDSC combined with VR tasks. After a 1-month washout, this group will be reallocated to another ten sessions with sham tDCS combined with VR tasks. In contrast, Group S will carry out the opposite protocol, starting with sham tDCS. For the active tDCS the protocol will use low frequency tDCS [intensity of 1 milliampere (mA)] over the primary cortex (M1) area on the dominant side of the brain. Clinical evaluations (reaction times and coincident timing through VR, functional scales: Abilhand-Kids, ACTIVLIM-CP, Paediatric Evaluation of Disability Inventory-PEDI- and heart rate variability-HRV) will be performed at baseline, during, and after active and sham tDCS.Conclusion: tDCS has produced positive results in treating individuals with CP; thus, its combination with new technologies shows promise as a potential mechanism for improving neurological functioning. The results of this study may provide new insights into motor rehabilitation, thereby contributing to the better use of combined tDCS and VR in people with CP.Trial Registration: ClinicalTrials.gov, NCT04044677. Registered on 05 August 2019.

Application of virtual reality in people with ASD from 1996 to 2019

PurposeDiversity is one of the main characteristics of modern societies. To be teachers and trainers, it is necessary to use all the tools to respond to students with diversified needs. Therefore, the main aim of this study is to review the scientific production in Web of Science (WOS) and SCOPUS of 1996-2019 on the application of Virtual reality in people with Autism Spectrum Disoders (ASD) for the improvement of social skills.Design/methodology/approachFor this purpose, two databases have been used: The Web of Science (WOS) and SCOPUS from the advanced search tab. After applying the search terms, 267 documents were obtained which were analysed according to a series of indicators.FindingsThe results indicate that the period 2016-2019 was the most productive and that SCOPUS has a focus on conferences and WOS is intended for journals. Furthermore, in SCOPUS, there are journals with higher quartiles (Q1) than in WOS. The study shows the great importance of virtual reality in people with ASD and its recent dissemination.Originality/valueCurrently, to the best of the authors’ knowledge, there are no studies on the use of virtual reality in people with ASD using bibliometric indicators. The study allows us to know which databases publish higher quality research. Likewise, information can be obtained about the most productive centres and the most important authors on the subject.

Motor Skill Acquisition Through Virtual Reality in People with Multiple Sclerosis: The Impact of Cognitive Function and Related Biomarkers

Neurorehabilitation that involves learning new motor skills is considered one of the promising clinical methods for motor recovery in individuals with multiple sclerosis (MS). Strategies that aim at optimizing motor skills rehabilitation in MS individuals become critical. Therefore, factors that influence motor skill acquisition in people with MS need to be investigated. Despite the fact that cognitive disturbances are among the most common and disabling manifestation of MS few studies have investigated the effect of cognitive function and related biomarkers on motor skill acquisition in people with MS.

Visuospatial Orientation Learning through Virtual Reality for People with Severe Disability

This study aims to test how an intervention based on virtual reality (VR) may enhance visuospatial skills amongst people with disability. A quasi-experimental intra-group study was therefore conducted. Participants were 20 people with severe disability (65% males; 34.35 years, on average, and 84.95% of disability rate according to the Andalusian Government index). Intervention consisted of 15 sessions of active navigation using a VR building similar to the participants’ day rehabilitation centre with the task of locating different rooms and objects. The time spent and errors in route in the virtual and the real environments were measured before and after the intervention. Additionally, participants had to fill out a map location task. As a result, participants showed fewer errors and less time at post-intervention assessments even with non-trained stimuli (p < .05). These results demonstrate the usefulness of VR-based interventions with active navigation to accelerate orientation learning in real-life situations.

The use of virtual reality for people with balance and vestibular disorders: the Pittsburgh experience

Objective: The purpose of this paper is to describe our experiments with virtual reality in the treatment of people with vestibular disorders. We will share insights about virtual reality use in people with complaints of dizziness and balance loss.Methods: Two experiments measured simulator sickness and discomfort in people with and without dizziness when viewing simulations that manipulated optic flow or required navigation and object recognition. A third experiment tested transfer of virtual environment training to self-report and balance performance measures for a group of individuals with vestibular hypofunction.Results: People with vestibular disease had greater symptoms in optic flow and virtual environments, but not greater than that which is experienced in conventional vestibular rehabilitation. Overall, patients improved on both self-perception and objective measures of balance and postural control.Discussion: Our next goal is to determine if virtual reality intervention is superior to results attained from the physical therapy standard of care.

Abstract concept and imagination teaching through Virtual Reality in people with Autism Spectrum Disorders

Abstract concept and imagination teaching through Virtual Reality in people with Autism Spectrum Disorders