Chewing gum reduces visually induced motion sickness

Effects of dynamic visual feedback system on seasickness

Motion sickness (MS) poses challenges for individuals affected, hindering their activities and travel. This study investigates the effect of a visual dynamic device, forming an artificial horizon plane, on symptoms and physiological changes induced by MS. This device consists of vertical light-emitting diodes whose illumination varies according to the boat's movements. Fifteen subjects with moderate-to-severe MS susceptibility were exposed to a seasickness simulator with and without the device. Symptoms were assessed immediately after exposure. Time spent in the simulator, heart rate, and temperature were also recorded. Symptom intensity at the end of the experience did not differ, but the time spent in the simulator was significantly longer with the device (+46%). Variations in heart rate were also observed. The device delays symptom onset and can be used as a tool against MS. Further research is needed to evaluate its effects, for example, during more prolonged exposure to MS-inducing stimuli.

Effects of Virtual Reality on Analgesia in Wound Care and Physical Therapy for Burn Patients: A Systematic Review and Meta-analysis

OBJECTIVES

This systematic review and meta-analysis aimed to determine the effectiveness of virtual reality (VR) in alleviating pain and improving the experience of burn patients during wound care and physical therapy.

DESIGN

A systematic review and meta-analysis.

DATA SOURCES

PubMed, Embase, the Cochrane Database, and the Web of Science.

REVIEW/ANALYSIS METHODS

We searched four electronic databases for randomized controlled trials (RCTs) published from the earliest available date up to March 1, 2022. The primary outcome was worst pain intensity, while secondary outcomes encompassed pain unpleasantness intensity, time spent thinking about pain, and fun experience intensity. Risk of bias was evaluated using the Cochrane Collaboration's tool.

RESULTS

This study included 21 trials. The combined data revealed that the VR group experienced a significant reduction in worst pain intensity, pain unpleasantness intensity, and time spent thinking about pain compared to the control group. Moreover, VR treatment was associated with a significant increase in the fun experience intensity.

IMPLICATIONS FOR NURSING

Virtual reality has the potential value of auxiliary analgesia in burn care, and exploring a more perfect scheme of VR-assisted analgesia is worthwhile.

CONCLUSIONS

The results of this meta-analysis indicate that VR can effectively reduce worst pain intensity, pain unpleasantness intensity, and time spent thinking about pain during wound care and physical therapy for burn patients. Additionally, it enhances fun experience intensity of the treatment period. Therefore, VR shows promise as a valuable complementary pain management intervention for burn patients.

Immersive virtual reality in orthopedic surgery as elective subject for medical students : First experiences in curricular teaching

BACKGROUND

Virtual reality (VR) simulators have been introduced for skills training in various medical disciplines to create an approximately realistic environment without the risk of patient harm and have improved to more immersive VR (iVR) simulators at affordable costs. There is evidence that training on VR simulators improves technical skills but its use in orthopedic training programs and especially in curricular teaching sessions for medical students are currently not well established. The aim of this study was to describe the implementation of a VR operating theater as an elective course for undergraduate medical students and to evaluate its effect on student learning.

METHODS

An elective course for 12 students was implemented during the summer semester of 2023. Using Oculus Quest 2 headsets (Reality Labs, Meta Platforms, USA) and controllers and the PrecisionOS platform, they were able to train five different surgical procedures. The courses were accompanied by weekly topic discussions and instructional videos. Students were assigned to two groups: group VR vs. group non-VR. The groups were switched after 5 weeks. User feedback and performance development (theoretical and procedural surgical knowledge) after VR training were assessed using three questionnaires.

RESULTS

The students highly appreciated the implementation of VR training into their curriculum and 91% stated that they would opt for further VR training. All students stated that VR training improved their understanding of surgical procedures and that it should be obligatory in surgical training for undergraduate medical students. After 5 weeks of training, students in the VR group achieved significantly better results (100 out of maximum 180 points) than the non-VR group (70 points, p = 0.0495) in procedural surgical knowledge. After completion of the VR training the VR group achieved 106 points and the non-VR group 104 points (p = 0.8564). The procedural knowledge for non-VR group after 5 weeks significantly improved after VR training from 70 to 106 points (p = 0.0087).

CONCLUSION

The iVR can be easily integrated into the curriculum of medical students and is highly appreciated by the participants. The iVR statistically improves the procedural knowledge of surgical steps compared to conventional teaching methods. Further implementation of iVR training in curricular teaching of medical students should be considered.

CyPVICS: A framework to prevent or minimise cybersickness in immersive virtual clinical simulation

Cybersickness is a global issue affecting users of immersive virtual reality. However, there is no agreement on the exact cause of cybersickness. Taking into consideration how it can differ greatly from one person to another, it makes it even more difficult to determine the exact cause or find a solution. Because cybersickness excludes so many prospective users, including healthcare professionals, from using immersive virtual reality as a learning tool, this research sought to find solutions in existing literature and construct a framework that can be used to prevent or minimise cybersickness during immersive virtual clinical simulation (CyPVICS). The Bestfit Framework by Carrol and authors were used to construct the CyPVICS framework. The process started by conducting two separate literature searchers using the BeHEMoTh (for models, theories, and frameworks) and SPIDER (for primary research articles) search techniques. Once the literature searches were completed the models, theories and framework were used to construct a priori framework. The models' theories and frameworks were analysed to determine aspects relevant to causes, reducing, eliminating, and detecting cybersickness. The priori framework was expanded by, first coding the findings of the primary research study into the existing aspects of the priori framework. Once coded the aspects that could not be coded were added in the relevant category, for example causes. After reviewing 1567 abstracts and titles as part of the BeHEMoTh search string,19 full text articles, a total of 15 papers containing models, theories, and frameworks, were used to construct the initial CyPVICS framework. Once the initial CyPVICS was created, a total 904 primary research studies (SPIDER) were evaluated, based on their titles and abstracts, of which 100 were reviewed in full text. In total, 67 articles were accepted and coded to expand the initial CyPVICS framework. This paper presents the CyPVICS framework for use, not only in health professions' education, but also in other disciplines, since the incorporated models, theories, frameworks, and primary research studies were not specific to virtual clinical simulation.

Using Virtual Reality in a Rehabilitation Program for Patients With Breast Cancer: Phenomenological Study

Background

Surgery is an essential treatment for early-stage breast cancer. However, various side effects of breast cancer surgery, such as arm dysfunction and lymphedema, remain causes for concern. Rehabilitation exercises to prevent such side effects should be initiated within 24 hours after surgery. Virtual reality (VR) can assist the process of rehabilitation; however, the feasibility of applying VR for rehabilitation must be explored, in addition to experiences of this application.

Objective

This study explored patients' attitudes toward and experiences of using VR for their rehabilitation to determine the feasibility of such VR use and to identify potential barriers.

Methods

A phenomenological qualitative study was conducted from September to December 2021. A total of 18 patients with breast cancer who had undergone surgical treatment were interviewed using open-ended questions. The Colaizzi 7-step procedure for phenomenological analysis was used for data analysis. To ensure high study reliability, this study followed previously reported quality criteria for trustworthiness.

Results

Three themes were identified: (1) VR was powerful in facilitating rehabilitation, (2) early and repetitive upper limb movements were an advantage of VR rehabilitation, and (3) extensive VR use had challenges to be overcome. Most of the interviewed patients reported positive experiences of using VR for rehabilitation. Specifically, VR helped these patients identify appropriate motion and angle limits while exercising; in other words, knowledge gained through VR can play a key role in the rehabilitation process. In addition, the patients reported that the use of VR provided them company, similar to when a physiotherapist is present. Finally, the gamified nature of the VR system seemed to make VR-based rehabilitation more engaging than traditional rehabilitation, particularly with respect to early rehabilitation; however, the high cost of VR equipment made VR-based rehabilitation difficult to implement at home.

Conclusions

The interviewed patients with breast cancer had positive experiences in using VR for rehabilitation. The high cost of both VR equipment and software development presents a challenge for applying VR-based rehabilitation.

Virtual reality techniques for trauma education

In this article we discuss the evolution of computers and the use of VR for trauma education. We reflect on available literature and share the lessons we learned. VR allows you to share your most interesting and rare patient cases with a bedside teaching experience. Since there are more and different possibilities with VR we recommend a new design of teaching. In our experience, creativity is needed to deviate from the conventional educational paths. Remember that VR technique alone cannot compensate for bad content. When designing your VR script, do not underestimate the digital insight of the new generations. To increase the learning curve, use interactive menus in VR environment with a restrained script. After the design of the educational content, recording with VR cameras is relatively easy, while editing is more complex. A choice between monoscopic versus stereoscopic viewing and a 180° or 360° field of view has to made, based on learning objectives. With the use of a questionnaire, we evaluated the learning and side effects of VR education in our students. We learned that nausea and uncomfortable feeling can be a negative side effect of VR education. 23% Of our students reported some form of cybersickness during the VR sessions. To reduce cybersickness we advise to use most modern VR devices to prevent lagging. Literature suggests that cybersickness can be reduced by chewing gum and by setting a correct interpupillary distance of the goggle. To reduce motion sickness acceleration and deceleration in the VR environment should be minimized. Based on our experience we advise to limit VR educational sessions to a maximum of one hour. Although the VR techniques currently have some limitations, the quality and possibilities of this technique are rapidly improving. VR education will certainly be a part of trauma education in the future; Be prepared!

Emotions are associated with the genesis of visually induced motion sickness in virtual reality

Visually induced motion sickness (VIMS) is a well-known side effect of virtual reality (VR) immersion, with symptoms including nausea, disorientation, and oculomotor discomfort. Previous studies have shown that pleasant music, odor, and taste can mitigate VIMS symptomatology, but the mechanism by which this occurs remains unclear. We predicted that positive emotions influence the VIMS-reducing effects. To investigate this, we conducted an experimental study with 68 subjects divided into two groups. The groups were exposed to either positive or neutral emotions before and during the VIMS-provoking stimulus. Otherwise, they performed exactly the same task of estimating the time-to-contact while confronted with a VIMS-provoking moving starfield stimulation. Emotions were induced by means of pre-tested videos and with International Affective Picture System (IAPS) images embedded in the starfield simulation. We monitored emotion induction before, during, and after the simulation, using the Self-Assessment Manikin (SAM) valence and arousal scales. VIMS was assessed before and after exposure using the Simulator Sickness Questionnaire (SSQ) and during simulation using the Fast Motion Sickness Scale (FMS) and FMS-D for dizziness symptoms. VIMS symptomatology did not differ between groups, but valence and arousal were correlated with perceived VIMS symptoms. For instance, reported positive valence prior to VR exposure was found to be related to milder VIMS symptoms and, conversely, experienced symptoms during simulation were negatively related to subjects’ valence. This study sheds light on the complex and potentially bidirectional relationship of VIMS and emotions and provides starting points for further research on the use of positive emotions to prevent VIMS.