Focusing on cybersickness: pervasiveness, latent trajectories, susceptibility, and effects on the virtual reality experience

Factors Associated With Continuous Use of a Cancer Education Metaverse Platform: Mixed Methods Study

BACKGROUND

Early detection of cancer and provision of appropriate treatment can increase the cancer cure rate and reduce cancer-related deaths. Early detection requires improving the cancer screening quality of each medical institution and enhancing the capabilities of health professionals through tailored education in each field. However, during the COVID-19 pandemic, regional disparities in educational infrastructure emerged, and educational accessibility was restricted. The demand for remote cancer education services to address these issues has increased, and in this study, we considered medical metaverses as a potential means of meeting these needs. In 2022, we used Metaverse Educational Center, developed for the virtual training of health professionals, to train radiologic technologists remotely in mammography positioning.

OBJECTIVE

This study aims to investigate the user experience of the Metaverse Educational Center subplatform and the factors associated with the intention for continuous use by focusing on cases of using the subplatform in a remote mammography positioning training project.

METHODS

We conducted a multicenter, cross-sectional survey between July and December 2022. We performed a descriptive analysis to examine the Metaverse Educational Center user experience and a logistic regression analysis to clarify factors closely related to the intention to use the subplatform continuously. In addition, a supplementary open-ended question was used to obtain feedback from users to improve Metaverse Educational Center.

RESULTS

Responses from 192 Korean participants (male participants: n=16, 8.3%; female participants: n=176, 91.7%) were analyzed. Most participants were satisfied with Metaverse Educational Center (178/192, 92.7%) and wanted to continue using the subplatform in the future (157/192, 81.8%). Less than half of the participants (85/192, 44.3%) had no difficulty in wearing the device. Logistic regression analysis results showed that intention for continuous use was associated with satisfaction (adjusted odds ratio 3.542, 95% CI 1.037-12.097; P=.04), immersion (adjusted odds ratio 2.803, 95% CI 1.201-6.539; P=.02), and no difficulty in wearing the device (adjusted odds ratio 2.020, 95% CI 1.004-4.062; P=.049). However, intention for continuous use was not associated with interest (adjusted odds ratio 0.736, 95% CI 0.303-1.789; P=.50) or perceived ease of use (adjusted odds ratio 1.284, 95% CI 0.614-2.685; P=.51). According to the qualitative feedback, Metaverse Educational Center was useful in cancer education, but the experience of wearing the device and the types and qualities of the content still need to be improved.

CONCLUSIONS

Our results demonstrate the positive user experience of Metaverse Educational Center by focusing on cases of using the subplatform in a remote mammography positioning training project. Our results also suggest that improving users' satisfaction and immersion and ensuring the lack of difficulty in wearing the device may enhance their intention for continuous use of the subplatform.

The Effects of Secondary Task Demands on Cybersickness in Active Exploration Virtual Reality Experiences

Active exploration in virtual reality (VR) involves users navigating immersive virtual environments, going from one place to another. While navigating, users often engage in secondary tasks that require attentional resources, as in the case of distracted driving. Inspired by research generally studying the effects of task demands on cybersickness (CS), we investigated how the attentional demands specifically associated with secondary tasks performed during exploration affect CS. Downstream of this, we studied how increased attentional demands from secondary tasks affect spatial memory and navigational performance. We discuss the results of a multi-factorial between-subjects study, manipulating a secondary task's demand across two levels and studying its effects on CS in two different sickness-inducing levels of an exploration experience. The secondary task's demand was manipulated by parametrically varying $n$ in an aural $n$-back working memory task and the provocativeness of the experience was manipulated by varying how frequently users experienced a yaw-rotational reorientation effect during the exploration. Results revealed that increases in the secondary task's demand increased sickness levels, also resulting in a higher temporal onset rate, especially when the experience was not already highly sickening. Increased attentional demand from the secondary task also vitiated navigational performance and spatial memory. Overall, increased demands from secondary tasks performed during navigation produce deleterious effects on the VR experience.

Who says you are so sick? An investigation on individual susceptibility to cybersickness triggers using EEG, EGG and ECG

In this research paper, we conducted a study to investigate the connection between three objective measures: Electrocardio-gram(EGG), Electrogastrogram (EGG), and Electroencephalogram (EEG), and individuals' susceptibility to cybersickness. Our primary objective was to identify which of these factors plays a central role in causing discomfort when experiencing rotations along three different axes: Roll, Pitch, and Yaw. This study involved 35 participants who were tasked with destroying asteroids using their eye gaze while undergoing passive rotations in four separate sessions. The results, when combined with subjective measurements (specifically, Fast motion sickness questionnaire (FMS) and Simulator sickness questionnaire (SSQ) score), demonstrated that EGG measurements were superior in detecting symptoms associated with nausea. As for ECG measurements, our observations did reveal significant changes in Heart Rate Variability (HRV) parameters. However, we caution against relying solely on ECG as a dependable indicator for assessing the extent of cybersickness. Most notably, EEG signals emerged as a crucial resource for discerning individual differences related to these rotational axes. Our findings were significant not only in the context of periodic activities but also underscored the potential of aperiodic activities in detecting the severity of cybersickness and an individual's susceptibility to rotational triggers.

Analysis of cybersickness in virtual nursing simulation: a German longitudinal study

BACKGROUND

Innovative educational approaches such as simulation-based nursing education using virtual reality (VR) technologies provide new opportunities for nursing education. However, there is a lack of information on side effects, especially health-related side effects, of head-mounted displays (HMDs) on the human body when using VR devices for nursing simulation. This study aims to validate the German version of the Virtual Reality Sickness Questionnaire (VRSQ) and to evaluate its associations with sex and age, as reflected in the VRSQG scores (total score, oculomotor, and disorientation) over time.

METHODS

A longitudinal-sectional study was conducted. In addition to the VRSQG (pre-, post-, and 20 min post-intervention), participants (all nursing students) completed data on personal characteristics. Participants completed a VR simulation of a blood draw. Confirmatory factor analysis (CFA) was used to evaluate whether the measured construct was consistent with the original. In addition to the validity, internal consistency was analyzed and generalized linear models (GLMs) were used for data analysis.

RESULTS

A total of 38 nursing students (mean age 26.8 years; SD = 7.1, 79.0% female) participated. The mean time spent in the VR simulation was 21 min. All participants completed the entire simulation. The CFA indicates (CFI = 0.981, SRMR = 0.040) VRSQG structure is given. Internal consistency showed low values for the subdomain Oculomotor (Cronbach alpha 0.670). For Disorientation and the Total score values showed a sufficient internal consistency. GLMs showed significant between subject associations with age over time with VRSQG total score, oculomotor, and disorientation. Older nursing students start with higher VRSQG-Scores. Over time, an approximation occurs, so that all participants reach a similar level by the final measurement point. No associations were found between sex (male/female) and VRSQG scores.

CONCLUSIONS

The VRSQG is a reliable and valid self-assessment for measuring cybersickness in VR based nursing simulations, with cybersickness symptoms positively associated with age. However, in depth-evaluation regarding age-associations with cybersickness should be done. As well as studies to explore additional associations and emphasizes the importance of establishing cut-off values to assess the clinical relevance of the scores.

Influence of Normal Aging and Multisensory Data Fusion on Cybersickness and Postural Adaptation in Immersive Virtual Reality

Immersive Virtual Reality (VR) systems are expanding as sensorimotor readaptation tools for older adults. However, this purpose may be challenged by cybersickness occurrences possibly caused by sensory conflicts. This study aims to analyze the effects of aging and multisensory data fusion processes in the brain on cybersickness and the adaptation of postural responses when exposed to immersive VR.

METHODS

We repeatedly exposed 75 participants, aged 21 to 86, to immersive VR while recording the trajectory of their Center of Pressure (CoP). Participants rated their cybersickness after the first and fifth exposure.

RESULTS

The repeated exposures increased cybersickness and allowed for a decrease in postural responses from the second repetition, i.e., increased stability. We did not find any significant correlation between biological age and cybersickness scores. On the contrary, even if some postural responses are age-dependent, a significant postural adaptation occurred independently of age. The CoP trajectory length in the anteroposterior axis and mean velocity were the postural parameters the most affected by age and repetition.

CONCLUSIONS

This study suggests that cybersickness and postural adaptation to immersive VR are not age-dependent and that cybersickness is unrelated to a deficit in postural adaptation or age. Age does not seem to influence the properties of multisensory data fusion.

Train vs. Play: Evaluating the Effects of Gamified and Non-Gamified Wheelchair Skills Training Using Virtual Reality

This study compares the influence of a gamified and a non-gamified virtual reality (VR) environment on wheelchair skills training. In specific, the study explores the integration of gamification elements and their influence on wheelchair driving performance in VR-based training. Twenty-two non-disabled participants volunteered for the study, of whom eleven undertook the gamified VR training, and eleven engaged in the non-gamified VR training. To measure the efficacy of the VR-based wheelchair skills training, we captured the heart rate (HR), number of joystick movements, completion time, and number of collisions. In addition, an adapted version of the Wheelchair Skills Training Program Questionnaire (WSTP-Q), the Igroup Presence Questionnaire (IPQ), and the Simulator Sickness Questionnaire (SSQ) questionnaires were administered after the VR training. The results showed no differences in wheelchair driving performance, the level of involvement, or the ratings of presence between the two environments. In contrast, the perceived cybersickness was statistically higher for the group of participants who trained in the non-gamified VR environment. Remarkably, heightened cybersickness symptoms aligned with increased HR, suggesting physiological connections. As such, while direct gamification effects on the efficacy of VR-based wheelchair skills training were not statistically significant, its potential to amplify user engagement and reduce cybersickness is evident.

Acceptance and use of virtual reality games: an extension of HMSAM

Virtual reality (VR) is considered as one of the technological megatrends of 2020s, and today, VR systems are used in various settings, digital gaming being among the most popular ones. However, there has been a dearth of understanding regarding the central factors behind VR gaming acceptance and use. The present study therefore aimed to explain the factors that drive the use and acceptance of VR games. We extended the hedonic-motivation system acceptance model with utilitarian and inconvenience factors to capture the pertinent features of VR systems more holistically. We proposed a theoretical model and analyzed it through covariance-based structural equation modeling using an online survey sample of 473 VR gamers. Our findings help explain the role of different antecedents behind VR gaming acceptance and demonstrate that VR gaming is driven more by the hedonic gaming aspects than by the utilitarian health and well-being aspects of VR games, enjoyment being the strongest driver behind VR gaming intention and immersion. Moreover, findings also suggested that use intentions and immersion levels are not significantly diminished by physical discomfort and VR sickness. The findings, which potentially extend to other VR systems as well, also pose important implications for the providers of VR games. As the main contribution, based on our empirical findings, we provide a greater theoretical understanding on VR gaming acceptance and use.

Potential of the omnidirectional walking platform with virtual reality as a rehabilitation tool

Introduction

The combination of virtual reality (VR) with an omnidirectional walking platform (ODWP) may have potential in rehabilitation settings. However, its use, acceptance, safety, and effectiveness are unclear. This preliminary study aims to understand the feasibility, safety, and user experience (including investigating the onset of cybersickness) while walking on the ODWP with fully immersive VR.

Methods

Participants engaged with eight immersive VR walking scenarios. The scenarios were created using 360-degree videos and were programmed to run with the ODWP. Safety modifications for the ODWP were made, with the addition of parallel bars. Quantitative feedback on the perceived safety and acceptance of using VR with an ODWP for rehabilitation was collected. Cybersickness was evaluated using the Simulation Symptoms Questionnaire (SSQ).

Results

Thirty-five participants (n = 8 physiotherapists, n = 27 healthy adults) were recruited for this study. The mean perceived safety score was 78.9/100 and acceptance was 64.5/100. Seventy-one percent of participants experienced mild to moderate symptoms of cybersickness as reported on the SSQ. The SSQ scores were not correlated to participant age or simulation exposure time.

Conclusion

VR while using ODWP has the potential for rehabilitation, however, more consideration is needed to address acceptance and cybersickness.