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Leal-Vega L, Piñero DP, Molina-Martín A, Hernández-Rodríguez CJ, Cuadrado-Asensio R, Martín-Gutiérrez A, Arenillas Lara JF, Coco Martín MB. Pilot Study Assessing the Safety and Acceptance of a Novel Virtual Reality System to Improve Visual Function. Semin Ophthalmol 2024; 39:394-399. [PMID: 38426308 DOI: 10.1080/08820538.2024.2324074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/22/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE To assess the feasibility of the clinical use of a novel Virtual Reality (VR) training software designed to be used for active vision therapy in amblyopic patients by determining its preliminary safety and acceptance on the visual function of healthy adults. METHODS Pilot study enrolling 10 individuals (3 men, 7 women, mean age: 31.8 ± 6.5 years) with a best-corrected visual acuity (BCVA) of ≥ .90 (decimal) in both eyes were evaluated before and after 20 minutes of exposure to the NEIVATECH VR system using the HTC Vive Pro Eye head mounted display. Visual function assessment included near (40 cm) and distance (6 m) cover test (CT), stereopsis, binocular accommodative facility (BAF), near point of convergence (NPC), near point of accommodation (NPA), accommodative-convergence over accommodation (AC/A) ratio and positive and negative fusional vergences. Safety was assessed using the VR Sickness Questionnaire (VRSQ) and acceptance using the Technology Acceptance Model ;(TAM). Changes in all these variables after VR exposure were analyzed. RESULTS Short-term exposure to the NEIVATECH VR system only induced statistically significant changes in distance phoria (p = .016), but these changes were not clinically relevant. No significant changes were observed in VRSQ oculo-motricity and disorientation scores after exposure (p = .197 and .317, respectively). TAM scores showed a good acceptance of the system in terms of perceived enjoyment and perceived ease of use, although some concerns were raised in relation to the intention-to-use domain. CONCLUSION Exposure to the NEIVATECH VR system does not seem to adversely affect the visual function in healthy adults and its safety and acceptance profile seems to be adequate for supporting its potential use in other populations, such as amblyopic patients.
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Affiliation(s)
- Luis Leal-Vega
- Group of Applied Clinical Neurosciences, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Valladolid, Spain
| | - David P Piñero
- Group of Applied Clinical Neurosciences, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Valladolid, Spain
- Clinical Optometry Unit, Department of Ophthalmology, Hospital Vithas Medimar International, Alicante, Spain
| | - Ainhoa Molina-Martín
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Carlos J Hernández-Rodríguez
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Clinical Optometry Unit. Department of Ophthalmology, Centro Médico Virgen de la Caridad Hospital, Cartagena, España
| | | | - Adrián Martín-Gutiérrez
- Group of Applied Clinical Neurosciences, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Valladolid, Spain
| | - Juan Francisco Arenillas Lara
- Group of Applied Clinical Neurosciences, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Valladolid, Spain
- Stroke Unit & Stroke Program, Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - María Begoña Coco Martín
- Group of Applied Clinical Neurosciences, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Valladolid, Spain
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Gómez-Patiño A, Piñero DP, Molina-Martín A. Impact of Immersive Virtual Reality on the Binocular and Accommodative Function: A Systematic Review About Literature and Its Current Limitations. Semin Ophthalmol 2024:1-11. [PMID: 38900011 DOI: 10.1080/08820538.2024.2368013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 06/06/2024] [Indexed: 06/21/2024]
Abstract
The use of virtual reality (VR) is expected to increase exponentially in next years, and it is important to study whether VR can generate oculomotor, accommodative and binocular alterations in future users. Visual symptoms after the immersion inside VR have been widely reported, specifically in the case of simulator sickness, but the causes are still in study. Some authors have reported changes on accommodative and binocular parameters, but differences between studies made conclusions difficult. PURPOSE The aim of this study is to analyze the scientific literature about the effect of VR on the accommodative and binocular function of healthy subjects with both normal visual conditions and binocular anomalies assessing the quality of the existing studies to detect possible limitations and improve future study designs. METHODS A search was performed in PubMed, Web of Science and Scopus databases with the search equation (Virtual reality OR head-mounted displays) AND (accommodation OR accommodative) AND (vergence* OR convergence OR divergence OR binocular vision). A limitation was made in terms of the date of publication from 2010 onwards, identifying a total of 198 publications. Finally, 15 publications were included in the quality analysis. After a comprehensive analysis of the publications, a quality assessment was performed using a Quality Appraisal Checklist. RESULTS Research on effects of immersive VR on accommodative and binocular function to this date was focused on quasi-experimental pre-post studies well written and with results supporting their conclusions. Unfortunately, this scientific evidence provides heterogeneous outcomes, being the results in some cases even contradictory. CONCLUSIONS Information about the devices, its interpupillary distance adjustment, the software characteristics and type of task performed by users should be better controlled in future studies. Additionally, participants accommodative and binocular baseline characteristics should be better analyzed to obtain firm conclusions about the consequences of the proper immersive VR experience on visual function.
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Affiliation(s)
- Andrea Gómez-Patiño
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - David P Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
| | - Ainhoa Molina-Martín
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
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Bexson C, Oldham G, Wray J. Safety of virtual reality use in children: a systematic review. Eur J Pediatr 2024; 183:2071-2090. [PMID: 38466416 DOI: 10.1007/s00431-024-05488-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/25/2024] [Accepted: 02/17/2024] [Indexed: 03/13/2024]
Abstract
The study aimed to systematically review available literature regarding the safety of virtual reality (VR) use via head-mounted display in children under 14 years of age. The study was a systematic review including all study designs. A search was conducted in January 2023 in PubMed and EMBASE using key terms referring to 'virtual reality', 'paediatrics' and 'safety'. Following title and abstract and full-text screening, data were extracted and a narrative synthesis undertaken. Twenty-six studies met criteria for inclusion in the final review. Limited data suggest that VR may cause mild cybersickness symptoms (not severe enough to cause participants to discontinue use of VR) and that for children with existing amblyopia using VR may result in double vision, which resolves on cessation of VR exposure. Two randomised control trials did not report differences in adverse events between the intervention (VR use) and control groups. Reporting of safety data was poor; only two studies used a validated measure, and in the remaining studies, it was often unclear how adverse events were defined (if at all), how they were categorised in terms of severity and how they were recorded. Conclusion: There is limited evidence regarding any potential harms from short exposure to VR in children under 14 years under supervision. Additional research is required to understand increases in cybersickness during and after VR exposure, and the impact of repeated exposure. Adverse events need to be accurately and routinely recorded to determine any hitherto unknown safety concerns for children < 14 years using VR. What is Known: • Virtual reality (VR) is increasingly being applied in paediatrics, with benefits in terms of anxiety reduction, improved pain management associated with procedures, as an adjunct to physiotherapy and supporting treatments in autistic spectrum disorder.. • Safety guidance in relation to VR use, particularly in younger children, is limited. What is New: • A systematic review of available literature regarding the safety of VR use via head-mounted display in children under 14 years of age demonstrated limited evidence regarding any potential harms from short exposure to VR.. • Studies rarely report safety data and adverse side effects are poorly defined, measured and/or reported. • The lack of a validated measure for evaluating VR-associated symptoms in children compounds the challenging ethical issues of undertaking research into the effects of VR on younger children.
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Affiliation(s)
- Charlotte Bexson
- Data Research, Innovation and Virtual Environments, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Geralyn Oldham
- Data Research, Innovation and Virtual Environments, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Jo Wray
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK.
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Wen E, Gupta C, Sasikumar P, Billinghurst M, Wilmott J, Skow E, Dey A, Nanayakkara S. VR.net: A Real-world Dataset for Virtual Reality Motion Sickness Research. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2024; 30:2330-2336. [PMID: 38437109 DOI: 10.1109/tvcg.2024.3372044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
Researchers have used machine learning approaches to identify motion sickness in VR experience. These approaches would certainly benefit from an accurately labeled, real-world, diverse dataset that enables the development of generalizable ML models. We introduce 'VR.net', a dataset comprising 165-hour gameplay videos from 100 real-world games spanning ten diverse genres, evaluated by 500 participants. VR.net accurately assigns 24 motion sickness-related labels for each video frame, such as camera/object movement, depth of field, and motion flow. Building such a dataset is challenging since manual labeling would require an infeasible amount of time. Instead, we implement a tool to automatically and precisely extract ground truth data from 3D engines' rendering pipelines without accessing VR games' source code. We illustrate the utility of VR.net through several applications, such as risk factor detection and sickness level prediction. We believe that the scale, accuracy, and diversity of VR.net can offer unparalleled opportunities for VR motion sickness research and beyond.We also provide access to our data collection tool, enabling researchers to contribute to the expansion of VR.net.
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Rhiel S, Kläy A, Keller U, van Hedel HJA, Ammann-Reiffer C. Comparing Walking-Related Everyday Life Tasks of Children with Gait Disorders in a Virtual Reality Setup With a Physical Setup: Cross-Sectional Noninferiority Study. JMIR Serious Games 2024; 12:e49550. [PMID: 38498048 PMCID: PMC10985604 DOI: 10.2196/49550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/13/2023] [Accepted: 02/02/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND A frequent rehabilitation goal for children with gait disorders is to practice daily-life walking activities. Unfortunately, these are often difficult to practice in a conventional therapeutic setting. Virtual reality (VR) with head-mounted displays (HMDs) could be a promising approach in neurorehabilitation to train such activities in a safe environment. First, however, we must know whether obstacles in VR are indeed mastered as obstacles. OBJECTIVE This study aimed to provide information on whether VR is feasible and motivating to induce and practice movements needed to master real obstacles in children and adolescents with gait disorders. Furthermore, this project aims to evaluate which kinds of everyday walking activities are appropriate to be practiced in VR. METHODS In this cross-sectional study, participants stepped over a bar, crossed a gap, balanced over a beam, and circumvented stationary obstructions arranged in a course under real physical and virtual conditions wearing a VR HMD. We recorded the respective primary outcomes (step height, step length, step width, and minimal shoulder-obstacle distance) with motion capture. We then calculated the mean differences and 95% CI of the spatiotemporal parameters between the VR and physical setup and later compared them using noninferiority analysis with margins defined a priori by a clinical expert panel. Additionally, the participants responded to a standardized questionnaire while the therapists observed and evaluated their movement performance. RESULTS We recruited 20 participants (mean age 12.0, range 6.6-17.8 years) with various diagnoses affecting their walking ability. At 3.77 (95% CI 1.28 to 6.26) cm, the mean difference in step height of the leading foot in the overstepping task did not exceed the predefined margin of -2 cm, thus signifying noninferiority of the VR condition compared to mastering the physical obstacles. The same was true for step length (-1.75, 95% CI -4.91 to 1.41 cm; margin -10 cm), step width (1.05, 95% CI 0.20 to -1.90 cm; margin 3 cm), and the minimal shoulder-obstacle distance (0.25, 95% CI -0.85 to 0.35 cm; margin -2 cm) in the other tasks. Only the trailing foot in the overstepping task yielded inconclusive results. CONCLUSIONS Children with gait disorders perform everyday walking tasks like overstepping, crossing, balancing, or circumventing similarly in physical and VR environments, suggesting that VR could be a feasible therapeutic tool to practice everyday walking tasks.
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Affiliation(s)
- Sophia Rhiel
- Swiss Children's Rehab, University Children's Hospital Zurich, University of Zurich, Affoltern am Albis, Switzerland
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Andrina Kläy
- Swiss Children's Rehab, University Children's Hospital Zurich, University of Zurich, Affoltern am Albis, Switzerland
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Urs Keller
- Swiss Children's Rehab, University Children's Hospital Zurich, University of Zurich, Affoltern am Albis, Switzerland
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Hubertus J A van Hedel
- Swiss Children's Rehab, University Children's Hospital Zurich, University of Zurich, Affoltern am Albis, Switzerland
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Corinne Ammann-Reiffer
- Swiss Children's Rehab, University Children's Hospital Zurich, University of Zurich, Affoltern am Albis, Switzerland
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
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Martarelli CS, Chiquet S, Ertl M. Keeping track of reality: embedding visual memory in natural behaviour. Memory 2023; 31:1295-1305. [PMID: 37727126 DOI: 10.1080/09658211.2023.2260148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 07/21/2023] [Indexed: 09/21/2023]
Abstract
Since immersive virtual reality (IVR) emerged as a research method in the 1980s, the focus has been on the similarities between IVR and actual reality. In this vein, it has been suggested that IVR methodology might fill the gap between laboratory studies and real life. IVR allows for high internal validity (i.e., a high degree of experimental control and experimental replicability), as well as high external validity by letting participants engage with the environment in an almost natural manner. Despite internal validity being crucial to experimental designs, external validity also matters in terms of the generalizability of results. In this paper, we first highlight and summarise the similarities and differences between IVR, desktop situations (both non-immersive VR and computer experiments), and reality. In the second step, we propose that IVR is a promising tool for visual memory research in terms of investigating the representation of visual information embedded in natural behaviour. We encourage researchers to carry out experiments on both two-dimensional computer screens and in immersive virtual environments to investigate visual memory and validate and replicate the findings. IVR is valuable because of its potential to improve theoretical understanding and increase the psychological relevance of the findings.
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Affiliation(s)
| | - Sandra Chiquet
- Faculty of Psychology, UniDistance Suisse, Brig, Switzerland
| | - Matthias Ertl
- Department of Psychology, University of Bern, Bern, Switzerland
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Ferron A, Robert MT, Fortin W, Bau O, Cardinal MC, Desgagné J, Saussez G, Bleyenheuft Y, Levac D. Virtual Reality and Active Video Game Integration within an Intensive Bimanual Therapy Program for Children with Hemiplegia. Phys Occup Ther Pediatr 2023; 44:410-426. [PMID: 37846035 DOI: 10.1080/01942638.2023.2259462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/11/2023] [Indexed: 10/18/2023]
Abstract
AIMS To describe the nature of custom and non-custom virtual reality and active video game (VR/AVG) implementation within a Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) intervention program for children with hemiplegia. METHODS Six children aged 8-11 years participated in a 10-day HABIT-ILE intervention (65 h; 6.5 planned VR/AVG hours). VR/AVG implementation details were recorded daily and summarized with descriptive statistics; active motor engagement was quantified as minutes of active game participation. Post-intervention interviews with interventionists were analyzed with qualitative content analysis. RESULTS On average, participants received 79% of the planned VR/AVG dosage (314/400 planned minutes, range 214-400 min), of which the per-session active motor engagement average was 68% (27 min, SD 12 min). Participation involved equivalent amounts of custom (49%) and non-custom (51%) VR/AVG system use. Material and verbal adaptations facilitated alignment with HABIT-ILE principles. Interventionists identified type of task (gross versus fine motor), children's perceived motivation, and VR/AVG attributes as factors influencing active motor engagement and alignment with HABIT-ILE principles. CONCLUSIONS Describing individual and technological challenges of VR/AVG integration within HABIT-ILE can advance knowledge about VR/AVG use in intensive interventions and identify directions for subsequent research.
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Affiliation(s)
- Audrey Ferron
- Centre Hospitalier Universitaire Sainte-Justine - Research Center, Montreal, Canada
| | | | - William Fortin
- Centre Hospitalier Universitaire Sainte-Justine - Research Center, Montreal, Canada
| | - Odette Bau
- Centre Hospitalier Universitaire Sainte-Justine - Marie Enfant Rehabilitation Center, Montreal, Canada
| | - Marie-Claude Cardinal
- Centre Hospitalier Universitaire Sainte-Justine - Marie Enfant Rehabilitation Center, Montreal, Canada
| | - Julie Desgagné
- Centre Hospitalier Universitaire Sainte-Justine - Marie Enfant Rehabilitation Center, Montreal, Canada
| | - Geoffroy Saussez
- Institute of Neuroscience, Université catholique de Louvain, Louvain, Belgium
| | - Yannick Bleyenheuft
- Institute of Neuroscience, Université catholique de Louvain, Louvain, Belgium
| | - Danielle Levac
- Centre Hospitalier Universitaire Sainte-Justine - Research Center, Montreal, Canada
- Faculty of Medicine, University of Montreal, Montreal, Canada
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Souchet AD, Lourdeaux D, Burkhardt JM, Hancock PA. Design guidelines for limiting and eliminating virtual reality-induced symptoms and effects at work: a comprehensive, factor-oriented review. Front Psychol 2023; 14:1161932. [PMID: 37359863 PMCID: PMC10288216 DOI: 10.3389/fpsyg.2023.1161932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/16/2023] [Indexed: 06/28/2023] Open
Abstract
Virtual reality (VR) can induce side effects known as virtual reality-induced symptoms and effects (VRISE). To address this concern, we identify a literature-based listing of these factors thought to influence VRISE with a focus on office work use. Using those, we recommend guidelines for VRISE amelioration intended for virtual environment creators and users. We identify five VRISE risks, focusing on short-term symptoms with their short-term effects. Three overall factor categories are considered: individual, hardware, and software. Over 90 factors may influence VRISE frequency and severity. We identify guidelines for each factor to help reduce VR side effects. To better reflect our confidence in those guidelines, we graded each with a level of evidence rating. Common factors occasionally influence different forms of VRISE. This can lead to confusion in the literature. General guidelines for using VR at work involve worker adaptation, such as limiting immersion times to between 20 and 30 min. These regimens involve taking regular breaks. Extra care is required for workers with special needs, neurodiversity, and gerontechnological concerns. In addition to following our guidelines, stakeholders should be aware that current head-mounted displays and virtual environments can continue to induce VRISE. While no single existing method fully alleviates VRISE, workers' health and safety must be monitored and safeguarded when VR is used at work.
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Affiliation(s)
- Alexis D. Souchet
- Heudiasyc UMR 7253, Alliance Sorbonne Université, Université de Technologie de Compiègne, CNRS, Compiègne, France
- Institute for Creative Technologies, University of Southern California, Los Angeles, CA, United States
| | - Domitile Lourdeaux
- Heudiasyc UMR 7253, Alliance Sorbonne Université, Université de Technologie de Compiègne, CNRS, Compiègne, France
| | | | - Peter A. Hancock
- Department of Psychology, University of Central Florida, Orlando, FL, United States
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9
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Davide E, Jenifer M, Alessia T, Alberto M, Monica G. Young children can use their subjective straight-ahead to remap visuo-motor alterations. Sci Rep 2023; 13:6427. [PMID: 37081091 PMCID: PMC10119127 DOI: 10.1038/s41598-023-33127-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 04/07/2023] [Indexed: 04/22/2023] Open
Abstract
Young children and adults process spatial information differently: the former use their bodies as primary reference, while adults seem capable of using abstract frames. The transition is estimated to occur between the 6th and the 12th year of age. The mechanisms underlying spatial encoding in children and adults are unclear, as well as those underlying the transition. Here, we investigated the role of the subjective straight-ahead (SSA), the body antero-posterior half-plane mental model, in spatial encoding before and after the expected transition. We tested 6-7-year-old and 10-11-year-old children, and adults on a spatial alignment task in virtual reality, searching for differences in performance when targets were placed frontally or sideways. The performance differences were assessed both in a naturalistic baseline condition and in a test condition that discouraged using body-centered coordinates through a head-related visuo-motor conflict. We found no differences in the baseline condition, while all groups showed differences between central and lateral targets (SSA effect) in the visuo-motor conflict condition, and 6-7-year-old children showed the largest effect. These results confirm the expected transition timing; moreover, they suggest that children can abstract from the body using their SSA and that the transition underlies the maturation of a world-centered reference frame.
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Affiliation(s)
- Esposito Davide
- Unit for Visually Impaired People, Fondazione Istituto Italiano di Tecnologia, 16163, Genova, Italy.
| | - Miehlbradt Jenifer
- Bertarelli Foundation Chair in Translational Neuroengineering, EPFL, 1015, Lausanne, Switzerland
| | - Tonelli Alessia
- Unit for Visually Impaired People, Fondazione Istituto Italiano di Tecnologia, 16163, Genova, Italy
| | - Mazzoni Alberto
- The Biorobotics Institute, Scuola Superiore Sant'Anna, 56127, Pontedera, Italy
| | - Gori Monica
- Unit for Visually Impaired People, Fondazione Istituto Italiano di Tecnologia, 16163, Genova, Italy
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Wolffsohn JS, Lingham G, Downie LE, Huntjens B, Inomata T, Jivraj S, Kobia-Acquah E, Muntz A, Mohamed-Noriega K, Plainis S, Read M, Sayegh RR, Singh S, Utheim TP, Craig JP. TFOS Lifestyle: Impact of the digital environment on the ocular surface. Ocul Surf 2023; 28:213-252. [PMID: 37062428 DOI: 10.1016/j.jtos.2023.04.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/06/2023] [Indexed: 04/18/2023]
Abstract
Eye strain when performing tasks reliant on a digital environment can cause discomfort, affecting productivity and quality of life. Digital eye strain (the preferred terminology) was defined as "the development or exacerbation of recurrent ocular symptoms and/or signs related specifically to digital device screen viewing". Digital eye strain prevalence of up to 97% has been reported, due to no previously agreed definition/diagnostic criteria and limitations of current questionnaires which fail to differentiate such symptoms from those arising from non-digital tasks. Objective signs such as blink rate or critical flicker frequency changes are not 'diagnostic' of digital eye strain nor validated as sensitive. The mechanisms attributed to ocular surface disease exacerbation are mainly reduced blink rate and completeness, partial/uncorrected refractive error and/or underlying binocular vision anomalies, together with the cognitive demand of the task and differences in position, size, brightness and glare compared to an equivalent non-digital task. In general, interventions are not well established; patients experiencing digital eye strain should be provided with a full refractive correction for the appropriate working distances. Improving blinking, optimizing the work environment and encouraging regular breaks may help. Based on current, best evidence, blue-light blocking interventions do not appear to be an effective management strategy. More and larger clinical trials are needed to assess artificial tear effectiveness for relieving digital eye strain, particularly comparing different constituents; a systematic review within the report identified use of secretagogues and warm compress/humidity goggles/ambient humidifiers as promising strategies, along with nutritional supplementation (such as omega-3 fatty acid supplementation and berry extracts).
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Affiliation(s)
- James S Wolffsohn
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK; Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand.
| | - Gareth Lingham
- Centre for Eye Research Ireland, Technological University Dublin, Dublin, Ireland
| | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Byki Huntjens
- Division of Optometry and Visual Sciences, City, University of London, EC1V 0HB, UK
| | - Takenori Inomata
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Saleel Jivraj
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK
| | | | - Alex Muntz
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Karim Mohamed-Noriega
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL). Monterrey, 64460, Mexico
| | - Sotiris Plainis
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK; Laboratory of Optics and Vision, School of Medicine, University of Crete, Greece
| | - Michael Read
- Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
| | - Rony R Sayegh
- Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sumeer Singh
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Tor P Utheim
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - Jennifer P Craig
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK; Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
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Ali SG, Wang X, Li P, Jung Y, Bi L, Kim J, Chen Y, Feng DD, Magnenat Thalmann N, Wang J, Sheng B. A systematic review: Virtual-reality-based techniques for human exercises and health improvement. Front Public Health 2023; 11:1143947. [PMID: 37033028 PMCID: PMC10076722 DOI: 10.3389/fpubh.2023.1143947] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Virtual Reality (VR) has emerged as a new safe and efficient tool for the rehabilitation of many childhood and adulthood illnesses. VR-based therapies have the potential to improve both motor and functional skills in a wide range of age groups through cortical reorganization and the activation of various neuronal connections. Recently, the potential for using serious VR-based games that combine perceptual learning and dichoptic stimulation has been explored for the rehabilitation of ophthalmological and neurological disorders. In ophthalmology, several clinical studies have demonstrated the ability to use VR training to enhance stereopsis, contrast sensitivity, and visual acuity. The use of VR technology provides a significant advantage in training each eye individually without requiring occlusion or penalty. In neurological disorders, the majority of patients undergo recurrent episodes (relapses) of neurological impairment, however, in a few cases (60-80%), the illness progresses over time and becomes chronic, consequential in cumulated motor disability and cognitive deficits. Current research on memory restoration has been spurred by theories about brain plasticity and findings concerning the nervous system's capacity to reconstruct cellular synapses as a result of interaction with enriched environments. Therefore, the use of VR training can play an important role in the improvement of cognitive function and motor disability. Although there are several reviews in the community employing relevant Artificial Intelligence in healthcare, VR has not yet been thoroughly examined in this regard. In this systematic review, we examine the key ideas of VR-based training for prevention and control measurements in ocular diseases such as Myopia, Amblyopia, Presbyopia, and Age-related Macular Degeneration (AMD), and neurological disorders such as Alzheimer, Multiple Sclerosis (MS) Epilepsy and Autism spectrum disorder. This review highlights the fundamentals of VR technologies regarding their clinical research in healthcare. Moreover, these findings will raise community awareness of using VR training and help researchers to learn new techniques to prevent and cure different diseases. We further discuss the current challenges of using VR devices, as well as the future prospects of human training.
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Affiliation(s)
- Saba Ghazanfar Ali
- Department of Computer Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Xiangning Wang
- Department of Ophthalmology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ping Li
- Department of Computing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- School of Design, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Younhyun Jung
- School of Computing, Gachon University, Seongnam, Republic of Korea
| | - Lei Bi
- Biomedical and Multimedia Information Technology Research Group, School of Computer Science, The University of Sydney, Sydney, NSW, Australia
| | - Jinman Kim
- Biomedical and Multimedia Information Technology Research Group, School of Computer Science, The University of Sydney, Sydney, NSW, Australia
| | - Yuting Chen
- Department of Computer Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - David Dagan Feng
- Biomedical and Multimedia Information Technology Research Group, School of Computer Science, The University of Sydney, Sydney, NSW, Australia
| | | | - Jihong Wang
- Shanghai University of Sport, Shanghai, China
| | - Bin Sheng
- Department of Computer Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
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Pavel IA, Bogdanici CM, Donica VC, Anton N, Savu B, Chiriac CP, Pavel CD, Salavastru SC. Computer Vision Syndrome: An Ophthalmic Pathology of the Modern Era. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020412. [PMID: 36837613 PMCID: PMC9961559 DOI: 10.3390/medicina59020412] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/08/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023]
Abstract
Digital device usage has increased significantly in last decade among all age groups, both for educational and recreational purposes. Computer vision syndrome (CVS), also known as digital eye strain (DES), represents a range of ocular, musculoskeletal, and behavioral conditions caused by prolonged use of devices with digital screens. This paper reviews the principal environmental, ocular, and musculoskeletal causes for this condition. Due to the high prevalence of DES and frequent usage of digital devices, it is important that eye care practitioners be able to provide advice and management options based on quality research evidence.
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Affiliation(s)
- Irina Andreea Pavel
- Department of Ophthalmology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No.16, 700115 Iasi, Romania
| | - Camelia Margareta Bogdanici
- Department of Ophthalmology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No.16, 700115 Iasi, Romania
- Correspondence: (C.M.B.); (V.C.D.)
| | - Vlad Constantin Donica
- Department of Ophthalmology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No.16, 700115 Iasi, Romania
- Correspondence: (C.M.B.); (V.C.D.)
| | - Nicoleta Anton
- Department of Ophthalmology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No.16, 700115 Iasi, Romania
| | - Bogdan Savu
- Department of Pediatrics, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No.16, 700115 Iasi, Romania
| | | | - Cristian Dan Pavel
- Department of Histology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No.16, 700115 Iasi, Romania
| | - Silvia Cristina Salavastru
- Department of Ophthalmology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No.16, 700115 Iasi, Romania
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Cao S, Li H. A Scoping Review of Digital Well-Being in Early Childhood: Definitions, Measurements, Contributors, and Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3510. [PMID: 36834204 PMCID: PMC9960550 DOI: 10.3390/ijerph20043510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Digital well-being concerns the balanced and healthy use of digital technology, and the existing studies in this area have focused on adolescents and adults. However, young children are more vulnerable to digital overuse and addiction than adults; thus, their digital well-being deserves empirical exploration. In this scoping review, we synthesized and evaluated 35 collected studies on young children's digital use and their associated well-being that were published up to October of 2022 to understand the related definitions, measurements, contributors, and interventions. The synthesis of the evidence revealed that (1) there was no consensus about the definition of the concept of digital well-being; (2) there were no effective ways of measuring young children's digital well-being; (3) both child factors (the duration and place of digital use, as well as the child's demographic characteristics) and parent factors (digital use, parental perception, and mediation) contribute to young children's well-being; and (4) there were some effective applications and digital interventions reported in the reviewed studies. This review contributes to the development of this concept by mapping the existing research on young children's digital well-being, as well as proposing a model and identifying the research gaps for future studies.
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Affiliation(s)
- Simin Cao
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai 200234, China
| | - Hui Li
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai 200234, China
- Macquarie School of Education, Macquarie University, Sydney, NSW 2109, Australia
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14
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Hummer TA, Wood ZM, Miller K, McCarthy RL, Brickman JE, Neumann D. Assessment of Boys' Responses to Interpersonal Conflict in Virtual Reality. Games Health J 2023; 12:53-62. [PMID: 36301265 PMCID: PMC9894598 DOI: 10.1089/g4h.2022.0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background: Continuous advances in virtual reality (VR) technology have increased its potential for clinical use in the research, assessment, and treatment of mental health difficulties. One potential target for VR use is childhood behavior problems, which are often associated with social-cognitive deficits that can be difficult to measure or modify. Materials and Methods: We enrolled 36 boys between the ages of 8-13 to assess the usability of a VR device and its feasibility as a psychiatric tool for youth. Each participant experienced three virtual school cafeteria scenes that varied in antisocial content and the intentions of a virtual counterpart (VC) (control, ambiguous, or hostile). Following each scene, participants completed questions about ease and comfort in using the headset as well as an assessment of hostile attribution bias (HAB). HAB is the tendency to attribute hostile motivations to others' behaviors, which contributes to antisocial thoughts and behaviors. Following this VR use, participants completed a standard text assessment of HAB. Results: In general, participants reported the VR headset to be enjoyable and easy to use, and scenes worked as intended, with VCs in the hostile scene rated the meanest. In addition, boys with more conduct problems reported that virtual characters were meaner to them, despite no difference in text vignette measures of HAB. Conclusion: This study provides preliminary evidence supporting the further development of VR programs to assess and treat childhood behavior problems.
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Affiliation(s)
- Tom A. Hummer
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Zebulun M. Wood
- Departments of Media Arts and Science and Human Centered Computing, School of Informatics and Computing, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, Indiana, USA
| | - Kevin Miller
- Departments of Media Arts and Science and Human Centered Computing, School of Informatics and Computing, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, Indiana, USA
| | - Rachel L. McCarthy
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jocelyn E. Brickman
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Dawn Neumann
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA
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15
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Checa D, Bustillo A. Virtual Reality for Learning. Curr Top Behav Neurosci 2023; 65:289-307. [PMID: 36592277 DOI: 10.1007/7854_2022_404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The consumer age of the Personal Computer and mobile devices has opened up a new world of opportunities for innovative teaching methodologies, many based on serious games and virtual worlds. Similar levels of market penetration are expected for the use of Immersive Virtual Reality (iVR) over upcoming decades, once all the core technologies for game engines and head-mounted displays are available on the market at affordable prices. In this chapter, a general overview of the state of the art of iVR learning experiences is presented. Firstly, the advantages of iVR over traditional learning are described - advantages that must be considered when defining iVR experiences for the optimization of student learning and satisfaction. Secondly, the relationship between learning theories and iVR experiences is briefly summarized; an area where constructivist theories appear to be the most commonly used theory in iVR experiences. Thirdly, some examples of the success of iVR applications at different learning levels, from primary school to higher education, are summarized. Fourthly, the key factors for the successful design and use of an iVR experience in education are identified, from the predesign stage to the final evaluation - with special attention given to the different possibilities of each type of HMD for different kinds of educational experiences. Finally, the main limitations of iVR for learning today and the future trends of this technology for teaching are also identified and discussed.
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16
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Kepp NE, Arrieta I, Schiøth C, Percy-Smith L. Virtual Reality pitch ranking in children with cochlear implants, hearing aids or normal hearing. Int J Pediatr Otorhinolaryngol 2022; 161:111241. [PMID: 35964492 DOI: 10.1016/j.ijporl.2022.111241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/03/2022] [Accepted: 07/11/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Nille Elise Kepp
- Research Unit at the Center of Hearing & Balance, Copenhagen University Hospital, Rigshospitalet, Denmark; Graduate School of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Irene Arrieta
- Basque Center on Cognition, Brain and Language - BCBL, Universidad del Paíz Vasco - UPV, Spain; Technical University of Denmark - DTU, Denmark
| | | | - Lone Percy-Smith
- Research Unit at the Center of Hearing & Balance, Copenhagen University Hospital, Rigshospitalet, Denmark
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Hsin LJ, Chao YP, Chuang HH, Kuo TBJ, Yang CCH, Huang CG, Kang CJ, Lin WN, Fang TJ, Li HY, Lee LA. Mild simulator sickness can alter heart rate variability, mental workload, and learning outcomes in a 360° virtual reality application for medical education: a post hoc analysis of a randomized controlled trial. VIRTUAL REALITY 2022; 27:1-17. [PMID: 36118174 PMCID: PMC9470506 DOI: 10.1007/s10055-022-00688-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 04/28/2022] [Indexed: 06/02/2023]
Abstract
Virtual reality (VR) applications could be beneficial for education, training, and treatment. However, VR may induce symptoms of simulator sickness (SS) such as difficulty focusing, difficulty concentrating, or dizziness that could impair autonomic nervous system function, affect mental workload, and worsen interventional outcomes. In the original randomized controlled trial, which explored the effectiveness of using a 360° VR video versus a two-dimensional VR video to learn history taking and physical examination skills, only the former group participants had SS. Therefore, 28 undergraduate medical students who participated in a 360° VR learning module were included in this post hoc study using a repeated measures design. Data of the Simulator Sickness Questionnaire (SSQ), heart rate variability (HRV) analysis, Task Load Index, and Mini-Clinical Evaluation Exercise were retrospectively reviewed and statistically analyzed. Ten (36%) participants had mild SS (total score > 0 and ≤ 20), and 18 (64%) had no SS symptom. Total SSQ score was positively related to the very low frequency (VLF) band power, physical demand subscale, and frustration subscale, and inversely related to physical examination score. Using multilevel modeling, the VLF power mediated the relationship between total SSQ score and physical examination score. Furthermore, frustration subscale moderated the mediating effects of the VLF power. Our results highlight the importance of documenting SS to evaluate a 360° VR training program. Furthermore, the combination of HRV analysis with mental workload measurement and outcome assessments provided the important clinical value in evaluating the effects of SS in VR applications in medical education.
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Affiliation(s)
- Li-Jen Hsin
- Department of Otorhinolaryngology-Head and Neck Surgery, Sleep Center, Linkou Medical Center, Linkou Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street, Gueishan District, Taoyuan City, 33305 Taiwan, Republic of China
- Faculty of Medicine, Graduate Institute of Clinical Medicine Sciences, Chang Gung University, Taoyuan, 33302 Taiwan
| | - Yi-Ping Chao
- Department of Computer Science and Information Engineering, Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan, 33302 Taiwan
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, 33305 Taiwan
| | - Hai-Hua Chuang
- Faculty of Medicine, Graduate Institute of Clinical Medicine Sciences, Chang Gung University, Taoyuan, 33302 Taiwan
- Department of Family Medicine, Taipei Branch and Linkou Main Branch, Linkou Medical Center, Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street, Gueishan District, Taoyuan, 33305 Taiwan, Republic of China
- Department of Industrial Engineering and Management, National Taipei University of Technology, Taipei, 10608 Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, 300044 Taiwan
| | - Terry B. J. Kuo
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 11221 Taiwan
| | - Cheryl C. H. Yang
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 11221 Taiwan
| | - Chung-Guei Huang
- Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, 33305 Taiwan
- Department of Medical Biotechnology and Laboratory Science, Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, 33302 Taiwan
| | - Chung-Jan Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Sleep Center, Linkou Medical Center, Linkou Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street, Gueishan District, Taoyuan City, 33305 Taiwan, Republic of China
- Faculty of Medicine, Graduate Institute of Clinical Medicine Sciences, Chang Gung University, Taoyuan, 33302 Taiwan
| | - Wan-Ni Lin
- Department of Otorhinolaryngology-Head and Neck Surgery, Sleep Center, Linkou Medical Center, Linkou Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street, Gueishan District, Taoyuan City, 33305 Taiwan, Republic of China
- Faculty of Medicine, Graduate Institute of Clinical Medicine Sciences, Chang Gung University, Taoyuan, 33302 Taiwan
| | - Tuan-Jen Fang
- Department of Otorhinolaryngology-Head and Neck Surgery, Sleep Center, Linkou Medical Center, Linkou Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street, Gueishan District, Taoyuan City, 33305 Taiwan, Republic of China
- Faculty of Medicine, Graduate Institute of Clinical Medicine Sciences, Chang Gung University, Taoyuan, 33302 Taiwan
| | - Hsueh-Yu Li
- Department of Otorhinolaryngology-Head and Neck Surgery, Sleep Center, Linkou Medical Center, Linkou Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street, Gueishan District, Taoyuan City, 33305 Taiwan, Republic of China
- Faculty of Medicine, Graduate Institute of Clinical Medicine Sciences, Chang Gung University, Taoyuan, 33302 Taiwan
| | - Li-Ang Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Sleep Center, Linkou Medical Center, Linkou Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street, Gueishan District, Taoyuan City, 33305 Taiwan, Republic of China
- Faculty of Medicine, Graduate Institute of Clinical Medicine Sciences, Chang Gung University, Taoyuan, 33302 Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 11221 Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, 300044 Taiwan
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Obukhov AD, Krasnyanskiy MN, Dedov DL, Nazarova AO. The study of virtual reality influence on the process of professional training of miners. VIRTUAL REALITY 2022; 27:735-759. [PMID: 36061945 PMCID: PMC9418660 DOI: 10.1007/s10055-022-00687-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 08/08/2022] [Indexed: 06/05/2023]
Abstract
Virtual reality technologies are actively applied for the organization of professional training in various industries, as well as in distance learning. However, numerous studies show the presence of a large number of negative factors that limit the effectiveness of using these technologies (united by the concept of "cybersickness"). The study, identification and reduction in the influence of these negative factors will increase the immersiveness and quality of the professional training process. Within the framework of this study, several hypotheses have been put forward regarding the negative and positive impact of VR technologies on the process of professional training, the coal and mining industry has been chosen as the subject area. Thus, the problem of effective training of miners for activities in regular and emergency situations is considered, in the latter case, VR technologies would allow forming the necessary set of skills and knowledge about actions in emergency situations. To confirm the declared hypotheses, an experimental group of 30 people was formed, corresponding to the trained miners by age characteristics. Based on the analysis, a list of quantitative and qualitative metrics for evaluating interaction with virtual reality was formed, the software of virtual scenes for two tasks (moving simple objects and a set of exercises in a virtual mine) was developed. The experimental group repeatedly performed these exercises, which allowed us to analyze the dynamics of changes in the average values of quantitative and qualitative metrics. The data obtained were processed by statistical tests (Shapiro-Wilk, Kruskal-Wallis, Mann-Whitney), which allowed us to assess the impact of the selected configurations (with and without VR) and the number of attempts on the selected metrics. The obtained results partially or completely confirmed the declared hypotheses and allowed us to form a list of recommendations for the organization of high-quality professional training using virtual reality technologies. Supplementary Information The online version contains supplementary material available at 10.1007/s10055-022-00687-7.
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Banstola S, Hanna K, O'Connor A. Changes to Visual Parameters Following Virtual Reality Gameplay. Br Ir Orthopt J 2022; 18:57-64. [PMID: 35855495 PMCID: PMC9249003 DOI: 10.22599/bioj.257] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 05/27/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction: Virtual reality (VR) gameplay is popular with a range of games and educational resources available. However, it puts high demands on the visual system. Current evidence shows conflicting impacts on visual parameters. Therefore, this study explores the changes to vision following VR gameplay. Methods: The study was conducted at the School of Health Sciences, University of Liverpool. All participants had binocular vision with good visual acuity and no manifest strabismus. Participants were assessed before and after playing 15 minutes of the VR game Beat Saber, which incorporated convergence and divergence movements. Clinical assessments including near point of convergence (NPC) and near point of accommodation (NPA) using the RAF rule; accommodative convergence to accommodation (AC/A) ratio; motor fusion using the prism fusion range (at 33cm), accommodation facility using +2.00/–2.00DS flipper lenses, and stereoacuity using the Frisby stereo test were assessed before and after playing. Results: Seventy-eight participants (19–25 years old) were included in the study, with 16 males and 41 females respectively. The breakpoint of convergence reduced by 0.5 cm (p = 0.001). The binocular accommodative facility improved by 2 cycles per minute (cpm); p = 0.004. The mean, near horizontal prism fusion range (PFR) base break and recovery points both worsened by of 5.0 dioptres (p = 0.003), whereas the mean near horizontal PFR base in recovery point improved by of 4.0 dioptres (p = 0.003). Discussion: The study validated previous findings as VR gameplay over-exercised and fatigued convergence muscles, but to a small degree. The VR experience improved the participants’ ability to change focus quickly and improve accommodation, as well as the divergence function of the eye. However, as the participants were retested directly after the VR gameplay, the findings were limited to short term effects on vision.
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Bernaerts S, Bonroy B, Daems J, Sels R, Struyf D, Gies I, van de Veerdonk W. Virtual Reality for Distraction and Relaxation in a Pediatric Hospital Setting: An Interventional Study With a Mixed-Methods Design. Front Digit Health 2022; 4:866119. [PMID: 35712230 PMCID: PMC9192964 DOI: 10.3389/fdgth.2022.866119] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 05/06/2022] [Indexed: 12/13/2022] Open
Abstract
Accumulating evidence supports the use of virtual reality (VR) as an effective pain and anxiety management tool for pediatric patients during specific medical procedures in dedicated patient groups. However, VR is still not widely adopted in everyday clinical practice. Feasibility and acceptability measures of clinicians' experiences are often missing in studies, thereby omitting an important stakeholder in VR use in a clinical setting. Therefore, the aim of this mixed-methods study was to investigate the feasibility, acceptability, tolerability (primary outcomes), and preliminary effectiveness (secondary outcome) of Relaxation-VR in both pediatric patients aged 4–16 years and clinicians. Relaxation-VR is a VR application prototype aimed to provide distraction and relaxation for a variety of patient populations and procedures and is used to reduce anxiety, stress (tension) and pain for children in hospital. Multiple measures of acceptability, feasibility and tolerability, and pre-to-post changes in measures of pain, anxiety, stress and happiness were assessed in pediatric patients. At the end of the study, acceptability and feasibility of VR use was assessed in clinicians. Results indicate that VR use (in particular, the Relaxation-VR prototype) for both distraction and relaxation is acceptable, feasible and tolerable for a variety of pediatric patients aged 4–16 years, as assessed in both patients and clinicians, and can reduce anxiety, pain and tension (stress), and increase happiness in a hospital setting.
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Affiliation(s)
- Sylvie Bernaerts
- Expertise Unit Psychology, Technology and Society, Thomas More University of Applied Sciences, Antwerp, Belgium
- *Correspondence: Sylvie Bernaerts
| | - Bert Bonroy
- Mobilab & Care, Thomas More University of Applied Sciences, Geel, Belgium
| | - Jo Daems
- Mobilab & Care, Thomas More University of Applied Sciences, Geel, Belgium
| | - Romy Sels
- Mobilab & Care, Thomas More University of Applied Sciences, Geel, Belgium
| | - Dieter Struyf
- Creative and Innovative Business, Thomas More University of Applied Sciences, Mechelen, Belgium
| | - Inge Gies
- Department of Pediatrics, Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
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21
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Drisdelle S, Power L, Thieu S, Sheriko J. Developing an Immersive Virtual Reality Training System for Novel Pediatric Power Wheelchair Users: Protocol for a Feasibility Study (Preprint). JMIR Res Protoc 2022; 11:e39140. [PMID: 36201405 PMCID: PMC9585445 DOI: 10.2196/39140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 11/30/2022] Open
Abstract
Background Power wheelchairs can empower children with physical limitations to gain independence in their everyday lives; however, traditional methods of power wheelchair training are often limited by poor accessibility and safety concerns. Immersive virtual reality technology (IVRT) uses advanced display technology to place users in a fully immersive web-based environment that can support real-time skills training, often requiring less resources and fewer safety concerns than real-world methods. IVRT interventions have shown to be a feasible training option among adult power wheelchair users; however, there is still a need to understand the technical and clinical feasibility of developing an IVRT power wheelchair training tool for the pediatric population. Objective This proposed study aims to use expert feedback and an iterative design process to develop an IVRT training intervention for pediatric power wheelchair skill development. Methods This 3-phase feasibility study will be conducted within the assistive technology unit of a public pediatric hospital. Separate participant groups will be recruited for each phase, consisting of approximately 10 to 15 clinicians (phase 1), 10 pediatric power wheelchair users (phase 2), and 15 to 20 additional pediatric power wheelchair users (phase 3). Phase 1 will be conducted to gather feedback on the baseline IVRT training intervention. Clinicians will test the intervention and assess its usability and acceptability using qualitative and quantitative methods. Phase 1 participants will also be invited back for a subsequent session to reassess a revised version of the training intervention that has been updated based on their previous feedback. Phase 2 and phase 3 will also use mixed methods to gather feedback on the usability, acceptability, and user experience of the IVRT training intervention from current pediatric power wheelchair users. In addition, phase 3 participants will perform a skills transfer assessment to compare power mobility skill performance between the virtual reality and real-life environments. Data gathered in phase 2 will be used to further refine the IVRT intervention, whereas phase 3 data will be used to statistically evaluate the final version. Results This study was approved by the Izaak Walton Killam Health Centre research ethics board in August 2021. Phase 1 testing began in February 2022. The entire study is expected to be completed by 2023. Conclusions The results of this study will be used to create an IVRT training intervention for pediatric power wheelchair skill development through an iterative and collaborative design process. Results may also assist in directing future studies in this area. International Registered Report Identifier (IRRID) DERR1-10.2196/39140
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Affiliation(s)
- Sara Drisdelle
- Department of Pediatrics, Izaak Walton Killam Health Centre, Halifax, NS, Canada
| | - Liam Power
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Scott Thieu
- Department of Pediatrics, Izaak Walton Killam Health Centre, Halifax, NS, Canada
| | - Jordan Sheriko
- Department of Pediatrics, Izaak Walton Killam Health Centre, Halifax, NS, Canada
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22
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A Perspective Review on Integrating VR/AR with Haptics into STEM Education for Multi-Sensory Learning. ROBOTICS 2022. [DOI: 10.3390/robotics11020041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
As a result of several governments closing educational facilities in reaction to the COVID-19 pandemic in 2020, almost 80% of the world’s students were not in school for several weeks. Schools and universities are thus increasing their efforts to leverage educational resources and provide possibilities for remote learning. A variety of educational programs, platforms, and technologies are now accessible to support student learning; while these tools are important for society, they are primarily concerned with the dissemination of theoretical material. There is a lack of support for hands-on laboratory work and practical experience. This is particularly important for all disciplines related to science, technology, engineering, and mathematics (STEM), where labs and pedagogical assets must be continuously enhanced in order to provide effective study programs. In this study, we describe a unique perspective to achieving multi-sensory learning through the integration of virtual and augmented reality (VR/AR) with haptic wearables in STEM education. We address the implications of a novel viewpoint on established pedagogical notions. We want to encourage worldwide efforts to make fully immersive, open, and remote laboratory learning a reality.
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Newbutt N, Bradley R. Using immersive virtual reality with autistic pupils: moving towards greater inclusion and co-participation through ethical practices. JOURNAL OF ENABLING TECHNOLOGIES 2022. [DOI: 10.1108/jet-01-2022-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe potential of head mounted displays based virtual reality (HMD-based VR) for autistic groups has been well documented. However, the deployment and application of this technology, especially in schools, has been extremely limited. One of the main criticisms in this field has been the lack of involvement from practitioners in research on educational approaches for autistic populations and the gap between research and practice in real-life settings.Design/methodology/approachThis conceptual article focuses on our research in a UK-based special needs school that sought to examine the effects and potential use of VR-HMDs, while seeking to establish best practices for safe and ethical application using this technology. This draws upon ethical and participatory research guidance, including British Educational Research Association and Autism Participatory Research.FindingsThe authors make recommendations on planning and implementing a participatory, safe and ethical approach to researching the use of VR-HMDs in special needs schools and engaging with the priorities of autistic children and young people and their teachers.Originality/valueThis conceptual article provides an initial first consideration of ways we can better include autistic people and their views in research that is with and about them. The value in this will mean we are able to better support autistic groups moving ahead using VR HMD-based technologies. Without this paradigm shift and including autistic people (and their stakeholders) the field might continue to build initiatives around medical-based models of disabilities rather that what the community need/want.
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Badke CM, Krogh-Jespersen S, Flynn RM, Shukla A, Essner BS, Malakooti MR. Virtual Reality in the Pediatric Intensive Care Unit: Patient Emotional and Physiologic Responses. Front Digit Health 2022; 4:867961. [PMID: 35419557 PMCID: PMC8995472 DOI: 10.3389/fdgth.2022.867961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/09/2022] [Indexed: 11/13/2022] Open
Abstract
Context Patients in the Pediatric Intensive Care Unit (PICU) are limited in their ability to engage in developmentally typical activity. Long-term hospitalization, especially with minimal interpersonal engagement, is associated with risk for delirium and delayed recovery. Virtual reality (VR) has growing evidence as a safe, efficacious, and acceptable intervention for pain and distress management in the context of uncomfortable healthcare procedures, and for enhancing engagement in, and improving outcomes of rehabilitation therapy. Hypothesis Critically ill children may experience high levels of engagement and physiologic effects while engaging with VR. Methods and Models This cross-sectional study of 3–17-year-old children admitted to a PICU used a VR headset to deliver 360-degree immersive experiences. This study had a mixed-method approach, including standardized behavioral coding, participant and parent surveys, and participant physiologic responses. Investigators noted comments the child made about VR, observed emotional responses, and documented an engagement score. To determine physiologic response to VR, integer heart rate variability (HRVi) was collected 30 min before, during, and 30 min after VR. Results One hundred fifteen participants were enrolled from 6/18 to 10/19, and they interacted with VR for a median of 10 min (interquartile range 7–17). Most children enjoyed the experience; 83% of participants smiled and 36% laughed while using VR. Seventy-two percent made positive comments while using VR. The strongest age-related pattern regarding comments was that the youngest children were more likely to share the experience with others. Seventy-nine percent of participants were highly engaged with VR. Ninety-two percent of parents reported that VR calmed their child, and 78% of participants felt that VR was calming. HRVi Minimum scores were significantly higher during VR than pre- (p < 0.001) or post-VR (p < 0.001). There was no significant difference between pre-and post-VR (p = 0.387); therefore, children returned to their pre-intervention state following VR. Interpretations and Conclusions Children admitted to the PICU are highly engaged with and consistently enjoyed using VR. Both participants and parents found VR to be calming, consistent with intra-intervention physiologic improvements in HRVi. VR is an immersive tool that can augment the hospital environment for children.
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Affiliation(s)
- Colleen M. Badke
- Division of Critical Care, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Pediatric Intensive Care Unit, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
- IGNITE Innovation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
- *Correspondence: Colleen M. Badke
| | - Sheila Krogh-Jespersen
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Rachel M. Flynn
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Avani Shukla
- Pediatric Intensive Care Unit, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Bonnie S. Essner
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
- Division of Gastroenterology, Hepatology, and Nutrition, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Marcelo R. Malakooti
- Division of Critical Care, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Pediatric Intensive Care Unit, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
- IGNITE Innovation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
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Maloca PM, Williams EA, Mushtaq F, Rueppel A, Müller PL, Lange C, Carvalho ER, Inglin N, Reich M, Egan C, Hasler PW, Tufail A, Scholl HP, Cattin PC. Feasibility and tolerability of ophthalmic virtual reality as a medical communication tool in children and young people. Acta Ophthalmol 2022; 100:e588-e597. [PMID: 33988309 PMCID: PMC9290670 DOI: 10.1111/aos.14900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 03/06/2021] [Accepted: 04/18/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE Virtual reality (VR) can be useful in explaining diseases and complications that affect children in order to improve medical communications with this vulnerable patient group. So far, children and young people's responses to high-end medical VR environments have never been assessed. METHODS An unprecedented number of 320 children and young people were given the opportunity to interact with a VR application displaying original ophthalmic volume data via a commercially available tethered head-mounted display (HMD). Participants completed three surveys: demographics and experience with VR, usability and perceived utility of this technology and the Simulator Sickness Questionnaire. The second survey also probed participants for suggestions on improvements and whether this system could be useful for increasing engagement in science. RESULTS A total of 206 sets of surveys were received. 165 children and young people (84 female) aged 12-18 years (mean, 15 years) completed surveys that could be used for analysis. 69 participants (47.59%) were VR-naïve, and 76 (52.41%) reported that they had previous VR experience. Results show that VR facilitated understanding of ophthalmological complications and was reasonably tolerated. Lastly, exposure to VR raised children and young people's awareness and interest in science. CONCLUSIONS The VR platform used was successfully utilized and was well accepted in children to display and interact with volume-rendered 3D ophthalmological data. Virtual reality (VR) is suitable as a novel image display platform in ophthalmology to engage children and young people.
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Affiliation(s)
- Peter M. Maloca
- Institute of Molecular and Clinical Ophthalmology Basel Basel Switzerland
- OCTlab Department of Ophthalmology University Hospital Basel Basel Switzerland
- Department of Ophthalmology University of Basel Basel Switzerland
- Moorfields Eye Hospital NHS Foundation Trust London UK
| | | | - Faisal Mushtaq
- School of Psychology University of Leeds Leeds UK
- Centre for Immersive Technologies University of Leeds Leeds UK
| | | | | | - Clemens Lange
- Eye Center, Medical Center‐University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | | | - Nadja Inglin
- Institute of Molecular and Clinical Ophthalmology Basel Basel Switzerland
| | - Michael Reich
- Eye Center, Medical Center‐University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | | | - Pascal W. Hasler
- OCTlab Department of Ophthalmology University Hospital Basel Basel Switzerland
- Department of Ophthalmology University of Basel Basel Switzerland
| | - Adnan Tufail
- Moorfields Eye Hospital NHS Foundation Trust London UK
| | - Hendrik P.N. Scholl
- Institute of Molecular and Clinical Ophthalmology Basel Basel Switzerland
- OCTlab Department of Ophthalmology University Hospital Basel Basel Switzerland
- Department of Ophthalmology University of Basel Basel Switzerland
| | - Philippe C. Cattin
- Center for medical Image Analysis & Navigation University Basel Switzerland
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Della Longa L, Valori I, Farroni T. Interpersonal Affective Touch in a Virtual World: Feeling the Social Presence of Others to Overcome Loneliness. Front Psychol 2022; 12:795283. [PMID: 35087455 PMCID: PMC8787079 DOI: 10.3389/fpsyg.2021.795283] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/10/2021] [Indexed: 12/25/2022] Open
Abstract
Humans are by nature social beings tuned to communicate and interact from the very beginning of their lives. The sense of touch represents the most direct and intimate channel of communication and a powerful means of connection between the self and the others. In our digital age, the development and diffusion of internet-based technologies and virtual environments offer new opportunities of communication overcoming physical distance. It however, happens that social interactions are often mediated, and the tactile aspects of communication are overlooked, thus diminishing the feeling of social presence, which may contribute to an increased sense of social disconnection and loneliness. The current manuscript aims to review the extant literature about the socio-affective dimension of touch and current advancements in interactive virtual environments in order to provide a new perspective on multisensory virtual communication. Specifically, we suggest that interpersonal affective touch might critically impact virtual social exchanges, promoting a sense of co-presence and social connection between individuals, possibly overcoming feelings of sensory loneliness. This topic of investigation will be of crucial relevance from a theoretical perspective aiming to understand how we integrate multisensory signals in processing and making sense of interpersonal exchanges, this is important in both typical and atypical populations. Moreover, it will pave the way to promising applications by exploring the possibility to use technical innovations to communicate more interactively in the case of people who suffer from social isolation and disconnection from others.
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Affiliation(s)
- Letizia Della Longa
- Department of Developmental Psychology and Socialization, University of Padova, Padua, Italy
| | - Irene Valori
- Department of Developmental Psychology and Socialization, University of Padova, Padua, Italy
| | - Teresa Farroni
- Department of Developmental Psychology and Socialization, University of Padova, Padua, Italy
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Vlahovic S, Suznjevic M, Skorin-Kapov L. A survey of challenges and methods for Quality of Experience assessment of interactive VR applications. JOURNAL ON MULTIMODAL USER INTERFACES 2022; 16. [PMCID: PMC9051501 DOI: 10.1007/s12193-022-00388-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
User acceptance of virtual reality (VR) applications is dependent on multiple aspects, such as usability, enjoyment, and cybersickness. To fully realize the disruptive potential of VR technology in light of recent technological advancements (e.g., advanced headsets, immersive graphics), gaining a deeper understanding of underlying factors and dimensions impacting and contributing to the overall end-user experience is of great benefit to hardware manufacturers, software and content developers, and service providers. To provide insight into user behaviour and preferences, researchers conduct user studies exploring the influence of various user-, system-, and context-related factors on the overall Quality of Experience (QoE) and its dimensions. When planning and executing such studies, researchers are faced with numerous methodological challenges related to study design aspects, such as specification of dependant and independent variables, subjective and objective assessment methods, preparation of test materials, test environment, and participant recruitment. Approaching these challenges from a multidisciplinary perspective, this paper reviews different aspects of performing perception-based QoE assessment for interactive VR applications and presents options and recommendations for research methodology design. We provide an overview of different influence factors and dimensions that may affect the overall QoE, with a focus on presence, immersion, and discomfort. Furthermore, we address ethical and practical issues regarding participant choice and test material, present different assessment methods and measures commonly used in VR research, and discuss approaches to choosing study duration and location. Lastly, we provide a concise analysis of key challenges that need to be addressed in future studies centered around VR QoE.
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Affiliation(s)
- Sara Vlahovic
- Faculty of Electrical Engineering and Computing, University of Zagreb, Unska 3, 10000 Zagreb, Croatia
| | - Mirko Suznjevic
- Faculty of Electrical Engineering and Computing, University of Zagreb, Unska 3, 10000 Zagreb, Croatia
| | - Lea Skorin-Kapov
- Faculty of Electrical Engineering and Computing, University of Zagreb, Unska 3, 10000 Zagreb, Croatia
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28
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Chang ZY, Kang GCY, Koh EYL, Fong RJK, Tang J, Goh CK, Tan NC. Immersive Virtual Reality in Alleviating Pain and Anxiety in Children During Immunization in Primary Care: A Pilot Randomized Controlled Trial. Front Pediatr 2022; 10:847257. [PMID: 35402359 PMCID: PMC8990251 DOI: 10.3389/fped.2022.847257] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Pediatric immunization is often associated with significant fear and anxiety among the children and their parents. Their distress may potentially affect their adherence to the childhood immunization schedule and the acceptance of other recommended vaccines by physicians. OBJECTIVE The study primarily aimed to assess the feasibility of using immersive virtual reality (VR) during immunization in children in primary care. The secondary aim was to determine the effectiveness of immersive VR in alleviating pain and anxiety among children, reduction of anxiety of their parents and attending nurses during immunization compared to usual care without VR. METHODS A pilot open-label randomized control trial was conducted at a public primary care clinic in Singapore. Thirty children, aged 4-10 years were randomized to an intervention group (n = 15) using VR and a control group (n = 15) without VR during immunization. Feasibility was assessed by the response rate to the use of VR. The Faces Pain Scale-Revised (FPS-R) and the Children's Fear Scale (CFS) were used to determine their pain and anxiety, respectively. The anxiety level of their accompanying parents and attending nurses were evaluated using Visual Analog Scale (VAS) prior and post-immunization of these children. The FPS-R and CFS scores, and anxiety assessment for parents and nurses were assessed using Mann-Whitney U test. Wilcoxon signed rank test was used to assess the difference in the nurses' experience of using the VR application. RESULTS One child refused to use the VR equipment, constituting a rejection rate of 6.7% (1/15) but no adverse event occurred in the intervention arm. The overall response rate of 88% (30/34) when the parents were approached to participate in the study, indicating feasibility of using VR in childhood immunization. In the intervention group compared to the control group, the change in scores for CFS (median -1, IQR -2 to 0; P = 0.04), parental VAS (median -4, IQR -5 to -1; P = 0.04) were significantly decreased. After immunization, nurses scored favorably for VR, in terms of simplicity (median 9.5, IQR 5.72 to 10; P = 0.01), acceptability (median 10, IQR 5 to 10; P = 0.005) and willingness to use VR in the future (median 10, IQR 5 to 10; P = 0.02). CONCLUSION Immersive VR is feasible, safe and effective in alleviating anxiety among the children and parents. Nurses viewed the application of VR in childhood immunization favorably. CLINICAL TRIAL REGISTRATION [https://clinicaltrials.gov/ct2/show/NCT04748367], identifier [NCT04748367].
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Affiliation(s)
- Zi Ying Chang
- SingHealth Polyclinics, Singapore, Singapore.,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
| | - Gary Chun-Yun Kang
- SingHealth Polyclinics, Singapore, Singapore.,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
| | | | - Rodney Jin Kai Fong
- SingHealth Polyclinics, Singapore, Singapore.,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
| | | | | | - Ngiap Chuan Tan
- SingHealth Polyclinics, Singapore, Singapore.,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
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Candy TR, Cormack LK. Recent understanding of binocular vision in the natural environment with clinical implications. Prog Retin Eye Res 2021; 88:101014. [PMID: 34624515 PMCID: PMC8983798 DOI: 10.1016/j.preteyeres.2021.101014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/26/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
Technological advances in recent decades have allowed us to measure both the information available to the visual system in the natural environment and the rich array of behaviors that the visual system supports. This review highlights the tasks undertaken by the binocular visual system in particular and how, for much of human activity, these tasks differ from those considered when an observer fixates a static target on the midline. The everyday motor and perceptual challenges involved in generating a stable, useful binocular percept of the environment are discussed, together with how these challenges are but minimally addressed by much of current clinical interpretation of binocular function. The implications for new technology, such as virtual reality, are also highlighted in terms of clinical and basic research application.
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Affiliation(s)
- T Rowan Candy
- School of Optometry, Programs in Vision Science, Neuroscience and Cognitive Science, Indiana University, 800 East Atwater Avenue, Bloomington, IN, 47405, USA.
| | - Lawrence K Cormack
- Department of Psychology, Institute for Neuroscience, and Center for Perceptual Systems, The University of Texas at Austin, Austin, TX, 78712, USA.
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Miehlbradt J, Cuturi LF, Zanchi S, Gori M, Micera S. Immersive virtual reality interferes with default head-trunk coordination strategies in young children. Sci Rep 2021; 11:17959. [PMID: 34580325 PMCID: PMC8476578 DOI: 10.1038/s41598-021-96866-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 08/10/2021] [Indexed: 11/09/2022] Open
Abstract
The acquisition of postural control is an elaborate process, which relies on the balanced integration of multisensory inputs. Current models suggest that young children rely on an 'en-block' control of their upper body before sequentially acquiring a segmental control around the age of 7, and that they resort to the former strategy under challenging conditions. While recent works suggest that a virtual sensory environment alters visuomotor integration in healthy adults, little is known about the effects on younger individuals. Here we show that this default coordination pattern is disrupted by an immersive virtual reality framework where a steering role is assigned to the trunk, which causes 6- to 8-year-olds to employ an ill-adapted segmental strategy. These results provide an alternate trajectory of motor development and emphasize the immaturity of postural control at these ages.
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Affiliation(s)
- Jenifer Miehlbradt
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne, 1202, Geneva, Switzerland. .,Brain Electrophysiology Attention Movement Laboratory, Institute of Psychology, Université de Lausanne, 1015, Lausanne, Switzerland.
| | - Luigi F Cuturi
- Unit for Visually Impaired People, Center for Human Technologies, Fondazione Istituto Italiano di Tecnologia, 16152, Genova, Italy
| | - Silvia Zanchi
- Unit for Visually Impaired People, Center for Human Technologies, Fondazione Istituto Italiano di Tecnologia, 16152, Genova, Italy.,Robotics Brain and Cognitive Sciences, Center for Human Technologies, Fondazione Istituto Italiano di Tecnologia, 16152, Genova, Italy.,DIBRIS Department, Università di Genova, 16145, Genova, Italy
| | - Monica Gori
- Unit for Visually Impaired People, Center for Human Technologies, Fondazione Istituto Italiano di Tecnologia, 16152, Genova, Italy
| | - Silvestro Micera
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne, 1202, Geneva, Switzerland.,The Biorobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, 56025, Pontedera, Italy
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Ong CW, Tan MCJ, Lam M, Koh VTC. Applications of Extended Reality in Ophthalmology: Systematic Review. J Med Internet Res 2021; 23:e24152. [PMID: 34420929 PMCID: PMC8414293 DOI: 10.2196/24152] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/19/2020] [Accepted: 04/06/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Virtual reality, augmented reality, and mixed reality make use of a variety of different software and hardware, but they share three main characteristics: immersion, presence, and interaction. The umbrella term for technologies with these characteristics is extended reality. The ability of extended reality to create environments that are otherwise impossible in the real world has practical implications in the medical discipline. In ophthalmology, virtual reality simulators have become increasingly popular as tools for surgical education. Recent developments have also explored diagnostic and therapeutic uses in ophthalmology. OBJECTIVE This systematic review aims to identify and investigate the utility of extended reality in ophthalmic education, diagnostics, and therapeutics. METHODS A literature search was conducted using PubMed, Embase, and Cochrane Register of Controlled Trials. Publications from January 1, 1956 to April 15, 2020 were included. Inclusion criteria were studies evaluating the use of extended reality in ophthalmic education, diagnostics, and therapeutics. Eligible studies were evaluated using the Oxford Centre for Evidence-Based Medicine levels of evidence. Relevant studies were also evaluated using a validity framework. Findings and relevant data from the studies were extracted, evaluated, and compared to determine the utility of extended reality in ophthalmology. RESULTS We identified 12,490 unique records in our literature search; 87 met final eligibility criteria, comprising studies that evaluated the use of extended reality in education (n=54), diagnostics (n=5), and therapeutics (n=28). Of these, 79 studies (91%) achieved evidence levels in the range 2b to 4, indicating poor quality. Only 2 (9%) out of 22 relevant studies addressed all 5 sources of validity evidence. In education, we found that ophthalmic surgical simulators demonstrated efficacy and validity in improving surgical performance and reducing complication rates. Ophthalmoscopy simulators demonstrated efficacy and validity evidence in improving ophthalmoscopy skills in the clinical setting. In diagnostics, studies demonstrated proof-of-concept in presenting ocular imaging data on extended reality platforms and validity in assessing the function of patients with ophthalmic diseases. In therapeutics, heads-up surgical systems had similar complication rates, procedural success rates, and outcomes in comparison with conventional ophthalmic surgery. CONCLUSIONS Extended reality has promising areas of application in ophthalmology, but additional high-quality comparative studies are needed to assess their roles among incumbent methods of ophthalmic education, diagnostics, and therapeutics.
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Affiliation(s)
- Chee Wui Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Marcus Chun Jin Tan
- Department of Ophthalmology, National University Hospital, Singapore, Singapore
| | - Michael Lam
- Department of Ophthalmology, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Victor Teck Chang Koh
- Department of Ophthalmology, National University Hospital, Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Pallavicini F, Pepe A, Mantovani F. Commercial Off-The-Shelf Video Games for Reducing Stress and Anxiety: Systematic Review. JMIR Ment Health 2021; 8:e28150. [PMID: 34398795 PMCID: PMC8406113 DOI: 10.2196/28150] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/26/2021] [Accepted: 05/22/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Using commercial off-the-shelf video games rather than custom-made computer games could have several advantages for reducing stress and anxiety, including their low cost, advanced graphics, and the possibility to reach millions of individuals worldwide. However, it is important to emphasize that not all commercial video games are equal, and their effects strongly depend on specific characteristics of the games. OBJECTIVE The aim of this systematic review was to describe the literature on the use of commercial off-the-shelf video games for diminishing stress and anxiety, examining the research outcomes along with critical variables related to computer game characteristics (ie, genre, platform, time of play). METHODS A systematic search of the literature was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The search databases were PsycINFO, Web of Science, Medline, IEEExplore, and the Cochrane Library. The search string was: [("video game*") OR ("computer game*")] AND [("stress") OR ("anxiety") OR ("relaxation")] AND [("study") OR ("trial") OR ("training")]. RESULTS A total of 28 studies met the inclusion criteria for the publication period 2006-2021. The findings demonstrate the benefit of commercial off-the-shelf video games for reducing stress in children, adults, and older adults. The majority of the retrieved studies recruited young adults, and fewer studies have involved children, middle-aged adults, and older adults. In addition to exergames and casual video games, other genres of commercial off-the-shelf games helped to reduce stress and anxiety. CONCLUSIONS Efficacy in reducing stress and anxiety has been demonstrated not only for exergames and casual video games but also for other genres such as action games, action-adventure games, and augmented reality games. Various gaming platforms, including consoles, PCs, smartphones, mobile consoles, and virtual reality systems, have been used with positive results. Finally, even single and short sessions of play had benefits in reducing stress and anxiety. TRIAL REGISTRATION International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY202130081; https://inplasy.com/?s=INPLASY202130081.
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Affiliation(s)
- Federica Pallavicini
- Department of Human Sciences for Education "Riccardo Massa", University of Milano Bicocca, Milano, Italy
| | - Alessandro Pepe
- Department of Human Sciences for Education "Riccardo Massa", University of Milano Bicocca, Milano, Italy
| | - Fabrizia Mantovani
- Department of Human Sciences for Education "Riccardo Massa", University of Milano Bicocca, Milano, Italy
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Kaimara P, Oikonomou A, Deliyannis I. Could virtual reality applications pose real risks to children and adolescents? A systematic review of ethical issues and concerns. VIRTUAL REALITY 2021; 26:697-735. [PMID: 34366688 PMCID: PMC8328811 DOI: 10.1007/s10055-021-00563-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 07/20/2021] [Indexed: 06/13/2023]
Abstract
Virtual reality technologies (VRTs) are high-tech human-computer interfaces used to develop digital content and can be applied to multiple different areas, often offering innovative solutions to existing problems. A wide range of digital games is being also developed with VRTs and together with their components, the games' structural elements are appealing to children and engaging them more in virtual worlds. Our research interest is directed towards children's development and the effects of VRTs within gaming environments. Contemporary psychology studies perceive human development as a holistic and lifelong process with important interrelationships between physical, mental, social and emotional aspects. For the objectives and scope of this work, we examine children development across three domains: physical, cognitive and psychosocial. In this context, the authors review the literature on the impact of VRTs on children, in terms of software and hardware. Since research requires an wide-ranging approach, we study the evidence reported on the brain and neural structure, knowledge, behaviour, pedagogy, academic performance, and wellness. Our main concern is to outline the emerging ethical issues and worries of parents, educators, ophthalmologists, neurologists, psychologists, paediatricians and all relevant scientists, as well as the industry's views and actions. The systematic review was performed on the databases Scopus, IEEE Xplore, PubMed, and Google Scholar from 2010 to 2020 and 85 studies were selected. The review concluded that findings remain contradictory especially for the psychosocial domain. Official recommendations from organizations and well-documented researches by academics on child well-being are reassuring if health and safety specifications and particularly the time limit are met. Research is still ongoing, constantly updated and consist of a priority for the scientific community given that technology evolves.
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Affiliation(s)
- Polyxeni Kaimara
- Department of Audio and Visual Arts, Ionian University, Tsirigoti Sq. 7, 49100 Corfu, Greece
| | - Andreas Oikonomou
- School of Pedagogical and Technological Education (ASPETE), Alexandrou Papanastasiou 13, Thessaloniki, Greece
| | - Ioannis Deliyannis
- Department of Audio and Visual Arts, Ionian University, Tsirigoti Sq. 7, 49100 Corfu, Greece
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Effects of prolonged use of virtual reality smartphone-based head-mounted display on visual parameters: a randomised controlled trial. Sci Rep 2021; 11:15382. [PMID: 34321504 PMCID: PMC8319184 DOI: 10.1038/s41598-021-94680-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 07/13/2021] [Indexed: 12/19/2022] Open
Abstract
We investigated the effects of using a virtual reality smartphone-based head-mounted display (VR SHMD) device for 2 h on visual parameters. Fifty-eight healthy volunteers were recruited. The participants played games using VR SHMD or smartphones for 2 h on different days. Visual parameters including refraction, accommodation, convergence, stereopsis, and ocular alignment and measured choroidal thickness before and after the use of VR SHMD or smartphones were investigated. Subjective symptoms were assessed using questionnaires. We analyzed the differences in visual parameters before and after the use of VR SHMD or smartphones and correlations between baseline visual parameters and those after the use of the devices. Significant changes were observed in near-point convergence and accommodation, exophoric deviation, stereopsis, and accommodative lag after the use of VR SHMD but not after that of smartphones. The subjective discomfort associated with dry eye and neurologic symptoms were more severe in the VR group than in the smartphone group. There were no significant changes in refraction and choroidal thickness after the use of either of the two devices. The poorer the participants' accommodation and convergence ability the greater the resistance to changes in these visual parameters, and participants with a large exophoria were more prone to worsening of exophoria than those with a small exophoria.
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Clinical predictors of cybersickness in virtual reality (VR) among highly stressed people. Sci Rep 2021; 11:12139. [PMID: 34108520 PMCID: PMC8190110 DOI: 10.1038/s41598-021-91573-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 05/28/2021] [Indexed: 11/18/2022] Open
Abstract
The use of virtual reality (VR) in the treatment of psychiatric disorders is increasing, and cybersickness has emerged as an important obstacle to overcome. However, the clinical factors affecting cybersickness are still not well understood. In this study, we investigated clinical predictors and adaptation effect of cybersickness during VR application in highly stressed people. Eighty-three healthy adult participants with high stress level were recruited. At baseline, we conducted psychiatric, ophthalmologic, and otologic evaluations and extracted physiological parameters. We divided the participants into two groups according to the order of exposure to VR videos with different degrees of shaking and repetitively administered the Simulator Sickness Questionnaire (SSQ) and the Fast Motion sickness Scale (FMS). There was no significant difference in changes in the SSQ or the FMS between groups. The 40–59 years age group showed a greater increase in FMS compared to the 19–39 years age group. Smoking was negatively associated with cybersickness, and a high Positive Affect and Negative Affect Schedule score was positively associated with cybersickness. In conclusion, changing the intensity of shaking in VR did not affect cybersickness. While smoking was a protective factor, more expression of affect was a risk factor for cybersickness.
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Iskander M, Ogunsola T, Ramachandran R, McGowan R, Al-Aswad LA. Virtual Reality and Augmented Reality in Ophthalmology: A Contemporary Prospective. Asia Pac J Ophthalmol (Phila) 2021; 10:244-252. [PMID: 34383716 PMCID: PMC9167643 DOI: 10.1097/apo.0000000000000409] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Most published systematic reviews have focused on the use of virtual reality (VR)/augmented reality (AR) technology in ophthalmology as it relates to surgical training. To date, this is the first review that investigates the current state of VR/AR technology applied more broadly to the entire field of ophthalmology. METHODS PubMed, Embase, and CINAHL databases were searched systematically from January 2014 through December 1, 2020. Studies that discussed VR and/or AR as it relates to the field of ophthalmology and provided information on the technology used were considered. Abstracts, non-peer-reviewed literature, review articles, studies that reported only qualitative data, and studies without English translations were excluded. RESULTS A total of 77 studies were included in this review. Of these, 28 evaluated the use of VR/AR in ophthalmic surgical training/assessment and guidance, 7 in clinical training, 23 in diagnosis/screening, and 19 in treatment/therapy. 15 studies used AR, 61 used VR, and 1 used both. Most studies focused on the validity and usability of novel technologies. CONCLUSIONS Ophthalmology is a field of medicine that is well suited for the use of VR/AR. However, further longitudinal studies examining the practical feasibility, efficacy, and safety of such novel technologies, the cost-effectiveness, and medical/legal considerations are still needed. We believe that time will indeed foster further technological advances and lead to widespread use of VR/AR in routine ophthalmic practice.
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Affiliation(s)
- Mina Iskander
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, US
| | - Titilola Ogunsola
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, US
| | - Rithambara Ramachandran
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, US
| | - Richard McGowan
- Department of Epidemiology and Health Promotion, NYU College of Dentistry, New York, New York, US
| | - Lama A. Al-Aswad
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, US
- Department of Population Health, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, US
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Gold JI, Annick ET, Lane AS, Ho K, Marty RT, Espinoza JC. "Doc McStuffins: Doctor for a Day" Virtual Reality (DocVR) for Pediatric Preoperative Anxiety and Satisfaction: Pediatric Medical Technology Feasibility Study. J Med Internet Res 2021; 23:e25504. [PMID: 33730687 PMCID: PMC8094020 DOI: 10.2196/25504] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/06/2021] [Accepted: 03/16/2021] [Indexed: 12/16/2022] Open
Abstract
Background Preoperative anxiety is a common occurrence among children and is associated with a host of maladaptive postoperative behaviors. Consequently, increased attention has been placed on interventions to reduce preoperative anxiety and its associated outcomes. Child Life preparation prior to surgery includes evidence-based practices such as age-appropriate distraction and therapeutic play. Virtual reality (VR) is a promising addition to the Child Life toolbox to address anxiety prior to surgery. The current study evaluates the implementation and feasibility of a VR experience, “Doc McStuffins: Doctor for a Day Virtual Reality Experience” (DocVR), developed by Disney Junior in collaboration with Children’s Hospital Los Angeles, to target pediatric preoperative anxiety. Objective The primary aim of this study was to examine the feasibility and efficacy of DocVR for preoperative anxiety. A secondary aim was to improve patient, caregiver, and health care provider satisfaction with the preoperative experience. Methods In this study, 51 patients (age 6-14 years) scheduled for surgery in the ambulatory surgery center and the main operating room at Children’s Hospital Los Angeles were approached to participate in Disney’s DocVR experience. The patients played the DocVR experience for an average of 18 minutes (3-55 minutes). Irrespective of surgical procedure, patients and their families were eligible, as long as they had no known marked cognitive or visual impairments that would interfere with completing the survey and engaging in the DocVR experience. Results Patients who tried the DocVR experience (n=51) responded overwhelmingly positively to both the VR technology and to the game itself. Patients experienced a statistically significant decrease in anxiety following DocVR game play (Z=–3.26, P=.001). On the Facial Affective Scale, the percentage of patients who chose the face with the most positive facial expression to represent their affect increased from 23% (12/51) pre-VR to 49% (25/47) post-VR. Furthermore, 97% (38/39) of patients reported feeling more comfortable at the hospital, and 74% (28/38) reported feeling less scared at the hospital after playing the game. The game was enjoyed by 94% (46/49) of patients, and 88% (30/34) of patients reported feeling both “Interested” and “Involved” in the game. Conclusions DocVR is a feasible and beneficial VR experience to relieve pediatric preoperative anxiety and improve satisfaction in the preoperative area. The VR experience resulted in a decrease in overall anxiety and an increase in overall positive affect during the preoperative time. Patients also responded positively to the game, confirming their interest in the content and affirming the quality of the DocVR experience. The positive response to the game indicates that DocVR has the potential to make the overall preoperative experience less anxiety-producing and more comfortable, which leads to improved patient satisfaction. Naturally, improved patient outcomes lead to improved caregiver and health care provider satisfaction.
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Affiliation(s)
- Jeffrey I Gold
- Department of Anesthesiology Critical Care Medicine, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, United States.,Departments of Anesthesiology, Pediatrics, and Psychiatry & Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Erin T Annick
- Department of Anesthesiology Critical Care Medicine, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Arianna S Lane
- Department of Anesthesiology Critical Care Medicine, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Katherine Ho
- Department of Anesthesiology Critical Care Medicine, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Ryan T Marty
- Department of Anesthesiology Critical Care Medicine, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Juan C Espinoza
- Division of General Pediatrics, Department of Pediatrics, The Saban Research Institute at Children's Hospital Los Angeles, The West Coast Consortium for Technology & Innovation Pediatrics, Los Angeles, CA, United States.,Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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Stimuli Characteristics and Psychophysical Requirements for Visual Training in Amblyopia: A Narrative Review. J Clin Med 2020; 9:jcm9123985. [PMID: 33316960 PMCID: PMC7764820 DOI: 10.3390/jcm9123985] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/16/2020] [Accepted: 12/07/2020] [Indexed: 12/03/2022] Open
Abstract
Active vision therapy using perceptual learning and/or dichoptic or binocular environments has shown its potential effectiveness in amblyopia, but some doubts remain about the type of stimuli and the mode and sequence of presentation that should be used. A search was performed in PubMed, obtaining 143 articles with information related to the stimuli used in amblyopia rehabilitation, as well as to the neural mechanisms implied in such therapeutic process. Visual deficits in amblyopia and their neural mechanisms associated are revised, including visual acuity loss, contrast sensitivity reduction and stereopsis impairment. Likewise, the most appropriate stimuli according to the literature that should be used for an efficient rehabilitation of the amblyopic eye are described in detail, including optotypes, Gabor’s patches, random-dot stimuli and Vernier’s stimuli. Finally, the properties of these stimuli that can be modified during the visual training are discussed, as well as the psychophysical method of their presentation and the type of environment used (perceptual learning, dichoptic stimulation or virtual reality). Vision therapy using all these revised concepts can be an effective option for treating amblyopia or accelerating the treatment period when combining with patching. It is essential to adapt the stimuli to the patient’s individual features in both monocular and binocular training.
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Long Y, Shen Y, Guo D, Wang X, Gu Y. The Effects of Consumer-grade Virtual Reality Headsets on Adult Visual Function. Semin Ophthalmol 2020; 35:170-173. [PMID: 32569490 DOI: 10.1080/08820538.2020.1776342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Consumer-grade virtual reality (VR) headset is being used with increasing frequency nowadays, however, the effect on visual function is not clear. OBJECTIVES We here investigate whether using VR headset changes adults' visual function and take into account the possible factors. METHODS We compared the uncorrected distant visual acuity (UDVA), uncorrected near visual acuity (UNVA), best corrected visual acuity (BCVA), low contrast visual acuity (LCVA), glare visual acuity (GVA), refractive error (RE), amplitude of accommodation (ACC), and pupil diameter (PD) before and after using VR headset 10 mintues at a time twice per day for 2 successive weeks in 40 volunteers with a mean age of 28.6 years. Differences in these 8 parameters before vs. after VR headset use were analyzed using SPSS 22.0. RESULTS In our study, we found that the amplitude of accommodation had significantly increased by 0.53 (F = 5.673; P = .006) after using, while visual acuity, refractive error and pupil diameter did not show statistically significant changes (P > .05). Correlation test showed that there was no significant correlation between any two parameters on visual function. CONCLUSION It is discovered that using a consumer-grade VR headset 10 minutes at a time twice daily for 2 weeks improved the amplitude of accommodation of adults dramatically, while neither visual acuity nor refractive error was affected. ABBREVIATIONS VR: visual reality; UDVA: uncorrected distant visual acuity; UNVA: uncorrected near visual acuity; BCVA: best corrected visual acuity; LCVA: low contrast visual acuity; GVA: glare visual acuity; RE: refractive error; ACC: amplitude of accommodation; PD: pupil diameter; 3D: three-dimensional; VDTS: visual display terminal syndrome; FOV: field of view; SEQ: spherical equivalent diopter.
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Affiliation(s)
- Yan Long
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University , Hangzhou, Zhejiang, China
| | - Ye Shen
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University , Hangzhou, Zhejiang, China
| | - DongYu Guo
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University , Hangzhou, Zhejiang, China
| | - XiaWei Wang
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University , Hangzhou, Zhejiang, China
| | - Yangshun Gu
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University , Hangzhou, Zhejiang, China
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Tychsen L, Thio LL. Concern of Photosensitive Seizures Evoked by 3D Video Displays or Virtual Reality Headsets in Children: Current Perspective. Eye Brain 2020; 12:45-48. [PMID: 32104130 PMCID: PMC7023866 DOI: 10.2147/eb.s233195] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 12/12/2019] [Indexed: 11/23/2022] Open
Abstract
This review assesses the risk of a photic-induced seizure in a child during viewing of 3D (binocular 3 dimensional, stereoscopic) movies or games, either on standard video displays or when wearing a virtual reality (VR) headset. Studies published by pediatric epilepsy experts emphasize the low risk of 3D viewing even for children with known photosensitive epilepsy (PSE). The low incidence of PSE is noteworthy because the number of hours devoted to 2D or 3D screen viewing and/or VR headset use by children worldwide has increased markedly over the last decade. The medical literature does not support the notion that VR headset use poses a risk for PSE.
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Affiliation(s)
- Lawrence Tychsen
- Department of Ophthalmology and Visual Sciences
- Department of Pediatrics
- Department of Neuroscience
| | - Liu Lin Thio
- Department of Pediatrics
- Department of Neuroscience
- Department of Neurology, St. Louis Children’s Hospital, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
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Coco-Martin MB, Piñero DP, Leal-Vega L, Hernández-Rodríguez CJ, Adiego J, Molina-Martín A, de Fez D, Arenillas JF. The Potential of Virtual Reality for Inducing Neuroplasticity in Children with Amblyopia. J Ophthalmol 2020; 2020:7067846. [PMID: 32676202 PMCID: PMC7341422 DOI: 10.1155/2020/7067846] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/02/2020] [Accepted: 06/11/2020] [Indexed: 12/12/2022] Open
Abstract
In recent years, virtual reality (VR) has emerged as a new safe and effective tool for neurorehabilitation of different childhood and adulthood conditions. VR-based therapies can induce cortical reorganization and promote the activation of different neuronal connections over a wide range of ages, leading to contrasted improvements in motor and functional skills. The use of VR for the visual rehabilitation in amblyopia has been investigated in the last years, with the potential of using serious games combining perceptual learning and dichoptic stimulation. This combination of technologies allows the clinician to measure, treat, and control changes in interocular suppression, which is one of the factors leading to cortical alterations in amblyopia. Several clinical researches on this issue have been conducted, showing the potential of promoting visual acuity, contrast sensitivity, and stereopsis improvement. Indeed, several systems have been evaluated for amblyopia treatment including the use of different commercially available types of head mounted displays (HMDs). These HMDs are mostly well tolerated by patients during short exposures and do not cause significant long-term side effects, although their use has been occasionally associated with some visual discomfort and other complications in certain types of subjects. More studies are needed to confirm these promising therapies in controlled randomized clinical trials, with special emphasis on the definition of the most adequate planning for obtaining an effective recovery of the visual and binocular function.
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Affiliation(s)
- María B. Coco-Martin
- 1Group of Applied Clinical Neurosciences and Advanced Data Analysis, Neurology Department, Faculty of Medicine, University of Valladolid, Valladolid, Spain
| | - David P. Piñero
- 2Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- 3Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
| | - Luis Leal-Vega
- 1Group of Applied Clinical Neurosciences and Advanced Data Analysis, Neurology Department, Faculty of Medicine, University of Valladolid, Valladolid, Spain
| | - Carlos J. Hernández-Rodríguez
- 2Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- 3Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
| | - Joaquin Adiego
- 4Group of Applied Clinical Neurosciences and Advanced Data Analysis, Computer Science Department, School of Computing, University of Valladolid, Valladolid, Spain
| | - Ainhoa Molina-Martín
- 2Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Dolores de Fez
- 2Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Juan F. Arenillas
- 1Group of Applied Clinical Neurosciences and Advanced Data Analysis, Neurology Department, Faculty of Medicine, University of Valladolid, Valladolid, Spain
- 5Department of Neurology, Stroke Unit and Stroke Program, University Hospital, University of Valladolid, Valladolid, Spain
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