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Vallageas V, Aissaoui R, Willaert I, Labbe DR. Embodying a self-avatar with a larger leg: its impacts on motor control and dynamic stability. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2024; 30:2066-2076. [PMID: 38437132 DOI: 10.1109/tvcg.2024.3372084] [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
Several studies have shown that users of immersive virtual reality can feel high levels of embodiment in self-avatars that have different morphological proportions than those of their actual bodies. Deformed and unrealistic morphological modifications are accepted by embodied users, underlying the adaptability of one's mental map of their body (body schema) in response to incoming sensory feedback. Before initiating a motor action, the brain uses the body schema to plan and sequence the necessary movements. Therefore, embodiment in a self-avatar with a different morphology, such as one with deformed proportions, could lead to changes in motor planning and execution. In this study, we aimed to measure the effects on movement planning and execution of embodying a self-avatar with an enlarged lower leg on one side. Thirty participants embodied an avatar without any deformations, and with an enlarged dominant or non-dominant leg, in randomized order. Two different levels of embodiment were induced, using synchronous or asynchronous visuotactile stimuli. In each condition, participants performed a gait initiation task. Their center of mass and center of pressure were measured, and the margin of stability (MoS) was computed from these values. Their perceived level of embodiment was also measured, using a validated questionnaire. Results show no significant changes on the biomechenical variables related to dynamic stability. Embodiment scores decreased with asynchronous stimuli, without impacting the measures related to stability. The body schema may not have been impacted by the larger virtual leg. However, deforming the self-avatar's morphology could have important implications when addressing individuals with impaired physical mobility by subtly influencing action execution during a rehabilitation protocol.
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Demir-Kaymak Z, Turan Z, Çit G, Akyaman S. Midwifery students' opinions about episiotomy training and using virtual reality: A qualitative study. NURSE EDUCATION TODAY 2024; 132:106013. [PMID: 37926004 DOI: 10.1016/j.nedt.2023.106013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/16/2023] [Accepted: 10/29/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND The use of simulations and digital technologies in education in the health field is common. Virtual reality technologies, which offer three-dimensional (immersive) simulation environments, have become easily accessible and cost-effective in recent years and this has this has increased this use of this technology in educating students who will work in the health field. OBJECTIVES The aim of the study was to investigate the views of midwifery undergraduate students about the current episiotomy education they received and their expectations when related education is given with virtual reality technology. PARTICIPANTS Students in their third or fourth year of undergraduate midwifery who have taken prior episiotomy education. DESIGN The research was carried out as a phenomenological design for qualitative research. Data were collected between December 2022 and January 2023 at a public university in Türkiye, with institutional ethical approval. METHODS Participants were asked open-ended questions to collect qualitative data. Data were analysed using content analysis by MaxQDA. RESULTS Data were analysed, and four main themes were determined. These main themes consisted of 16 sub-themes, and included midwifery department students' positive and negative opinions about the current episiotomy education and their expectations in cases where the education is carried out using virtual education environments. CONCLUSIONS Although the current episiotomy education has positive aspects, such as suturing ability, it does not give a sense of reality, is not repetitive, and has many negative aspects, such as cost. It was determined that in virtual reality episiotomy education environments, students' expectations are similar to the real birth environment, and they have expectations of simulating risky situations because they think it will be more useful.
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Affiliation(s)
- Zeliha Demir-Kaymak
- Department of Computer Education and Instructional Technologies, Faculty of Education, Sakarya University, Sakarya, Türkiye.
| | - Zekiye Turan
- Department of Nursing, Faculty of Health Sciences, Sakarya University, Sakarya, Türkiye.
| | - Gülüzar Çit
- Department of Software Engineering, Faculty of Computer and Information Sciences, Sakarya University, Sakarya, Türkiye.
| | - Serefraz Akyaman
- Department of Architecture, Faculty of Art Design and Architecture, Sakarya University, Sakarya, Türkiye.
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Lülsdorff K, Junker FB, Studer B, Wittenberg H, Pickenbrock H, Schmidt-Wilcke T. Neurorehabilitation of the upper extremity - immersive virtual reality vs. electromechanically assisted training. A comparative study. Front Neurol 2023; 14:1290637. [PMID: 38187150 PMCID: PMC10768030 DOI: 10.3389/fneur.2023.1290637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024] Open
Abstract
Background Severe paresis of the contralesional upper extremity is one of the most common and debilitating post-stroke impairments. The need for cost-effective high-intensity training is driving the development of new technologies, which can complement and extent conventional therapies. Apart from established methods using electromechanical devices, immersive virtual reality (iVR) systems hold promise to provide cost-efficient high-intensity arm training. Objective We investigated whether iVR-based arm training yields at least equivalent effects on upper extremity function as compared to an electromechanically assisted training in stroke patients with severe arm paresis. Methods 52 stroke patients with severe arm paresis received a total of ten daily group therapy sessions over a period of three weeks, which consisted of 20 min of conventional therapy and 20 min of either electromechanically assisted (ARMEOSpring®) or iVR-based (CUREO®) arm training. Changes in upper extremity function was assessed using the Action Research Arm Test (ARAT) and user acceptance was measured with the User Experience Questionnaire (UEQ). Results iVR-based training was not inferior to electromechanically assisted training. We found that 84% of patients treated with iVR and 50% of patients treated with electromechanically assisted arm training showed a clinically relevant improvement of upper extremity function. This difference could neither be attributed to differences between the groups regarding age, gender, duration after stroke, affected body side or ARAT scores at baseline, nor to differences in the total amount of therapy provided. Conclusion The present study results show that iVR-based arm training seems to be a promising addition to conventional therapy. Potential mechanisms by which iVR unfolds its effects are discussed.
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Affiliation(s)
- Kira Lülsdorff
- Mauritius Hospital and Neurorehabilitation Center Meerbusch, Meerbusch, Germany
| | - Frederick Benjamin Junker
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
| | - Bettina Studer
- Mauritius Hospital and Neurorehabilitation Center Meerbusch, Meerbusch, Germany
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
| | - Heike Wittenberg
- Mauritius Hospital and Neurorehabilitation Center Meerbusch, Meerbusch, Germany
| | - Heidrun Pickenbrock
- Mauritius Hospital and Neurorehabilitation Center Meerbusch, Meerbusch, Germany
| | - Tobias Schmidt-Wilcke
- Mauritius Hospital and Neurorehabilitation Center Meerbusch, Meerbusch, Germany
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
- Center of Neurology, District Hospital Mainkofen, Deggendorf, Germany
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Flores-Cortes M, Guerra-Armas J, Pineda-Galan C, La Touche R, Luque-Suarez A. Sensorimotor Uncertainty of Immersive Virtual Reality Environments for People in Pain: Scoping Review. Brain Sci 2023; 13:1461. [PMID: 37891829 PMCID: PMC10604973 DOI: 10.3390/brainsci13101461] [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: 09/14/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
INTRODUCTION Decision making and action execution both rely on sensory information, and their primary objective is to minimise uncertainty. Virtual reality (VR) introduces uncertainty due to the imprecision of perceptual information. The concept of "sensorimotor uncertainty" is a pivotal element in the interplay between perception and action within the VR environment. The role of immersive VR in the four stages of motor behaviour decision making in people with pain has been previously discussed. These four processing levels are the basis to understand the uncertainty that a patient experiences when using VR: sensory information, current state, transition rules, and the outcome obtained. METHODS This review examines the different types of uncertainty that a patient may experience when they are immersed in a virtual reality environment in a context of pain. Randomised clinical trials, a secondary analysis of randomised clinical trials, and pilot randomised clinical trials related to the scope of Sensorimotor Uncertainty in Immersive Virtual Reality were included after searching. RESULTS Fifty studies were included in this review. They were divided into four categories regarding the type of uncertainty the intervention created and the stage of the decision-making model. CONCLUSIONS Immersive virtual reality makes it possible to alter sensorimotor uncertainty, but studies of higher methodological quality are needed on this topic, as well as an exploration into the patient profile for pain management using immersive VR.
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Affiliation(s)
- Mar Flores-Cortes
- Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain
| | | | | | - Roy La Touche
- Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), 28008 Madrid, Spain
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
| | - Alejandro Luque-Suarez
- Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain
- Instituto de Investigacion Biomedica de Malaga (IBIMA), 29071 Malaga, Spain
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Cardona-Álvarez YN, Álvarez-Meza AM, Cárdenas-Peña DA, Castaño-Duque GA, Castellanos-Dominguez G. A Novel OpenBCI Framework for EEG-Based Neurophysiological Experiments. SENSORS (BASEL, SWITZERLAND) 2023; 23:3763. [PMID: 37050823 PMCID: PMC10098804 DOI: 10.3390/s23073763] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 06/19/2023]
Abstract
An Open Brain-Computer Interface (OpenBCI) provides unparalleled freedom and flexibility through open-source hardware and firmware at a low-cost implementation. It exploits robust hardware platforms and powerful software development kits to create customized drivers with advanced capabilities. Still, several restrictions may significantly reduce the performance of OpenBCI. These limitations include the need for more effective communication between computers and peripheral devices and more flexibility for fast settings under specific protocols for neurophysiological data. This paper describes a flexible and scalable OpenBCI framework for electroencephalographic (EEG) data experiments using the Cyton acquisition board with updated drivers to maximize the hardware benefits of ADS1299 platforms. The framework handles distributed computing tasks and supports multiple sampling rates, communication protocols, free electrode placement, and single marker synchronization. As a result, the OpenBCI system delivers real-time feedback and controlled execution of EEG-based clinical protocols for implementing the steps of neural recording, decoding, stimulation, and real-time analysis. In addition, the system incorporates automatic background configuration and user-friendly widgets for stimuli delivery. Motor imagery tests the closed-loop BCI designed to enable real-time streaming within the required latency and jitter ranges. Therefore, the presented framework offers a promising solution for tailored neurophysiological data processing.
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Affiliation(s)
| | | | | | - Germán Albeiro Castaño-Duque
- Cultura de la Calidad en la Educación Research Group, Universidad Nacional de Colombia, Manizales 170003, Colombia
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Guerra-Armas J, Flores-Cortes M, Pineda-Galan C, Luque-Suarez A, La Touche R. Role of Immersive Virtual Reality in Motor Behaviour Decision-Making in Chronic Pain Patients. Brain Sci 2023; 13:brainsci13040617. [PMID: 37190582 DOI: 10.3390/brainsci13040617] [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: 03/17/2023] [Revised: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 05/17/2023] Open
Abstract
Primary chronic pain is a major contributor to disability worldwide, with an estimated prevalence of 20-33% of the world's population. The high socio-economic impact of musculoskeletal pain justifies seeking an appropriate therapeutic strategy. Immersive virtual reality (VR) has been proposed as a first-line intervention for chronic musculoskeletal pain. However, the growing literature has not been accompanied by substantial progress in understanding how VR exerts its impact on the pain experience and what neurophysiological mechanisms might be involved in the clinical effectiveness of virtual reality interventions in chronic pain patients. The aim of this review is: (i) to establish the state of the art on the effects of VR on patients with chronic pain; (ii) to identify neuroplastic changes associated with chronic pain that may be targeted by VR intervention; and (iii) to propose a hypothesis on how immersive virtual reality could modify motor behavioral decision-making through an interactive experience in patients with chronic pain.
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Affiliation(s)
- Javier Guerra-Armas
- Faculty of Health Sciences, Universidad Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas, Spain
| | - Mar Flores-Cortes
- Faculty of Health Sciences, Universidad de Malaga, 29071 Malaga, Spain
| | | | - Alejandro Luque-Suarez
- Faculty of Health Sciences, Universidad de Malaga, 29071 Malaga, Spain
- Instituto de la Investigacion Biomedica de Malaga (IBIMA), 29071 Malaga, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), 28008 Madrid, Spain
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Muir KJ, Webb-Jones J, Farish N, Barker K, Miller-Davis C, Galloway S. "Room to Reflect": A Pilot Workplace Resiliency Intervention for Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127272. [PMID: 35742534 PMCID: PMC9224273 DOI: 10.3390/ijerph19127272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/03/2022] [Accepted: 06/10/2022] [Indexed: 11/16/2022]
Abstract
Rising workload demands for nurses necessitate the implementation of easily accessible and innovative clinician well-being resources on health care units. This pre/post pilot study sought to measure the impact of a mobile workplace intervention, “Room to Reflect” on staff nurse and nurse manager resilience. A mobile toolbox with a sound machine, Virtual Reality headset, and associated Quick Response code audio/video offerings, and a paper Pocket Guide of mindful restoration practices were provided to 7 health care units for a 3 month period. Pre/post questionnaires assessed perceived resilience using the Connor-Davidson Resilience scale, and intervention feasibility (ease of use), accessibility (spaces used), and effectiveness (restoration). Data analysis consisted of descriptive statistics, paired and independent samples t-tests, and Wilcoxon Signed Rank tests. From the pre (n = 97) to post (n = 57) intervention period, there was a significant difference in resilience for Clinician 3 staff nurses. A mean increase in resilience was noted among nurse managers following participation in the intervention, z = −2.03, p < 0.05. The Pocket Guide was the easiest offering to use, while VR offerings were accessed the most through Quick Response code. Space and time were the most common barriers to Room to Reflect use. Staff nurses felt supported by managers to use the program, and managers perceived that the program improved nurse job satisfaction.
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Affiliation(s)
- K. Jane Muir
- PhD Program, University of Virginia School of Nursing, Charlottesville, VA 22903, USA
- Correspondence:
| | - Jeanell Webb-Jones
- UVA Health: Infectious Disease Clinic, Post-Anesthesia Care Unit, Nursing Research Office, Charlottesville, VA 22903, USA; (J.W.-J.); (N.F.); (C.M.-D.); (S.G.)
| | - Nancy Farish
- UVA Health: Infectious Disease Clinic, Post-Anesthesia Care Unit, Nursing Research Office, Charlottesville, VA 22903, USA; (J.W.-J.); (N.F.); (C.M.-D.); (S.G.)
| | - Kimberley Barker
- University of Virginia Health Sciences Library, Charlottesville, VA 22908, USA;
| | - Claiborne Miller-Davis
- UVA Health: Infectious Disease Clinic, Post-Anesthesia Care Unit, Nursing Research Office, Charlottesville, VA 22903, USA; (J.W.-J.); (N.F.); (C.M.-D.); (S.G.)
| | - Susan Galloway
- UVA Health: Infectious Disease Clinic, Post-Anesthesia Care Unit, Nursing Research Office, Charlottesville, VA 22903, USA; (J.W.-J.); (N.F.); (C.M.-D.); (S.G.)
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