The Effect of Virtual Reality Technology on the Imagery Skills and Performance of Target-Based Sports Athletes

Virtual and Augmented Reality Simulators Show Intraoperative, Surgical Training, and Athletic Training Applications: A Scoping Review

PURPOSE

To review published literature to identify and evaluate the effect of virtual reality (complete immersion) and augmented reality (overlay of digital information onto the physical world) simulators on intraoperative use for orthopaedic surgeons, orthopaedic surgical education, and athletic training.

METHODS

A systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify studies, published since 2014, that evaluated the role of augmented/virtual reality on intraoperative use for orthopaedic surgeons, orthopaedic surgical education, and athletic training.

RESULTS

Virtual reality (VR) simulators provide 3-dimensional graphical simulation of the physical world, and augmented reality (AR) simulators overlay digital information onto the physical world. Simulators can include interactive features (i.e., replication of intraoperative bleeding), haptic feedback, and unrestricted task repetition, and they can record, compare, and analyze performance while being easily accessible and eliminating the need for the presence of a mentor or coach. Four studies reported on VR for intraoperative use, 47 studies on surgical education, and 10 studies on athletic training. Two studies revealed the advantages of using VR simulation during intraoperative procedures, specifically showcasing its benefits for elbow arthroscopy, while 2 studies demonstrated similar positive outcomes for hip arthroscopy. Seventeen studies demonstrated that a VR simulator could be a beneficial tool to assist in surgical education for the knee, while 12 studies found that VR simulation is a valuable tool for aiding in surgical education of shoulder arthroscopy. Ten studies demonstrated that VR simulation improves skills in the operating room. Three studies revealed that individuals with more experience exhibit superior performance on these simulators compared to those with less experience. In the realm of athletic training, 10 studies showcased the potential of VR simulation to play a significant role in athletic performance and injury rehabilitation.

CONCLUSIONS

VR simulation shows benefits in the operating room, is a valuable tool for surgical education resulting in improved skills, and can be used to enhance athletic performance and injury rehabilitation.

CLINICAL RELEVANCE

Understanding that VR simulators can improve surgical outcomes, surgical skill training, and athletic training and rehabilitation could facilitate development and adoption of this advanced technology.

Adaptive Shooting Disciplines: A Scoping Review of the Literature with Bibliometric Analysis

Para-archery and para-shooting, two very popular adaptive shooting disciplines that have earned their place as major official events in the Paralympic Games, share some similarities, as well as distinctive features in terms of rules, physiological requirements, and equipment used. The International Paralympic Committee has a clear responsibility to ensure that all sports within its jurisdiction, including adaptive shooting, can achieve excellence in their respective fields. To achieve this, the conduct of well-designed studies and rigorous research is essential. Although some research has been conducted in this area, a comprehensive and systematic evaluation is still needed. Therefore, the present study aims to provide a thorough review and synthesis of existing research on adaptive shooting disciplines, identify strengths and gaps, and suggest future directions. Arksey and O'Malley's methodology is leveraged and enhanced with bibliometric and policy analyses to review literature on adaptive shooting. Databases like PubMed/MEDLINE, Scopus, Web of Science, OvidSP, and EMBASE were searched, focusing on studies in adaptive shooting disciplines and analysing these findings through a blend of thematic and statistical methods. Twenty-four studies totalling 483 para-athletes (299 para-shooters and 184 para-archers) are included in this scoping review, focusing on a range of aspects, including physiological responses (n = 9), research design and measurement methods for evidence-based classification (n = 6), biopsychosocial aspects (n = 3), development of new methods and technologies (n = 4), kinematic and biomechanical assessment (n = 1), and epidemiology of injuries (n = 1). Seven articles focused exclusively on para-archery, thirteen exclusively on para-shooting, and four on both para-archery and para-shooting. In conclusion, the available literature on adaptive shooting disciplines is still very limited, especially regarding para-archery compared to para-shooting. This highlights the need for further research in many key areas to ensure a better understanding of the different disciplines and to provide appropriate support for para-athletes. Future research in para-archery and para-shooting should focus on technological innovations, biomechanical studies, and psychological support to enhance athlete performance and accessibility. Addressing the imbalance between the two disciplines, along with injury prevention and global participation, can drive the sports towards greater inclusivity and equity for para-athletes worldwide.

Virtual training, real effects: a narrative review on sports performance enhancement through interventions in virtual reality

The present article reports a narrative review of intervention (i.e., training) studies using Virtual Reality (VR) in sports contexts. It provides a qualitative overview and narrative summary of such studies to clarify the potential benefits of VR technology for sports performance enhancement, to extract the main characteristics of the existing studies, and to inform and guide future research. Our literature search and review eventually resulted in 12 intervention studies with a pre vs. post design focused on different sports, including target and precision sports (archery, bowling, curling, darts, golf), bat/racquet and ball sports (baseball, table tennis), goal sports (football/soccer, basketball), martial arts (karate), and sport-unspecific processes such as bodily sensations and balancing. The samples investigated in the primary studies included novice, amateur, and expert athletes (total aggregated sample size N = 493). Many studies found statistically significant effects in relevant target skills following interventions in VR, often outperforming training effects in passive or active control conditions (e.g., using conventional training protocols). Therefore, interventions in VR (or extended reality) have the potential to elicit real effects in sports performance enhancement through training of motor and psychological skills and capabilities in athletes, including perception-action skills, strategic, tactical and decision-making, responding to unexpected events, and enhancing psychological resilience and mental performance under pressure. The neurocognitive mechanisms (e.g., visual search behavior, imagery), methodological aspects (e.g., adaptive training difficulty), and the issues of real-world transfer and generalizability via which these potential sports-performance-related improvements may occur are discussed. Finally, limitations of the present review, the included studies, the current state of the field in general as well as an outlook and future perspectives for research designs and directions are taken into consideration.

Environmental enrichment through virtual reality as multisensory stimulation to mitigate the negative effects of prolonged bed rest

Prolonged bed rest causes a multitude of deleterious physiological changes in the human body that require interventions even during immobilization to prevent or minimize these negative effects. In addition to other interventions such as physical and nutritional therapy, non-physical interventions such as cognitive training, motor imagery, and action observation have demonstrated efficacy in mitigating or improving not only cognitive but also motor outcomes in bedridden patients. Recent technological advances have opened new opportunities to implement such non-physical interventions in semi- or fully-immersive environments to enable the development of bed rest countermeasures. Extended Reality (XR), which covers augmented reality (AR), mixed reality (MR), and virtual reality (VR), can enhance the training process by further engaging the kinesthetic, visual, and auditory senses. XR-based enriched environments offer a promising research avenue to investigate the effects of multisensory stimulation on motor rehabilitation and to counteract dysfunctional brain mechanisms that occur during prolonged bed rest. This review discussed the use of enriched environment applications in bedridden patients as a promising tool to improve patient rehabilitation outcomes and suggested their integration into existing treatment protocols to improve patient care. Finally, the neurobiological mechanisms associated with the positive cognitive and motor effects of an enriched environment are highlighted.

Virtual reality lifeguarding scenarios as a potential training solution for pool lifeguards

BACKGROUND

Ensuring that pool lifeguards develop the skills necessary to detect drowning victims is challenging given that these situations are relatively rare, unpredictable and are difficult to simulate accurately and safely. Virtual reality potentially provides a safe and ecologically valid approach to training since it offers a near-to-real visual experience, together with the opportunity to practice task-related skills and receive feedback. As a prelude to the development of a training intervention, the aim of this research was to establish the construct validity of virtual reality drowning detection tasks.

METHOD

Using a repeated measures design, a total of 38 qualified lifeguards and 33 non-lifeguards completed 13 min and 23 min simulated drowning detection tasks that were intended to reflect different levels of sustained attention. During the simulated tasks, participants were asked to monitor a virtual pool and identify any drowning targets with accuracy, response latency, and dwell time recorded.

RESULTS

During the simulated scenarios, pool lifeguards detected drowning targets more frequently and spent less time than non-lifeguards fixating on the drowning target prior to the drowning onset. No significant differences in response latency were evident between lifeguards and non-lifeguards nor for first fixations on the drowning target.

CONCLUSION

The results provide support for the construct validity of virtual reality lifeguarding scenarios, thereby providing the basis for their development and introduction as a potential training approach for developing and maintaining performance in lifeguarding and drowning detection.

APPLICATION

This research provides support for the construct validity of virtual reality simulations as a potential training tool, enabling improvements in the fidelity of training solutions to improve pool lifeguard competency in drowning detection.

The Inhibition of Return of Sanda Athletes in Three Dimensional Static and Dynamic Scenes

Sanda is a combat sport in which athletes adopt offensive and defensive techniques for barehanded confrontations. Inhibition of return (IOR) describes a phenomenon in which an individual's response time to a target appearing at a previously cued location is slower than to a target appearing at an un-cued location. Because Sanda requires attention skills and fast response times in dynamic situations, a good understanding of IOR among Sanda athletes is important for enhancing their performance. We recruited 180 research participants for a 3-part study - 90 Sanda athletes (age M = 21.56, SD = 2.68; 52 males, 38 females) and 90 college student controls (age M = 21.64, SD = 2.40; 45 males, 45 females). We used the IOR paradigm with virtual reality technology to explore Sanda athletes' IOR in three experimental conditions: three-dimensional (3-D) static, dynamic, and mixed. There was a robust IOR effect in the 3-D static scenario, with the IOR effect larger among Sanda athletes than controls. There were different IOR spread patterns between Sanda athletes and controls, and the IOR effect was weaker or absent when the objects moved. There was a speed advantage for Sanda athletes once a static object started moving. In conclusion, the Sanda athletes' faster response times and more fine-graded IOR in 3-D environments may benefit their visual search in combat, and the reference of the static location may be critical for the IOR effect.

The Effects of Virtual Reality Nonphysical Mental Training on Balance Skills and Functional Near-Infrared Spectroscopy Activity in Healthy Adults

CONTEXT

Athletic skills such as balance are considered physical skills. However, these skills may not just improve by physical training, but also by mental training. The purpose of this study was to investigate the effects of mental training programs on balance skills and hemodynamic responses of the prefrontal cortex.

DESIGN

Randomized controlled trial.

METHODS

Fifty-seven healthy adults (28 females, 29 males), aged between 18-25 years, participated in this study. Participants were randomly assigned to 3 groups: virtual reality mental training (VRMT) group, conventional mental training (CMT) group, and control group. The training program included action observation and motor imagery practices with balance exercise videos. The VRMT group trained with a VR head-mounted display, while the CMT group trained with a non-immersive computer screen, for 30 minutes, 3 days per week for 4 weeks. At baseline and after 4 weeks of training, balance was investigated with stabilometry and Star Excursion Balance Test (SEBT). Balance tests were performed with simultaneous functional near-infrared spectroscopy (fNIRS) imaging to measure prefrontal cortex oxygenation.

RESULTS

For the stabilometry test, at least 1 variable improved significantly in both VRMT and CMT groups but not in the control group. For SEBT, composite reach distance significantly increased in both VRMT and CMT groups but significantly decreased in the control group. For separate directional scores, reach distance was significantly increased in both mental training groups for nondominant leg posterolateral and posteromedial directions, and dominant leg posterolateral direction, while nondominant posteromedial score was significantly increased only in the VRMT group. Between-group comparisons showed that dominant leg posteromedial and posterolateral score improvements were significantly higher than control group for both mental training groups, while nondominant leg improvements were significantly higher than control group only for the VRMT group. The fNIRS oxyhemoglobin levels were not significantly changed during stabilometry tests. However, oxyhemoglobin levels significantly reduced only in the control group during SEBT.

CONCLUSIONS

Our findings suggest that both mental training interventions can significantly improve balance test results. Additionally, VRMT may have some advantages over CMT. These findings are promising for the use of mental training in prevention and rehabilitation for special populations such as athletes and older adults.

VR Health Experience: A Virtual Space for Arts and Psychomotor Therapy

Introduction: Mental health and well-being are under pressure because of the corona pandemic. Arts and psychomotor therapists said that they had almost no experience with working online, but despite the fact that they felt incapable, they were positive towards it.

Method: This qualitative action research was aimed at how arts and psychomotor therapists can become more skilled in offering online arts and psychomotor therapy and how they can methodically enlist the VR Health Experience (a virtual arts and psychomotor therapy space) in therapy. It is envisaged that the arts and psychomotor therapist could be telepresent in order to offer arts and psychomotor therapy remotely. In online training that made use of the Lean Startup Method, participants (n = 5) integrated their working knowledge with the VR Health Experience. The interventions were immediately tested by the participants and in practice. Participants were interviewed retrospectively and their experiences were thematically analysed.

Results: The VR Health Experience came forward as an innovative addition to the usual arts and psychomotor therapy. Often, clients were encouraged to play and experiment, and the VR world offered several options. The VR Health Experience lowered the threshold, expanded the training areas and held a great attraction for play.

Discussion: This project offered an innovative quality boost for arts and psychomotor therapy. Arts and psychomotor therapy have proven to be possible remotely via telepresence of the therapist. The therapist is present together with the client in the VR Health Experience, the virtual arts and psychomotor therapy space, where connectedness can be felt and new experiences can be gained. VR also offers further possibilities in arts and psychomotor therapy.

Sport Cyberpsychology in Action During the COVID-19 Pandemic (Opportunities, Challenges, and Future Possibilities): A Narrative Review

Interest in sport cyberpsychology has become more popular over the last decade, primarily due to the increased use of technology and the online world, including social media, within sport settings (Hurley, 2018). In 2020, this became even more apparent for many athletes, their support teams and their sport organisations, when their professional and social worlds became cyber-dominated due to the COVID-19 pandemic. Many challenges were encountered by: (i) the athletes, in their efforts to remain active and well during this time when all competitions were cancelled and (ii) the healthcare professionals, working with these athletes, in their efforts to continue to support the athletes, when severe travel restrictions and social distancing were in place for considerable periods of time. The purpose of this paper, using a narrative review process, is to present and scrutinise an array of Internet interventions, remote psychological supports and applications (apps) that the athletes and their support personnel used to help them meet their physical, social, and emotional needs during the pandemic. The beneficial and restrictive features of these online options will be presented. Two main themes will be considered in order to focus this discussion, namely, (i) the potential physical and mental opportunities and challenges using the online world extensively during this time presented for the individuals working in sport and (ii) suggestions for how such online interventions used by the athletes, their coaches and sport science personnel during the pandemic may be maintained in some positive ways into the future, to help the athletes prepare for their upcoming competitions, their training and their future careers when they retire from elite sport.