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Diriba Kenea C, Gemechu Abessa T, Lamba D, Bonnechère B. Technological Features of Immersive Virtual Reality Systems for Upper Limb Stroke Rehabilitation: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2024; 24:3546. [PMID: 38894337 PMCID: PMC11175221 DOI: 10.3390/s24113546] [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: 05/05/2024] [Revised: 05/24/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024]
Abstract
Stroke is the second most common cause of death worldwide, and it greatly impacts the quality of life for survivors by causing impairments in their upper limbs. Due to the difficulties in accessing rehabilitation services, immersive virtual reality (IVR) is an interesting approach to improve the availability of rehabilitation services. This systematic review evaluates the technological characteristics of IVR systems used in the rehabilitation of upper limb stroke patients. Twenty-five publications were included. Various technical aspects such as game engines, programming languages, headsets, platforms, game genres, and technical evaluation were extracted from these papers. Unity 3D and C# are the primary tools for creating IVR apps, while the Oculus Quest (Meta Platforms Technologies, Menlo Park, CA, USA) is the most often used headset. The majority of systems are created specifically for rehabilitation purposes rather than being readily available for purchase (i.e., commercial games). The analysis also highlights key areas for future research, such as game assessment, the combination of hardware and software, and the potential integration incorporation of biofeedback sensors. The study highlights the significance of technological progress in improving the effectiveness and user-friendliness of IVR. It calls for additional research to fully exploit IVR's potential in enhancing stroke rehabilitation results.
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Affiliation(s)
- Chala Diriba Kenea
- Department of Information Science, Faculty of Computing and Informatics, Jimma Institute of Technology, Jimma University, Jimma P.O. Box 378, Oromia, Ethiopia
- REVAL Rehabilitation Research Center, Technology-Supported and Data-Driven Rehabilitation, Data Science Institute, Faculty of Rehabilitation Sciences, University of Hasselt, 3590 Diepenbeek, Belgium; (T.G.A.); (B.B.)
| | - Teklu Gemechu Abessa
- REVAL Rehabilitation Research Center, Technology-Supported and Data-Driven Rehabilitation, Data Science Institute, Faculty of Rehabilitation Sciences, University of Hasselt, 3590 Diepenbeek, Belgium; (T.G.A.); (B.B.)
- Department of Special Needs & Inclusive Education, Jimma University, Jimma P.O. Box 378, Oromia, Ethiopia
| | - Dheeraj Lamba
- Department of Physiotherapy, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma P.O. Box 378, Oromia, Ethiopia;
| | - Bruno Bonnechère
- REVAL Rehabilitation Research Center, Technology-Supported and Data-Driven Rehabilitation, Data Science Institute, Faculty of Rehabilitation Sciences, University of Hasselt, 3590 Diepenbeek, Belgium; (T.G.A.); (B.B.)
- Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, Hasselt University, 3590 Diepenbeek, Belgium
- Department of PXL—Healthcare, PXL University of Applied Sciences and Arts, 3500 Hasselt, Belgium
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Amin F, Waris A, Syed S, Amjad I, Umar M, Iqbal J, Omer Gilani S. Effectiveness of Immersive Virtual Reality-Based Hand Rehabilitation Games for Improving Hand Motor Functions in Subacute Stroke Patients. IEEE Trans Neural Syst Rehabil Eng 2024; 32:2060-2069. [PMID: 38801680 DOI: 10.1109/tnsre.2024.3405852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Stroke rehabilitation faces challenges in attaining enduring improvements in hand motor function and is frequently constrained by interventional limitations. This research aims to present an innovative approach to the integration of cognitive engagement within visual feedback incorporated into fully immersive virtual reality (VR) based games to achieve enduring improvements. These innovative aspects of interaction provide more functional advantages beyond motivation to efficiently execute repeatedly hand motor tasks. The effectiveness of virtual reality games incorporated with innovative aspects has been investigated for improvements in hand motor functions. A randomized controlled trial was conducted, a total of (n=56) subacute stroke patients were assessed for eligibility and (n=52) patients fulfilled the inclusion criteria. (n=26) patients were assigned to the experimental group and (n=26) patients were assigned to the control group. VR intervention involves four VR based games, developed based on hand movements including flexion/extension, close/open, supination/pronation and pinch. All patients got therapy of 24 sessions, lasting 4 days/week for a total of 6 weeks. Five clinical outcome measures were Fugl- Meyer Assessment-Upper Extremity, Action Research Arm Test, Box and Block Test, Modified Barthel Index, and Stroke-Specific Quality of Life were assessed to evaluate patients' performance. Results revealed that after therapy there was significant improvement between the groups (p<0.05) and within groups (p<0.05) in all assessment weeks in all clinical outcome measures however, improvement was observed significantly greater in the experimental group due to fully immersive VR-based games. Results indicated that cognitive engagement within visual feedback incorporated in VR-based hand games effectively improved hand motor functions.
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De Pasquale P, Bonanno M, Mojdehdehbaher S, Quartarone A, Calabrò RS. The Use of Head-Mounted Display Systems for Upper Limb Kinematic Analysis in Post-Stroke Patients: A Perspective Review on Benefits, Challenges and Other Solutions. Bioengineering (Basel) 2024; 11:538. [PMID: 38927774 PMCID: PMC11200415 DOI: 10.3390/bioengineering11060538] [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: 04/11/2024] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
In recent years, there has been a notable increase in the clinical adoption of instrumental upper limb kinematic assessment. This trend aligns with the rising prevalence of cerebrovascular impairments, one of the most prevalent neurological disorders. Indeed, there is a growing need for more objective outcomes to facilitate tailored rehabilitation interventions following stroke. Emerging technologies, like head-mounted virtual reality (HMD-VR) platforms, have responded to this demand by integrating diverse tracking methodologies. Specifically, HMD-VR technology enables the comprehensive tracking of body posture, encompassing hand position and gesture, facilitated either through specific tracker placements or via integrated cameras coupled with sophisticated computer graphics algorithms embedded within the helmet. This review aims to present the state-of-the-art applications of HMD-VR platforms for kinematic analysis of the upper limb in post-stroke patients, comparing them with conventional tracking systems. Additionally, we address the potential benefits and challenges associated with these platforms. These systems might represent a promising avenue for safe, cost-effective, and portable objective motor assessment within the field of neurorehabilitation, although other systems, including robots, should be taken into consideration.
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Affiliation(s)
- Paolo De Pasquale
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy; (P.D.P.); (A.Q.); (R.S.C.)
| | - Mirjam Bonanno
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy; (P.D.P.); (A.Q.); (R.S.C.)
| | - Sepehr Mojdehdehbaher
- Department of Mathematics, Computer Science, Physics and Earth Sciences (MIFT), University of Messina, Viale Ferdinando Stagno d’Alcontres, 31, 98166 Messina, Italy;
| | - Angelo Quartarone
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy; (P.D.P.); (A.Q.); (R.S.C.)
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy; (P.D.P.); (A.Q.); (R.S.C.)
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Komariah M, Amirah S, Abdurrahman MF, Handimulya MFS, Platini H, Maulana S, Nugrahani AD, Mulyana AM, Qadous SG, Mediani HS, Mago A. Effectivity of Virtual Reality to Improve Balance, Motor Function, Activities of Daily Living, and Upper Limb Function in Children with Cerebral Palsy: A Systematic Review and Meta-Analysis. Ther Clin Risk Manag 2024; 20:95-109. [PMID: 38375076 PMCID: PMC10875340 DOI: 10.2147/tcrm.s432249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/03/2024] [Indexed: 02/21/2024] Open
Abstract
Background Cerebral palsy (CP) is the most common motor disorder in childhood. CP limits movement, which can interfere with children's daily activities. As a technology that provides intensive mass practice to children, virtual reality (VR) can create an interactive and motivating environment. With the intensity set by the therapist and feedback that can be used to produce individualized therapy, VR has great potential to improve CP patients' quality of life, especially in a safe, enjoyable, and playful environment. Purpose This systematic review and meta-analysis sought to determine the effectiveness of VR for children with CP. Methods We conducted a comprehensive literature search based on the PRISMA guidelines through PubMed, Scopus, Embase, Wiley, and ProQuest to assess the efficacy of VR in managing children with CP up to 15 September 2022. Risk assessment of bias was performed using Cochrane RoB 2. Results Nineteen randomized controlled trials with 467 and 427 patients with CP were included in the intervention and control groups in qualitative and quantitative analyses. Participants consisted of cerebral palsy with hemiplegia (n=7), diplegia (n=2), a combination of both (n=4), and undefined (n=13). From all studies conducted, VR showed significant results where VR could improve balance (MD: 2.71[1.95, 3.48]; p < 0.00001), motor function (MD: 3.73 [1.67, 5.79]; p = 0.0004), and activity daily living (MD: 10.05 [2.89, 17.22]. However, VR showed not effective in improving upper limb function. Conclusion With its advantages and excellent effectiveness, VR may improve functional mobility and the quality of life of children with CP.
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Affiliation(s)
- Maria Komariah
- Department of Fundamental Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 45363, Indonesia
| | - Shakira Amirah
- Faculty of Medicine, Universitas Indonesia, Depok, West Java, 16424Indonesia
| | | | | | - Hesti Platini
- Department of Medical-Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 45363, Indonesia
| | - Sidik Maulana
- Master of Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Annisa Dewi Nugrahani
- Maternal Fetal Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
| | - Aep Maulid Mulyana
- Master of Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Shurouq Ghalib Qadous
- Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Henny Suzana Mediani
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 45363, Indonesia
| | - Arpit Mago
- Department of Clinical Medicine, Jawaharlal Nehru Medical College, Belagavi, Karnataka, 590010, India
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Villada Castillo JF, Montoya Vega MF, Muñoz Cardona JE, Lopez D, Quiñones L, Henao Gallo OA, Lopez JF. Design of Virtual Reality Exergames for Upper Limb Stroke Rehabilitation Following Iterative Design Methods: Usability Study. JMIR Serious Games 2024; 12:e48900. [PMID: 38206670 PMCID: PMC10811592 DOI: 10.2196/48900] [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: 05/10/2023] [Revised: 09/28/2023] [Accepted: 11/24/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Since the early 2000s, there has been a growing interest in using exercise video games (exergames) and virtual reality (VR)-based interventions as innovative methods to enhance physical rehabilitation for individuals with multiple disabilities. Over the past decade, researchers and exercise professionals have focused on developing specialized immersive exercise video games for various populations, including those who have experienced a stroke, revealing tangible benefits for upper limb rehabilitation. However, it is necessary to develop highly engaging, personalized games that can facilitate the creation of experiences aligned with the preferences, motivations, and challenges communicated by people who have had an episode of stroke. OBJECTIVE This study seeks to explore the customization potential of an exergame for individuals who have undergone a stroke, concurrently evaluating its usability as a technological tool in the realm of physical therapy and rehabilitation. METHODS We introduce a playtest methodology to enhance the design of a VR exergame developed using a user-centered approach for upper limb rehabilitation in stroke survivors. Over 4 playtesting sessions, stroke survivors interacted with initial game versions using VR headsets, providing essential feedback for refining game content and mechanics. Additionally, a pilot study involving 10 stroke survivors collected data through VR-related questionnaires to assess game design aspects such as mechanics, assistance, experience, motion sickness, and immersion. RESULTS The playtest methodology was beneficial for improving the exergame to align with user needs, consistently incorporating their perspectives and achieving noteworthy results. The pilot study revealed that users had a positive response. In the first scenario, a carpenter presents a game based on the flexion-extension movement of the elbow; the second scenario includes a tejo game (a traditional Colombian throwing game) designed around game mechanics related to the flexion-extension movement of the shoulder; and in the third scenario, a farmer challenges the player to perform a movement combining elbow flexion and extension with internal and external rotation of the shoulder. These findings suggest the potential of the studied exergame as a tool for the upper limb rehabilitation of individuals who have experienced a stroke. CONCLUSIONS The inclusion of exergames in rehabilitation for stroke-induced hemiparesis has significantly benefited the recovery process by focusing on essential shoulder and elbow movements. These interactive games play a crucial role in helping users regain mobility and restore practical use of affected limbs. They also serve as valuable data sources for researchers, improving the system's responsiveness. This iterative approach enhances game design and markedly boosts user satisfaction, suggesting exergames have promising potential as adjunctive elements in traditional therapeutic approaches.
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Affiliation(s)
| | | | | | - David Lopez
- Engineering Faculty, Universidad Tecnologica de Pereira, Pereira, Colombia
| | - Leonardo Quiñones
- Engineering Faculty, Universidad Tecnologica de Pereira, Pereira, Colombia
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Aderinto N, Olatunji G, Abdulbasit MO, Edun M, Aboderin G, Egbunu E. Exploring the efficacy of virtual reality-based rehabilitation in stroke: a narrative review of current evidence. Ann Med 2023; 55:2285907. [PMID: 38010358 PMCID: PMC10836287 DOI: 10.1080/07853890.2023.2285907] [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: 08/09/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Stroke rehabilitation presents a complex challenge, necessitating innovative approaches to optimise functional recovery. Virtual Reality-Based Rehabilitation (VRBR) has emerged as a promising intervention that capitalises on immersive technology to engage stroke survivors in their recovery journey. This review aims to examine the efficacy of VRBR in stroke rehabilitation, focusing on its advantages and challenges. METHODS A comprehensive search of relevant literature was conducted to gather evidence on the efficacy of VRBR in stroke survivors. Studies that investigated the impact of VRBR on patient engagement, functional recovery, and overall rehabilitation outcomes were included. The review also assessed the ability of VRBR to simulate real-life scenarios and facilitate essential daily activities for stroke survivors. RESULTS The review highlights that VRBR offers a unique immersive experience that enhances patient engagement and motivation during rehabilitation. The immersive nature of VRBR fosters a sense of presence, which can positively impact treatment adherence and outcomes. Moreover, VRBR's capacity to replicate real-world scenarios provides stroke survivors with opportunities to practice vital daily activities, promoting functional independence. In contrast, conventional rehabilitation methods lack the same level of engagement and real-world simulation. CONCLUSION VRBR holds promise as an efficacious intervention in stroke rehabilitation. Its immersive nature enhances patient engagement and motivation, potentially leading to better treatment adherence and outcomes. The ability of VRBR to simulate real-life scenarios offers a unique platform. However, challenges such as cost, equipment, patient suitability, data privacy, and acceptance must be addressed for successful integration into stroke rehabilitation practice.
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Affiliation(s)
- Nicholas Aderinto
- Department of Medicine and Surgery, LadokeAkintola University of Technology, Ogbomoso, Nigeria
| | - Gbolahan Olatunji
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | | | - Mariam Edun
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | - Gbolahan Aboderin
- Department of Medicine and Surgery, LadokeAkintola University of Technology, Ogbomoso, Nigeria
| | - Emmanuel Egbunu
- Department of Medicine and Surgery, Federal Medical Centre Bida, Niger, Nigeria
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Casile A, Fregna G, Boarini V, Paoluzzi C, Manfredini F, Lamberti N, Baroni A, Straudi S. Quantitative Comparison of Hand Kinematics Measured with a Markerless Commercial Head-Mounted Display and a Marker-Based Motion Capture System in Stroke Survivors. SENSORS (BASEL, SWITZERLAND) 2023; 23:7906. [PMID: 37765963 PMCID: PMC10535006 DOI: 10.3390/s23187906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/25/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
Upper-limb paresis is common after stroke. An important tool to assess motor recovery is to use marker-based motion capture systems to measure the kinematic characteristics of patients' movements in ecological scenarios. These systems are, however, very expensive and not readily available for many rehabilitation units. Here, we explored whether the markerless hand motion capabilities of the cost-effective Oculus Quest head-mounted display could be used to provide clinically meaningful measures. A total of 14 stroke patients executed ecologically relevant upper-limb tasks in an immersive virtual environment. During task execution, we recorded their hand movements simultaneously by means of the Oculus Quest's and a marker-based motion capture system. Our results showed that the markerless estimates of the hand position and peak velocity provided by the Oculus Quest were in very close agreement with those provided by a marker-based commercial system with their regression line having a slope close to 1 (maximum distance: mean slope = 0.94 ± 0.1; peak velocity: mean slope = 1.06 ± 0.12). Furthermore, the Oculus Quest had virtually the same sensitivity as that of a commercial system in distinguishing healthy from pathological kinematic measures. The Oculus Quest was as accurate as a commercial marker-based system in measuring clinically meaningful upper-limb kinematic parameters in stroke patients.
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Affiliation(s)
- Antonino Casile
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy
- Center of Translational Neurophysiology of Speech and Communication (CTNSC), Istituto Italiano di Tecnologia (IIT), 44121 Ferrara, Italy;
| | - Giulia Fregna
- Doctoral Program in Translational Neurosciences and Neurotechnologies, University of Ferrara, 44121 Ferrara, Italy;
| | - Vittorio Boarini
- Center of Translational Neurophysiology of Speech and Communication (CTNSC), Istituto Italiano di Tecnologia (IIT), 44121 Ferrara, Italy;
- Department of Mathematics and Computer Science, University of Ferrara, 44121 Ferrara, Italy
| | - Chiara Paoluzzi
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy; (C.P.); (N.L.); (A.B.); (S.S.)
| | - Fabio Manfredini
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy; (C.P.); (N.L.); (A.B.); (S.S.)
- Department of Neuroscience, Ferrara University Hospital, 44124 Ferrara, Italy
| | - Nicola Lamberti
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy; (C.P.); (N.L.); (A.B.); (S.S.)
| | - Andrea Baroni
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy; (C.P.); (N.L.); (A.B.); (S.S.)
- Department of Neuroscience, Ferrara University Hospital, 44124 Ferrara, Italy
| | - Sofia Straudi
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy; (C.P.); (N.L.); (A.B.); (S.S.)
- Department of Neuroscience, Ferrara University Hospital, 44124 Ferrara, Italy
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Straudi S, Cano-de-la-Cuerda R. Clinical Application of Physical Therapy in Neurorehabilitation. J Clin Med 2023; 12:jcm12082752. [PMID: 37109089 PMCID: PMC10140811 DOI: 10.3390/jcm12082752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
The knowledge from basic neuroscience studies on mechanisms of motor recovery and the development of theoretical models of learning and recovery has favoured the development and implementation of neurophysiologically sounded rehabilitative interventions [...].
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Affiliation(s)
- Sofia Straudi
- Department of Neuroscience and Rehabilitation, Ferrara University, 44121 Ferrara, Italy
| | - Roberto Cano-de-la-Cuerda
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Rey Juan Carlos University, 28922 Madrid, Spain
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Marini M, Casile A. I can see my virtual body in a mirror: The role of visual perspective in changing implicit racial attitudes using virtual reality. Front Psychol 2022; 13:989582. [PMID: 36518959 PMCID: PMC9742480 DOI: 10.3389/fpsyg.2022.989582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 11/04/2022] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION Recent studies showed that VR is a valid tool to change implicit attitudes toward outgroup members. Here, we extended this work by investigating conditions under which virtual reality (VR) is effective in changing implicit racial attitudes. METHODS To this end, participants were embodied in a Black or White avatar and we manipulated the perspective through which they could see their virtual body. Participants in one condition, could see their virtual body both from a first-person perspective (i.e., by looking down toward themselves) and reflected in a mirror placed in front of them in the VR environment. Participants in another condition could instead see their virtual body only from a first-person perspective (i.e., by looking down toward themselves) as no mirror was placed in the VR environment. Implicit racial attitudes were assessed using the Implicit Association Test (IAT) before and immediately after the VR intervention. RESULTS Results showed that when White participants were embodied in a Black avatar compared to a White avatar, they showed a decrease in their implicit pro-White attitudes but only when they could see their virtual body both from a first-person perspective and in a mirror. DISCUSSION These results suggest that, in immersive virtual reality interventions, the possibility for participants to see their body also reflected in a mirror, might be a critical factor in changing their implicit racial attitudes.
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Affiliation(s)
- Maddalena Marini
- Center for Translational Neurophysiology of Speech and Communication, Istituto Italiano di Tecnologia, Ferrara, Italy
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Antonino Casile
- Center for Translational Neurophysiology of Speech and Communication, Istituto Italiano di Tecnologia, Ferrara, Italy
- Department of Mathematics and Computer Science, University of Ferrara, Ferrara, Italy
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