A Systematic Survey on Cybersickness in Virtual Environments

Feasibility of In-Home Virtual Reality for Chronic Pain in Sickle Cell Disease

PURPOSE

This study assessed the feasibility of an in-home virtual reality intervention for chronic pain in adults with sickle cell disease.

DESIGN

Two-group, parallel, randomized, multiple methods design with surveys, and interviews.

METHODS

Participants were randomized to virtual reality or audio control, with 2-16-minute daily modules for 8 weeks, a daily pain diary survey, and a post study interview. Chronic pain and pain correlates were evaluated at baseline and every 4 weeks for 3 months. Feasibility outcomes were participant enrollment (set at > 50%), questionnaire response (> 50%), intervention use, and cybersickness (< 20%).

RESULTS

Of the individuals approached, 67.8% (n = 19) were enrolled. Questionnaire response rates were 100% at baseline, 57.8% at week 4, and < 50% at weeks 8 and 12. The intervention was used for a median of 781 minutes and 210 minutes in the virtual reality and audio groups, respectively. Participants reported slight symptoms of cybersickness with no reports of severe symptoms, and the intervention was acceptable.

CONCLUSIONS

Home-based virtual reality can be used in future sickle cell disease research. To further strengthen evaluations of virtual reality in adults with sickle cell who experience chronic pain, future trials should address sample size limitations and incorporate recommended strategies to address cybersickness and questionnaire response.

CLINICAL IMPLICATIONS

The first known application of in-home virtual reality for chronic pain in adults with sickle cell disease was successful. Findings can inform future in-home investigations of virtual reality in this underserved population.

The Behavioral Intention to Use Virtual Reality in Schools: A Technology Acceptance Model

This paper presents the impact of using virtual reality (VR) in education and focuses on the main factors that affect the behavioral intention of using this new technology for the benefit of both professors and students. As part of our research methodology, we conducted a survey based on the Technology Acceptance Model and used partial least squares structural equation modelling. The results show that the intention to use VR technology in education is influenced by both usage satisfaction and the task-technology fit. The system quality of the VR technology proved to be important in influencing both the task-technology fit and perceived usefulness. The findings are useful for professors considering the adoption of new technologies that might improve the efficiency of learning for their students. Additionally, managers of educational institutions can use these insights to direct investments towards this type of innovation, which appeals to newer generations.

The use of Virtual Reality (VR) to assess the impact of geographical environments on walking and cycling: a systematic literature review

BACKGROUND

Geographical environments influence people's active mobility behaviors, contributing to their physical and mental health. The use of Virtual Reality (VR) in experimental research can unveil new insights into the relationship between exposure to geographic environments and active mobility behaviors. This systematic review aims to (1) identify environmental attributes investigated in relation with walking and cycling, using VR, (2) assess their impacts on active mobility behaviors and attitudes, and (3) identify research gaps, strengths and limitations in VR-based experimental research.

METHODS

Articles published between January 2010 and February 2022 within five databases (PubMed, Scopus, EBSCO, IEEE Xplore, and Cochrane Library) were explored using three keywords and their synonyms: Virtual Reality, Active mobility behavior, and Geographical environments. Studies focusing on indoor environments, driving simulation, disease-specific groups, non-relevant disciplines (e.g. military, emergency evacuation), VR methodology/software optimization, and those with static participants' involvement were excluded. The full protocol is available from PROSPERO (ID = CRD42022308366).

RESULTS

Out of 3255 articles, 18 peer-reviewed papers met the selection criteria, mostly focusing on walking (83%). Most studies used head-mounted displays (94%) and relied on convenience sampling (72% below 100 participants). Both static (33%) and dynamic (45%) environmental attributes have been investigated, with only 22% of them simultaneously in the same virtual environment. Greenness and crowd density were the most frequent attributes, rather consistently associated with emotional states and movement behaviors. Few studies have taken into account participant's previous VR experience (33%) and cybersickness (39%) while both are likely to affect an individual's perception and behavior.

CONCLUSIONS

Future research should explore a broader range of environmental attributes, including static and dynamic ones, as well as a more complex integration of these attributes within a single experiment to mimic the effect of realistic environments on people's active mobility behaviors and attitudes. Larger and more diverse population samples are deemed required to improve result generalizability. Despite methodological challenges, VR emerges as a promising tool to disentangle the effect of complex environments on active mobility behaviors.

Virtual Reality Distraction for Needle-Related Pain and Distress in Children: A Multicenter Randomized Controlled Trial

This international multicenter randomized controlled trial aimed to compare the effectiveness of virtual reality (VR) distraction with an identical non-VR game in reducing needle-related pain and anxiety in children undergoing venous blood draw. The study involved 304 children aged 5-9 years undergoing a blood draw procedure, randomly allocated to one of three groups: VR distraction, non-VR distraction, and control group (usual care). The distraction task was based on the Multiple Object Tracking (MOT) paradigm, and the game was identical in design and gameplay for both VR and non-VR distraction groups. The primary outcome was self-reported pain intensity using the Faces Pain Scale-Revised (FPS-R). Secondary outcomes included child distress, attention/distraction to the blood draw, and parent and medical staff satisfaction with procedure. Analyses were conducted using analysis of variance and multivariable linear regression models. The results showed that VR distraction and non-VR distraction performed similarly, showing large effect sizes compared with standard care. There was no significant difference between the two types of distraction. The study's findings suggest that VR and non-VR distraction are similarly effective in reducing needle-related pain and anxiety in children undergoing venous blood draw. This is the first well-powered study comparing modern VR distraction with an identical task displayed on a smartphone or monitor screen. The study's results have important implications for using VR in clinical settings and suggest that investing in expensive VR equipment for acute pain management may not be necessary. The study protocol was pre-registered on Open Science Framework at https://osf.io/frsyc.

Effects of Virtual Reality on Pain, Anxiety, Patient Satisfaction in Coronary Angiography: A Randomized Trial

BACKGROUND

Since patients are conscious during the coronary angiography procedure, they may experience pain and anxiety regarding possible complications and an uncertain outcome.

AIM

This study was conducted to determine the effects of virtual reality application on pain severity, anxiety level, and patient satisfaction in patients who undergo coronary angiography.

METHOD

This randomized controlled study was conducted with a total of 70 patients, including 35 patients in the intervention and 35 patients in the control group. Apart from their routine treatment, virtual reality glasses application was used in the intervention group patients during the procedure. The patients in the control group were given only routine treatment. Data were collected by using "Descriptive Information Form", "Visual Analogue Scale (VAS)", Anxiety Assessment Scale (AAS), "Physiological Symptoms of Anxiety Follow-up Form", and "Virtual Reality Glass Application Satisfaction Form".

RESULTS

Mean post-intervention scores of VAS, AAS, heart rate, diastolic and systolic blood pressure, respiratory rate of the intervention group decreased significantly compared with the control group, while O2 saturation value was found to increase significantly.

CONCLUSIONS

In this study, it was found that virtual reality application was effective in reducing pain and anxiety, increasing patient satisfaction, and normative regulation of vital signs in patients who undergo coronary angiography.

Enhancing Physical Activity with Immersive Virtual Reality: A Systematic Review

The aim of this article is to review how immersive virtual reality-enhanced physical activity (IVR-PA) can be used to improve psychological, physiological, and performance outcomes linked to exercising and to compare it with non-immersive virtual reality-enhanced physical activity (nIVR-PA) and with traditional physical activity (TR-PA). We also aimed to explore the effectiveness of IVR-PA in promoting psychological well-being and engagement in physical activity. A systematic literature review (Prospero CRD42022330572) was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. OVID (including Medline, Embase, GlobalHealth, and APA PsychInfo), Web of Science, and Sport Discuss were searched. The quality of the studies was assessed using the Effective Public Health Practice Project Quality Assessment. The search identified 26,548 titles. After screening, 20 studies (the total number of participants was 798) published between 2009 and 2023 were included in this systematic review. The quality of the studies was rated as weak (n = 9), moderate (n = 10), or strong (n = 1). Overall, the reviewed studies indicated that, compared with TR-PA and nIVR-PA, IVR-PA was associated with an increase in enjoyment of physical activity, a reduction in perceived exertion, and increased rates of self-efficacy, intrinsic motivation, and exercise intention. Furthermore, some studies showed higher muscular strength and aerobic increase after an IVR-PA intervention compared with TR-PA. The findings suggest that IVR-PA can improve psychological, physiological, and performance outcomes linked to exercising, as well as improving psychological well-being and engagement in physical activity. However, owing to the methodological limitations of the reviewed studies, further research is encouraged.

Beyond traditional training: Integrating data from semi-immersive VR dual-task intervention in Parkinsonian Syndromes. A study protocol

Completing cognitive and motor tasks simultaneously requires a high level of cognitive control in terms of executive processes and attentional abilities. Most of the daily activities require a dual-task performance. While walking, for example, it may be necessary to adapt gait to obstacles of the environment or simply participate in a conversation; all these activities involve more than one ability at the same time. This parallel performance may be critical in the cognitive or motor load, especially for patients with neurological diseases such as Parkinsonian Syndromes. Patients are often characterized by a crucial impairment in performing both tasks concurrently, showing a decrease in attention skills and executive functions, thus leading to increased negative outcomes. In this scenario, the accurate assessment of the components involved in dual-task performance is crucial, and providing an early specific training program appears to be essential. The objective of this protocol is to assess cognitive and motor components involved in dual-task performance and create a training program based on ecological activities focusing on executive and motor functions. Thus, we will employ Virtual Reality to provide semi-immersive, multisensory, ecological, standardized, and realistic experiences for rehabilitative purposes in patients with Parkinsonian Syndromes, considering its high prevalence in aging and the incidence of motor and cognitive dysfunctions in this population. Moreover, we propose to integrate the great amount of different data provided by dual-task and Virtual Reality system, using machine learning techniques. These integrations may increase the treatment's reliability in terms of better prognostic indexes and individualized training.

In too deep? A systematic literature review of fully-immersive virtual reality and cybersickness among older adults

BACKGROUND

Virtual reality technology holds great promise in improving the health and well-being of older adults; however, this technology is associated with potential risks that may outweigh the benefits. The purpose of this systematic review is to synthesize and critique the existing literature on fully-immersive virtual reality interventions for older adults and the associated risk of cybersickness.

METHODS

We searched eight databases for studies that utilized fully-immersive virtual reality, stated the population as older adults, provided outcomes related to cybersickness, and were written or translated into the English language. Our search generated 332 articles, 39 of which were selected for inclusion in this systematic synthesis and appraisal.

RESULTS

We found that the majority of studies utilized a one-time session. The studies generally had weak sample generalizability and methodological design, but strong data collection and participant retention. The studies nearly all used the Simulator Sickness Questionnaire to measure cybersickness, but the scoring for the Simulator Sickness Questionnaire varied or was not mentioned. Most included studies reported only minor cybersickness among older adult participants.

CONCLUSION

Researchers might conclude that the benefits of virtual reality interventions outweigh the risk of cybersickness in this population. Going forward, researchers should concentrate on the efficacy of virtual reality interventions among older adults, using larger samples and randomized controlled study design, along with measuring dosage effects.