XR Programmers Give Their Perspective on How XR Technology can be Effectively Utilised in High-Performance Sport

BACKGROUND

The successful use of extended reality (XR) in sport is highly dependent on the extent to which it can represent the perception-action couplings that exist in the performance setting. However, there are many unknowns regarding the effectiveness of XR technology which is limiting its adoption in sport. Therefore, providing high-performance sporting organisations with more information about the efficacy and utility of XR, specifically its strengths and limitations, is warranted.

RESULTS

The results provide insight into the limitations of XR and how those limitations are likely to reduce the effectiveness of XR for training motor skills. The participants described opportunities provided by XR for measuring athlete performance and highlighted several practical applications for enhancing athlete and coaching performance. Using artificial intelligence (AI) for training tactical decision-making and creating new movement solutions was also a key finding.

CONCLUSIONS

The use of XR in sport is in its infancy, and more research is required to establish a deeper understanding of its utility and efficacy. This research provides sporting organisations, coaches, athletes, and XR technology companies with insights into where XR technology can have the greatest positive impact on performance in sport.

A Narrative Review of the Current State of Extended Reality Technology and How it can be Utilised in Sport

Extended reality is an umbrella term used to describe three computer-generated technologies including virtual reality, augmented reality and mixed reality. Extended reality is an emerging technology that has been utilised in many high-performance domains including psychology, medicine and the military, with the aim of enhancing perceptual-cognitive skills and motor skills. However, the use of extended reality in sport, particularly at the elite level, has only recently started to receive attention. While the growth of extended reality technology continues to accelerate at a rapid rate, empirical evidence aimed at understanding how these devices can best be applied in high-performance sport has not followed suit. Therefore, the purpose of this review is to provide clarity for high-performance sport organisations, researchers, sport scientists, coaches and athletes about the current state of extended reality technology and how it has been utilised in sport. In doing so, we first define and give examples of the types of extended reality technology including virtual reality, augmented reality and mixed reality that are available at the present time. Second, we detail how skill acquisition principles underpinned by the theoretical framework of ecological dynamics can be used to help inform the design and assessment of extended reality training tools. Third, we describe how extended reality has been utilised in sport, including how extended reality tools have been assessed for their level of representativeness, and the effectiveness of extended reality training interventions for improving perceptual-cognitive skills and motor skills. Finally, we discuss the future utilisation of extended reality in sport, including the key learnings that can be drawn from other domains, future research directions, practical applications and areas for consideration related to the use of extended reality for training skills in sport.

The Impact of Virtual Reality Exposure on Stress Level and Sense of Competence in Ambulance Workers

Virtual reality (VR) exposure is used in clinical psychology to treat anxiety disorders. It is also used to enhance resilience in soldiers by allowing them to confront virtual combat environments to help fortify them against the negative consequences of trauma exposure. Most VR studies have focused on military and emergency medical staff; however, thus far, none have investigated VR in ambulance workers (AWs), who are confronted with traumatic situations daily. The current study aimed to assess the impact of a single VR exposure session on self-perceived competence and stress level in a sample of AWs. Participants (N = 40) were randomly assigned to either a VR immersion (i.e., experimental group, n = 20) or an audio immersion (i.e., control group, n = 20) of a shooting attack situation. We hypothesized that compared to controls, VR participants would report decreased anxiety, as measured using visual analog scales, as well as an increased sense of competence. The results showed a significant reduction in fear in both groups, d = 0.33, and an increased sense of competence in VR participants, d = 0.35. Although our hypotheses were only partially confirmed, the observed beneficial effects of VR and the audio immersion on stress levels in AWs suggest that VR exposure could be a useful way to increase resilience in AWs.

Efficacy, Effectiveness, and Quality of Resilience-Building Mobile Health Apps for Military, Veteran, and Public Safety Personnel Populations: Scoping Literature Review and App Evaluation

BACKGROUND

Military members (MMs) and public safety personnel (PSP) are vulnerable to occupational stress injuries because of their job demands. When MMs and PSP transition out of these professions, they may continue to experience mental health challenges. The development and implementation of resilience-building mobile health (mHealth) apps as an emergent mental health intervention platform has allowed for targeted, cost-effective, and easily accessible treatment when in-person therapy may be limited or unavailable. However, current mHealth app development is not regulated, and often lacks both clear evidence-based research and the input of health care professionals.

OBJECTIVE

This study aims to evaluate the evidence-based quality, efficacy, and effectiveness of resilience-building mobile apps targeted toward the MMs, PSP, and veteran populations via a scoping literature review of the current evidence base regarding resilience apps for these populations and an evaluation of free resilience apps designed for use among these populations.

METHODS

The studies were selected using a comprehensive search of MEDLINE, CINAHL Plus, PsycINFO, SocINDEX, Academic Search Complete, Embase, and Google and were guided by PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). A narrative synthesis of the resulting papers was performed. The Alberta Rating Index for Apps was used to conduct a review of each of the identified apps. The inclusion criteria consisted of apps that were free to download in either the Google Play Store or the Apple App Store; updated within the last 3 years; available in English and in Canada; and intended for use by MMs, veterans, and PSP.

RESULTS

In total, 22 apps met the inclusion criteria for evaluation. The resilience strategies offered by most apps included psychoeducation, mindfulness, cognitive behavioral therapy, and acceptance and commitment therapy. Overall, 50% (11/22) of apps had been tested in randomized controlled trials, 7 (32%) apps had been evaluated using other research methods, and 5 (23%) apps had not been studied. Using the Alberta Rating Index for Apps, the app scores ranged from 37 to 56 out of 72, with higher rated apps demonstrating increased usability and security features.

CONCLUSIONS

The mHealth apps reviewed are well-suited to providing resilience strategies for MMs, PSP, and veterans. They offer easy accessibility to evidence-based tools while working to encourage the use of emotional and professional support with safety in mind. Although not intended to function as a substitute for professional services, research has demonstrated that mHealth apps have the potential to foster a significant reduction in symptom severity for posttraumatic stress disorder, depression, anxiety, and other mental health conditions. In clinical practice, apps can be used to supplement treatment and provide clients with population-specific confidential tools to increase engagement in the treatment process.

Digital Technologies for Emotion-Regulation Assessment and Intervention: A Conceptual Review

The ability to regulate emotions in response to stress is central to healthy development. While early research in emotion regulation predominantly employed static, self-report measurement, the past decade has seen a shift in focus toward understanding the dynamic nature of regulation processes. This is reflected in recent refinements in the definition of emotion regulation, which emphasize the importance of the ability to flexibly adapt regulation efforts across contexts. The latest proliferation of digital technologies employed in mental health research offers the opportunity to capture the state- and context-sensitive nature of emotion regulation. In this conceptual review, we examine the use of digital technologies (ecological momentary assessment; wearable and smartphone technology, physical activity, acoustic data, visual data, and geo-location; smart home technology; virtual reality; social media) in the assessment of emotion regulation and describe their application to interventions. We also discuss challenges and ethical considerations, and outline areas for future research.

Virtual reality in the assessment and treatment of psychosis: a systematic review of its utility, acceptability and effectiveness

Over the last two decades, there has been a rapid increase of studies testing the efficacy and acceptability of virtual reality in the assessment and treatment of mental health problems. This systematic review was carried out to investigate the use of virtual reality in the assessment and the treatment of psychosis. Web of Science, PsychInfo, EMBASE, Scopus, ProQuest and PubMed databases were searched, resulting in the identification of 638 articles potentially eligible for inclusion; of these, 50 studies were included in the review. The main fields of research in virtual reality and psychosis are: safety and acceptability of the technology; neurocognitive evaluation; functional capacity and performance evaluation; assessment of paranoid ideation and auditory hallucinations; and interventions. The studies reviewed indicate that virtual reality offers a valuable method of assessing the presence of symptoms in ecologically valid environments, with the potential to facilitate learning new emotional and behavioural responses. Virtual reality is a promising method to be used in the assessment of neurocognitive deficits and the study of relevant clinical symptoms. Furthermore, preliminary findings suggest that it can be applied to the delivery of cognitive rehabilitation, social skills training interventions and virtual reality-assisted therapies for psychosis. The potential benefits for enhancing treatment are highlighted. Recommendations for future research include demonstrating generalisability to real-life settings, examining potential negative effects, larger sample sizes and long-term follow-up studies. The present review has been registered in the PROSPERO register: CDR 4201507776.

What I have changed my mind about and why: public health and technology perspectives in the field of trauma studies

Background: This paper is based on a panel discussion at the 32nd annual meeting of the International Society for Traumatic Stress Studies in Dallas, Texas, in November 2016. Objective: Paula Schnurr convened a panel of experts in the fields of public health and technology to address the topic: 'What I have changed my mind about and why.' Method: The panel included Richard Bryant, Lucy Berliner, Dean Kilpatrick, Albert ('Skip') Rizzo, and Josef Ruzek. Results: Panellists discussed innovative strategies for the dissemination of scientific knowledge and evidence-based treatment. Conclusions: Although there are effective treatments, there is a need to enhance the effectiveness of these treatments. There also is a need to develop simpler, low-cost strategies to disseminate effective treatments. However, technology approaches also offer pathways to increased dissemination. Researchers must communicate scientific findings more effectively to impact public opinion and public policy.

Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD

Numerous reports indicate that the incidence of posttraumatic stress disorder (PTSD) in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) military personnel has created a significant behavioural healthcare challenge. These findings have served to motivate research on how to better develop and disseminate evidence-based treatments for PTSD. The current article presents the use of Virtual Reality (VR) as a clinical tool to address the assessment, prevention, and treatment of PTSD, based on the VR projects that were evolved at the University of Southern California Institute for Creative Technologies since 2004. A brief discussion of the definition and rationale for the clinical use of VR is followed by a description of a VR application designed for the delivery of prolonged exposure (PE) for treating Service Members (SMs) and Veterans with combat- and sexual assault-related PTSD. The expansion of the virtual treatment simulations of Iraq and Afghanistan for PTSD assessment and prevention is then presented. This is followed by a forward-looking discussion that details early efforts to develop virtual human agent systems that serve the role of virtual patients for training the next generation of clinical providers, as healthcare guides that can be used to support anonymous access to trauma-relevant behavioural healthcare information, and as clinical interviewers capable of automated behaviour analysis of users to infer psychological state. The paper will conclude with a discussion of VR as a tool for breaking down barriers to care in addition to its direct application in assessment and intervention.

Using virtual reality to investigate psychological processes and mechanisms associated with the onset and maintenance of psychosis: a systematic review

PURPOSE

In the last decade researchers have embraced virtual reality to explore the psychological processes and mechanisms that are involved in the onset and maintenance of psychosis. A systematic review was conducted to synthesise the evidence of using virtual reality to investigate these mechanisms.

METHODS

Web of Science, PsycINFO, Embase, and Medline were searched. Reference lists of collected papers were also visually inspected to locate any relevant cited journal articles. In total 6001 articles were potentially eligible for inclusion; of these, 16 studies were included in the review.

RESULTS

The review identified studies investigating the effect of interpersonal sensitivity, childhood bullying victimisation, physical assault, perceived ethnic discrimination, social defeat, population density and ethnic density on the real-time appraisal of VR social situations. Further studies demonstrated the potential of VR to investigate paranoid ideation, anomalous experiences, self-confidence, self-comparison, physiological activation and behavioural response.

CONCLUSIONS

The reviewed studies suggest that VR can be used to investigate psychological processes and mechanisms associated with psychosis. Implications for further experimental research, as well as for assessment and clinical practise are discussed. The present review has been registered in the PROSPERO register: CRD42016038085.

Virtual reality in the psychological treatment for mental health problems: An systematic review of recent evidence

The aim of this paper is to provide a review of controlled studies of the use of Virtual Reality in psychological treatment (VRT). Medline, PsychInfo, Embase and Web of Science were searched. Only studies comparing immersive virtual reality to a control condition were included. The search resulted in 1180 articles published between 2012 and 2015, of these, 24 were controlled studies. The reviewed studies confirm the effectiveness of VRT compared to treatment as usual, and show similar effectiveness when VRT is compared to conventional treatments. Current developments and future research are discussed.

Evidence-based treatment of post-traumatic stress disorder

The term translational research is typically used to refer both to "bench to bedside" research, in which preclinical research findings inform the development of novel therapeutics, and to the dissemination of new treatments to the community to encourage the use of the new health practices and treatments. Both definitions are germane to understanding the evidence base for treatment of post-traumatic stress disorder (PTSD) today. This article offers (a) an overview of evidence-based treatments for PTSD, (b) a description of a translational model of PTSD, and (c) a discussion of common barriers to dissemination and implementation of the empirically validated treatments. Recent studies in the field are discussed with a focus on pharmacotherapies, psychotherapies, and combined treatments.

Future directions: advances and implications of virtual environments designed for pain management

Pain symptoms have been addressed with a variety of therapeutic measures in the past, but as we look to the future, we begin encountering new options for patient care and individual health and well-being. Recent studies indicate that computer-generated graphic environments--virtual reality (VR)--can offer effective cognitive distractions for individuals suffering from pain arising from a variety of physical and psychological illnesses. Studies also indicate the effectiveness of VR for both chronic and acute pain conditions. Future possibilities for VR to address pain-related concerns include such diverse groups as military personnel, space exploration teams, the general labor force, and our ever increasing elderly population. VR also shows promise to help in such areas as drug abuse, at-home treatments, and athletic injuries.