Virtual reality in brain damage rehabilitation: review.

Given the high incidence of brain injury in the population, brain damage rehabilitation is still a relatively undeveloped field. Virtual reality (VR) has the potential to assist current rehabilitation techniques in addressing the impairments, disabilities, and handicaps associated with brain damage. The main focus of much of the exploratory research performed to date has been to investigate the use of VR in the assessment of cognitive abilities, but there is now a trend for more studies to encompass rehabilitation training strategies. This review describes studies that have used VR in the assessment and rehabilitation of specific disabilities resulting from brain injury, including executive dysfunction, memory impairments, spatial ability impairments, attention deficits, and unilateral visual neglect. In addition, it describes studies that have used VR to try to offset some of the handicaps that people experience after brain injury. Finally, a table is included which, although not an exhaustive list of everything that has been published, includes many more studies that are relevant to the use of VR in the assessment and rehabilitation of brain damage. The review concludes that the use of VR in brain damage rehabilitation is expanding dramatically and will become an integral part of cognitive assessment and rehabilitation in the future.     

The Use of the Term Virtual Reality in Post-Stroke Rehabilitation: A Scoping Review and Commentary

Virtual reality (VR) offers many opportunities for post-stroke rehabilitation. However, “VR” can refer to several types of computer-based rehabilitation systems. Since these systems may impact the feasibility and the efficacy of VR interventions, consistent terminology is important. In this study, we aimed to optimize the terminology for VR-based post-stroke rehabilitation by assessing whether and how review papers on this topic defined VR and what types of mixed reality systems were discussed. In addition, this review can inspire the use of consistent terminology for other researchers working with VR. We assessed the use of the term VR in review papers on post-stroke rehabilitation extracted from Scopus, Web of Science and PubMed. We also developed a taxonomy distinguishing 16 mixed reality systems based on three factors: immersive versus semi-immersive displays, the way in which real and virtual information is mixed, and the main input device. 64% of the included review papers (N = 121) explicitly defined VR and 33% of them described different subtypes of VR, with immersive and non-immersive VR as the most common distinction. The most frequently discussed input devices were motion-capture cameras and handheld devices, while regular 2D monitors were the most frequently mentioned output devices. Our analysis revealed that reviews on post-stroke VR rehabilitation did not or only broadly defined “VR” and did not focus on a specific system. Since the efficacy and feasibility of rehabilitation may depend on the specific system, we propose a new data-driven taxonomy to distinguish different systems, which is expected to facilitate communication amongst researchers and clinicians working with virtual reality.     

Virtual environments for motor rehabilitation: review.

In this paper, the current "state of the art" for virtual reality (VR) applications in the field of motor rehabilitation is reviewed. The paper begins with a brief overview of available equipment options. Next, a discussion of the scientific rationale for use of VR in motor rehabilitation is provided. Finally, the major portion of the paper describes the various VR systems that have been developed for use with patients, and the results of clinical studies reported to date in the literature. Areas covered include stroke rehabilitation (upper and lower extremity training, spatial and perceptual-motor training), acquired brain injury, Parkinson's disease, orthopedic rehabilitation, balance training, wheelchair mobility and functional activities of daily living training, and the newly developing field of telerehabilitation. Four major findings emerge from these studies: (1) people with disabilities appear capable of motor learning within virtual environments; (2) movements learned by people with disabilities in VR transfer to real world equivalent motor tasks in most cases, and in some cases even generalize to other untrained tasks; (3) in the few studies (n = 5) that have compared motor learning in real versus virtual environments, some advantage for VR training has been found in all cases; and (4) no occurrences of cybersickness in impaired populations have been reported to date in experiments where VR has been used to train motor abilities.     

Gaze direction affects walking speed when using a self-paced treadmill with a virtual reality environment

BackgroundIn a previous study it was observed that participants increase their walking speed during a dual task while walking on a self-paced treadmill in a virtual reality (VR) environment (Gait Real time Analysis Interactive Lab (GRAIL)). This observation is in contrast with the limited resources hypothesis, which suggests walking speed of healthy persons to decrease when performing a cognitive dual task.AimThe aim of the present study was therefore to determine whether the cognitive demand of the task, an aroused feeling, discrepancy in optic flow or a change in gaze direction caused participants to walk faster in this computer assisted rehabilitation environment.MaterialsThe GRAIL included a self-paced treadmill, a motion-capture system and synchronized VR environments.MethodsThirteen healthy young adults (mean age 21.6 ± 2.5) were included in this study. Participants walked on the self-paced treadmill while seven different intervention conditions (IC) were offered. Prior to each IC, a control condition (CC) was used to determine the natural self-selected walking speed. Walking speed during the last 30 s of each IC was compared with the walking speed during the last 30 s of the preceding CC.ResultsResults show that the height on which a visual task was presented in the VR environment, influenced walking speed. Participants walked faster when gaze was directed above the focus of expansion.SignificanceThese findings contribute to a further understanding of the differences between walking in a real life environment or computer assisted rehabilitation environment. When analyzing gait on a self-paced treadmill in the future, one must be attentive where to place a visual stimulus in the VR environment.     

A virtual reality assessment and training system for unilateral neglect.

Patients with unilateral neglect have problems reporting, responding, or orienting to novel or meaningful stimuli that is presented to the side opposite to that of a brain lesion. This creates a serous problem in regards to daily living activities. However, the established methods for assessing and training of unilateral neglect patients have several deficits. Recently, virtual reality (VR) technologies have been used as an assessment and treatment tool for rehabilitation. Hence, this study designed a VR system to assess and train unilateral neglect patients. In addition, the suitability and feasibility of our VR system for unilateral neglect patients was verified.     

The impact of enhanced incentives on vocational rehabilitation outcomes for dually diagnosed veterans

This study evaluated the efficacy of adding contingency management techniques to vocational rehabilitation (VR) to improve treatment outcome as measured by entry into competitive employment. Nineteen dually diagnosed veterans who entered VR in the Veterans' Administration's compensated work therapy (CWT) program were randomly assigned to CWT (n = 8) or to CWT with enhanced incentives (n = 11). Over the first 16 weeks of rehabilitation, those in the incentives condition could earn up to dollar 1,006 in cash for meeting two sets of clinical goals: (a) remaining abstinent from drugs and alcohol and (b) taking steps to obtain and maintain a competitive job. Results indicate that relative to participants in the CWT-only group, those in the incentives condition engaged in more job-search activities, were more likely to remain abstinent from drugs and alcohol, were more likely to obtain competitive employment, and earned an average of 68% more in wages. These results suggest that rehabilitation outcomes may be enhanced by restructuring traditional work-for-pay contingencies to include direct financial rewards for meeting clinical goals.     

Neurofeedback training with virtual reality for inattention and impulsiveness.

In this research, the effectiveness of neurofeedback, along with virtual reality (VR), in reducing the level of inattention and impulsiveness was investigated. Twenty-eight male participants, aged 14-18, with social problems, took part in this study. They were separated into three groups: a control group, a VR group, and a non-VR group. The VR and non-VR groups underwent eight sessions of neurofeedback training over 2 weeks, while the control group just waited during the same period. The VR group used a head-mounted display (HMD) and a head tracker, which let them look around the virtual world. Conversely, the non-VR group used only a computer monitor with a fixed viewpoint. All participants performed a continuous performance task (CPT) before and after the complete training session. The results showed that both the VR and non-VR groups achieved better scores in the CPT after the training session, while the control group showed no significant difference. Compared with the other groups, the VR group presented a tendency to get better results, suggesting that immersive VR is applicable to neurofeedback for the rehabilitation of inattention and impulsiveness.     

Exploring the Vocational Rehabilitation Acceptance Rates for Hispanics Versus Non‐Hispanics in the United States

Compared with other ethnic minorities in the United States, numbers for the Hispanic population are significantly escalating. In the study described here, a chi‐square test of proportions was used to examine the vocational rehabilitation (VR) acceptance rates among Hispanics and non‐Hispanics. The test statistic revealed a statistically significant difference between race/ethnicity and VR acceptance. In particular, Hispanics are more likely to be accepted for VR services than are non‐Hispanics in the United States. Implications for VR counselors are discussed.     

Training Vocational Rehabilitation Counselors in Group Dynamics: A Psychoeducational Model

Vocational rehabilitation (VR) counselors often head interdisciplinary teams composed of various medical, educational, and allied health care professionals. Issues stemming from team dynamics can impede the delivery of services to eligible clients with disabilities. A psychoeducational program for training VR counselors in group dynamics is described, and the reactions of participants are discussed     

Transformation of flow in rehabilitation: The role of advanced communication technologies

Authentic rehabilitation requires the active participation of patients and their involvement with opportunities for action and development. Within this framework, in this article we outline the possibility of using two emerging computing and communication technologies—ambient intelligence (AmI) and virtual reality (VR)—for a new breed of rehabilitative and clinical applications based on a strategy defined astransformation of flow. Transformation of flow is a person’s ability to exploit an optimal (flow) experience to identify and use new and unexpected psychological resources as sources of involvement. We identify the feeling ofpresence—the feeling of being in a world that exists outside oneself—as the theoretical link between the technology and rehabilitation. AmI and VR are used to trigger broad empowerment processes induced by a strong sense of presence, leading to greater agency and control over one’s actions and environment.     

Virtual reality applications to agoraphobia: a protocol.

Recently, educators and instructional designers have focused on the development and implementation of virtual learning environments that effectively combine theoretical and applied knowledge to teach university students. One of the trusts of the Psychology Virtual Teaching Laboratory in collaboration with the IXTLI observatory is to develop dissemination programs to promote the insertion of virtual reality (VR) technologies applied to rehabilitation in their clinical practice. This paper describes the development of (1) agoraphobia VR learning objects to be use as a teaching support tools in class and (2) a multimedia teaching program that incorporate digital video and VR scenarios address to students in the field of mental health. Promotion among professors and students about the use of this technology will allow us to initiate research in our country as well as to validate contextualized applications for our culture, therefore contributing with new advances in this field.     

Integrating haptic-tactile feedback into a video-capture-based virtual environment for rehabilitation.

Video-capture virtual reality (VR) systems are gaining popularity as intervention tools. To date, these platforms offer visual and audio feedback but do not provide haptic feedback. We contend that adding haptic feedback may enhance the quality of intervention for various theoretical and empirical reasons. This study aims to integrate haptic-tactile feedback into a video capture system (GX VR), which is currently applied for rehabilitation. The proposed multi-modal system can deliver audio-visual as well as vibrotactile feedback. The latter is provided via small vibratory discs attached to the patient's limbs. This paper describes the system, the guidelines of its design, and the ongoing usability study.     

Virtual reality promotes greater improvements than video-stimulation screen on perceptual-cognitive skills in young soccer athletes

BackgroundThe literature has shown the positive effect of virtual reality (VR) in percepto-cognitive skills. However, the literature lacks findings about at what extent VR would be better than video.PurposeThis study aimed to analyze the chronic effect of VR and video-stimulation screen training on passing decision-making, visual search behavior, and inhibitory control performance in young soccer athletes.MethodA total of 26 young soccer players underwent an 8-week training protocol after being randomly assigned to the VR (n = 13) or video-screen (VID, n = 13) group. Passing decision-making, visual search behavior, and inhibitory control performance were measured before and after both interventions.ResultsA group x time interaction was found for decision-making performance (p < 0.01) and visual search behavior (p < 0.01). Both groups improved both decision-making performance (p < 0.01) and visual search behavior (p < 0.01); however, greater improvements were verified in VR (p < 0.01). Both VR and VID improved inhibitory control (p < 0.01), but no group interaction effect was observed (p > 0.05).ConclusionOur results suggest that VR leads to greater improvements in decision-making and visual search behavior in young soccer athletes than VID.     

The influence of visual perception of self-motion on locomotor adaptation to unilateral limb loading

Self-perception of motion through visual stimulation may be important for adapting to locomotor conditions. Unilateral limb loading is a locomotor condition that can improve stability and reduce abnormal limb movement. In the present study, the authors investigated the effect of self-perception of motion through virtual reality (VR) on adaptation to unilateral limb loading. Healthy young adults, assigned to either a VR or a non-VR group, walked on a treadmill in the following 3 locomotor task periods--no load, loaded, and load removed. Subjects in the VR group viewed a virtual corridor during treadmill walking. Exposure to VR reduced cadence and muscle activity. During the loaded period, the swing time of the unloaded limb showed a larger increase in the VR group. When the load was removed, the swing time of the previously loaded limb and the stance time of the previously unloaded limb showed larger decrease and the swing time of the previously unloaded limb showed a smaller increase in the VR group. Lack of visual cues may cause the adoption of cautious strategies (higher muscle activity, shorter and more frequent steps, changes in the swing and stance times) when faced with situations that require adaptations. VR technology, providing such perceptual cues, has an important role in enhancing locomotor adaptation.     

听觉刺激对虚拟环境中空间压缩的影响

人们往往会低估虚拟环境中空间的距离(空间压缩)。早期研究发现视听刺激的不一致会改善空间压缩,但听觉刺激在其中的作用及其影响效果需进一步研究。本研究首先探究了听觉刺激的有无对空间压缩的影响,接着操控视听刺激之间的物物距离进一步探究其对空间压缩的影响和改善。研究发现听觉刺激以两种方式影响空间压缩：听觉刺激的存在可以改善空间压缩;空间压缩与视听刺激的物物距离负相关。研究建议为了改善空间压缩,视听刺激应当同时呈现且物物距离至少为1 m。     

Consistency in reasoning test scores over time

Background: UK schools have a long history of using reasoning tests, most frequently of Verbal Reasoning (VR), Non‐Verbal Reasoning (NVR), and to a lesser extent Quantitative Reasoning (QR). Results are used for identifying students' learning needs, for grouping students, for identifying underachievement, and for providing indicators of future academic performance. Despite this widespread use there are little empirical data on the long‐term consistency of VR, QR and NVR as discrete abilities. Aims: To evaluate and compare the consistency of VR, QR and NVR scores over a 3‐year period, and to explore the influence of the secondary school on pupils' progress in the tests. Sample: Data were collected on a longitudinal sample of over 10,000 pupils who completed the Cognitive Abilities Test Second Edition in year 6 (age 10+) and year 9 (age 13+), and GCSE public examinations in year 11 (age 15+). Methods: Correlation coefficients and change scores for individual pupils are calculated. Multilevel modelling is used to determine school effects on reasoning scores and GCSE public examination results. Results: The results reveal high correlations in scores over time, ranging from .87 for VR to .76 for NVR, but also show around one‐sixth of pupils on the VR test and one‐fifth of pupils on the QR and NVR tests change their scores by 10 or more standard score points. Schools account for only a small part of the total variation in reasoning score, although they account for a much greater proportion of the variation in measures of attainment such as GCSE. School effects on pupils' progress in the reasoning tests between age 10 and age 13 are relatively modest. Conclusions: Reasoning tests make excellent baseline assessments for secondary schools. Some practical and policy implications for schools are discussed.     

A controlled trial of cognitive-behavior therapy combined with vestibular rehabilitation in the treatment of dizziness

Dizziness is a common and often untreated symptom in the general population. The aim of this study was to investigate the effects of a combined cognitive-behavioral/vestibular rehabilitation (VR) program, using a randomized control design. A total of 29 participants were randomized to treatment consisting of psychoeducation, vestibular exercises, relaxation and cognitive interventions, or to serve as waiting list controls. Measures of dizziness-related handicap, dizziness-provoking movements, and daily diary registrations of dizziness symptoms at pre- and post-treatment showed statistically significant improvements in many domains, which translated to moderate effect sizes. These findings provide preliminary support for the combination of Cognitive-behavioral therapy (CBT) and VR methods in the treatment of dizziness.     

虚拟现实技术在心理学领域的应用与展望

虚拟现实(VR)技术因其能够提高实验研究的生态效度、条件控制水平、可重复性以及避免实地操作带来的危险,被众多研究者引入心理学领域。VR技术除了被用于改良实验程序外,也广泛应用于注意、记忆和执行能力等神经心理测验评估,在恐惧症、焦虑症、创伤后应激障碍和精神分裂症等精神障碍的临床治疗中亦取得丰硕成果。未来研究可致力于改进VR技术本身存在的问题、扩大样本量并扩展研究方法和范围,为VR应用提供更可靠的信效度证据。     

The Rutgers Arm, a rehabilitation system in virtual reality: a pilot study.

Stroke is one of the leading causes of death and disability worldwide. Its prevalence calls for innovative rehabilitation methods. The Rutgers Arm is a novel upper extremity rehabilitation system consisting of a low-friction table, three-dimensional (3D) tracker, custom forearm support, PC workstation, library of Java 3D virtual reality (VR) exercises, clinical database module, and a tele-rehabilitation extension. The system was tested on a chronic stroke subject, under local and tele-rehabilitation conditions, over 5 weeks of training. Results show improvements in arm motor control and shoulder range of motion, corresponding to improved Fugl-Meyer test scores. Exercise duration, level of difficulty, and patient motivation were maintained under tele-rehabilitaion. A 1-week retention trial showed that gains were maintained.     

Virtual reality as an immersive projective and autodriving advancement technique

The COVID-19 lockdown posed challenges for traditional qualitative researchers, as well as opportunities for innovative qualitative research. While online interviews and focus groups via video conferencing platforms were the most widely used methods, Zoom Fatigue also occurred, hampering some participants' experiences and eventually impacting data quality. Incorporating virtual reality (VR) was one possible solution. This study explores the experiences and involvement of family participants in a qualitative research study using VR during the COVID-19 pandemic lockdown. The research aims to assess the impact of VR on data quantity and quality, as well as the depth of insights compared to traditional methods without VR. The study employs VR roleplay and autodriving methods to elicit family participant engagement. The findings suggest that the application of VR in autodriving improves data quality and quantity while also making the research process more enjoyable for participating parents and children. The results indicate that VR holds significant potential for advancing qualitative research methodology, especially for previously underrepresented groups such as children.