Feasibility of using virtual reality in geriatric psychiatry.

OBJECTIVES: Virtual Reality-based interventions have become an important element of digital mental health, offering accessible and scalable treatment options. However, studies on VR-based approaches in elderly patients are scarce. This explorative study examined the feasibility of using Virtual Reality (VR) for elderly patients with psychiatric illness, focusing on the sense of presence as the primary outcome. METHODS: The study included N = 30 patients between the ages of 59-92 years who were currently in geriatric psychiatric inpatient and day clinic treatment. Participants were assessed before, during and after a relaxing ten-minute VR experience. Attitude towards digital media and VR, subjective digital competence, and previous experience were examined using questionnaires. Motion sickness was measured repeatedly during the VR experience using the Fast Motion Sickness Scale (FMS). Patients rated their motion sickness and their general well-being in the virtual environment. Sense of presence in the virtual environment was quantified with the Igroup Presence Questionnaire (IPQ). RESULTS: Participants reported a notable sense of presence (M = 0.41 ± 1.4) in the virtual environment, particularly in terms of spatial presence. Motion sickness was reported by a minority of patients. Three patients terminated the VR application before it was finished. The average well-being during the VR experience was reported as high (70/100). Sense of presence and motion sickness showed a significant negative correlation. Presence, motion sickness and well-being were not significantly correlated with age, nor did they differ significantly between groups. CONCLUSIONS: This study underscores the potential of VR-based experiences in the treatment of elderly psychiatric patients and highlights their willingness and ability to engage with VR technology. While the results are promising, future research should explore more interactive VR scenarios and assess their safety and feasibility in elderly populations.

A Deep Motion Sickness Predictor Induced by Visual Stimuli in Virtual Reality.

In a virtual reality (VR) environment, where visual stimuli predominate over other stimuli, the user experiences cybersickness because the balance of the body collapses due to self-motion. Accordingly, the VR experience is accompanied by unavoidable sickness referred to as visually induced motion sickness (VIMS). In this article, our primary purpose is to simultaneously estimate the VIMS score by referring to the content and calculate the temporally induced VIMS sensitivity. To seek our goals, we propose a novel architecture composed of two consecutive networks: 1) neurological representation and 2) spatiotemporal representation. In the first stage, the network imitates and learns the neurological mechanism of motion sickness. In the second stage, the significant feature of the spatial and temporal domains is expressed over the generated frames. After the training procedure, our model can calculate VIMS sensitivity for each frame of the VR content by using the weakly supervised approach for unannotated temporal VIMS scores. Furthermore, we release a massive VR content database. In the experiments, the proposed framework demonstrates excellent performance for VIMS score prediction compared with existing methods, including feature engineering and deep learning-based approaches. Furthermore, we propose a way to visualize the cognitive response to visual stimuli and demonstrate that the induced sickness tends to be activated in a similar tendency, as done in clinical studies.

Floor-vibration VR: Mitigating Cybersickness Using Whole-body Tactile Stimuli in Highly Realistic Vehicle Driving Experiences.

This work addresses cybersickness, a major barrier to successful long-exposure immersive virtual reality (VR) experiences since user discomfort frequently leads to prematurely ending such experiences. Starting from sensory conflict theory, we posit that if a vibrating floor delivers vestibular stimuli that minimally match the vibration characteristics of a scenario, the size of the conflict between the visual and vestibular senses will be reduced and, thus, the incidence and/or severity of cybersickness will also be reduced. We integrated a custom-built, computer-controlled vibrating floor in our VR system. To evaluate the system, we implemented a realistic off-road vehicle driving simulator in which participants rode multiple laps as passengers on an off-road course. We programmed the floor to generate vertical vibrations similar to those experienced in real off-road vehicle travel. The scenario and driving conditions were designed to be cybersickness-inducing for users in both the Vibration and No-vibration conditions. We collected subjective and objective data for variables previously shown to be related to levels of cybersickness or presence. These included presence and simulator sickness questionnaires (SSQ), self-rated discomfort levels, and the physiological signals of heart rate, galvanic skin response (GSR), and pupil size. Comparing data between participants in the Vibration group (N=11) to the No-Vibration group (N=11), we found that Delta-SSQ Oculomotor response and the GSR physiological signal, both known to be positively correlated with cybersickness, were significantly lower (with large effect sizes) for the Vibration group. Other variables differed between groups in the same direction, but with trivial or small effect sizes. The results indicate that the floor vibration significantly reduced some measures of cybersickness.

Sea Voyage Training and Motion Sickness Effects on Working Ability and Life Quality After Landing.

BACKGROUND: The effects of seasickness on working performance during motion exposure have been reported, while the aftereffects on working ability and life quality decline (WLD) still remain unclarified.METHODS: Two cohorts of healthy male Chinese subjects received either a single (SSV) or repeated (RSV) sea voyage training program on different vessels. A seasickness incidence (SSI) questionnaire was administered to assess the prevalence of seasickness symptoms (vomiting, nausea, other, or no symptoms). A WLD questionnaire was used to survey the general feeling of WLD (severe, moderate, slight, and none) by a 4-point score as well as the incidence rate (IR) of specific WLD items within 24 h after landing.RESULTS: The RSV cohort had lower overall IR of WLD than the SSV cohort (54.64% vs. 63.78%, N 657 for both cohorts). The landing ship trainees in both cohorts showed higher general WLD score and higher IRs of physical fatigue, sleep disorder, and spontaneous locomotion decrement than those trained on the small vessels. Subjects with vomiting or nausea had higher general WLD score and higher IRs of concentration distraction, physical fatigue, anorexia, and spontaneous locomotion decrement than those with no symptoms. Higher IRs of firing accuracy decline (SSV: 21.35% vs. 7.13%, 9.14%; RSV: 22.11% vs. 9.28%, 5.27%), equipment operation disturbance (SSV: 16.85% vs. 3.57%, 6.85%; RSV: 20.47% vs. 7.85%, 7.03%) were also observed in the vomiting subjects than those with other symptoms and no symptoms.DISCUSSION: Significant WLD after landing was associated with transportation types, seasickness severity, and habituation during sea voyage training.Qi R-R, Xiao S-F, Su Y, Mao Y-Q, Pan L-L, Li C-H, Lu Y-L, Wang J-Q, Cai Y-L. Sea voyage training and motion sickness effects on working ability and life quality after landing. Aerosp Med Hum Perform. 2021; 92(2):9298.

Seasickness and its impact on researchers' work on board French oceanographic vessels.

BACKGROUND: Seasickness (SS) is an often hidden pathology, but one that can significantly disrupt work on board. The aim of the study is to evaluate the influence of SS on the workability of workers on board vessels. MATERIALS AND METHODS: We performed a cross-sectional questionnaire study conducted on 250 oceanographers in 2015 during 3 months. Based on the "Bos seasickness susceptibility questionnaire", we created a specific questionnaire with 49 questions. RESULTS: 151 men and 72 women responded to the survey. 188 of them (91.7% of women and 80.8% of men) report being seasick, either occasionally (69%) or at each boarding where there is female predominance (23.6% vs. 11.3% for men). The major symptoms are nausea (82%) and vomiting (56%). 60% of the workers think that SS has an influence on the success of their mission, by first affecting their mood (50%), relationship (23%), and increased risk of accidents such as falls, accidents on machines or in laboratories (40%). Antinaupathic treatments also produce deleterious effects on their workstation. Women have higher risk of developing SS (odds ratio [OR] 2.6; 95% confidence interval [CI] 1.03-6.6; p = 0.04), more frequently taking medicines when ill (OR 4.1; 95% CI 1.27-13.2; p = 0.004) and coming with her own tablets (OR 2.3; 95% CI 1.3-4.1; p = 0.04). CONCLUSIONS: Gender is a trending factor of SS. Information on SS clinical signs, impact and therapeutics could be prone to prevent sickness and impact of it on workability.

Virtual and augmented reality in a simulated naval engagement: Preliminary comparisons of simulator sickness and human performance.

The aim of this study was to compare simulator sickness symptoms while participants wore either a virtual reality (VR) or augmented reality (AR) headset. A secondary aim involved comparing how physical motion affects symptoms. During a simulation, participants wore VR and AR headsets while standing on a motion platform and firing at hostile ships under three motion conditions: No Physical Motion; Synchronous Motion, in which the physical and displayed motion were coupled; and Asynchronous Motion, in which the physical motion did not match the display. Symptoms increased over time but were not different with respect to headset or motion. The VR condition had higher accuracy and faster response time to the commence fire instruction. Further research is necessary to determine if this holds under more extreme motion. The use of VR or AR headsets for training under gentle motion conditions is practicable and should be permissible under normal conditions during deployment.

Individual predictors of the susceptibility for motion-related sickness: A systematic review.

BACKGROUND: Individuals seem to be differently susceptible to motion-related sickness (motion sickness, visually induced sickness etc.). Investigations of the reasons for these different susceptibilities have revealed many potential factors that could predict individual susceptibility to motion-related sickness. OBJECTIVE: This paper attempts to conduct a comprehensive literature review on inter-individual predictors of susceptibility to motion-related sickness using systematic approaches. METHODS: After a systematic literature research, titles and abstracts of 1778 publications were screened for relevance. Reference lists of selected publications were searched for additional studies. This procedure yielded 184 relevant publications. RESULTS: The identified predictors were clustered into demographic, physiological and psychological aspects. Among these predictors, the factors gender, length of velocity storage and anxiety showed the greatest predictive power. In addition, individual susceptibility to motion-related sickness is also to a large extent dependent on the degree of habituation to the aversive stimulus. CONCLUSIONS: Some of the identified influencing factors seem to have different effects on physically and visually induced motion sickness. More research is needed to close gaps, especially on predictive factors of visually induced motion sickness.

Effects of synchronised engine sound and vibration presentation on visually induced motion sickness.

Driving simulator usage is often accompanied by motion sickness, and techniques for its prevention are not yet established. To reduce visually induced motion sickness (VIMS), we investigated the effects of synchronised presentation of engine sounds and motorcycle vibration on VIMS. A total of 80 participants experienced a driving scene with a head-mounted display for 5 minutes with or without synchronised presentation of engine sound and vibration. The results showed that VIMS scores, as measured by the Fast Motion Sickness scale, were significantly lower in participants who experienced the driving scene with sounds and vibration than in those who experienced the scene with sounds only, vibration only, or neither. Multiple regression analyses revealed that susceptibility to VIMS consistently explained the severity of VIMS to some extent but not with perceived realism of the virtual reality (VR) scene, sex, and experiences about VR devices and vehicles. This study demonstrated that simultaneous presentation of engine sounds and vibration, which were synchronous to each other and tightly coupled with the visual flow speed, effectively reduces VIMS while experiencing motorcycling simulators. The findings not only improve practical knowledge for reducing VIMS in driving simulators but also provide evidence for understanding the mechanisms of VIMS.

Knowing what's coming: Anticipatory audio cues can mitigate motion sickness.

Being able to anticipate upcoming motion is known to potentially mitigate sickness resulting from provocative motion. We investigated whether auditory cues could increase anticipation and subsequently reduce motion sickness. Participants (N = 20) were exposed on a sled on a rail track to two 15-min conditions. Both were identical in terms of motion, being composed of the same repeated 9 m fore-aft displacements, with a semi-random timing of pauses and direction. The auditory cues were either 1) informative on the timing and direction of the upcoming motion, or 2) non-informative. Illness ratings were recorded at 1-min intervals using a 11-point scale. After exposure, average illness ratings were significantly lower for the condition that contained informative auditory cues, as compared to the condition without informative cues. This knowledge, i.e. that auditory signals can improve anticipation to motion, could be of importance in reducing carsickness in domains such as that of autonomous vehicles.

The Effect of Optic Flow Speed on Active Participation During Robot-Assisted Treadmill Walking in Healthy Adults.

This study aimed to investigate: 1) the effect of optic flow speed manipulation on active participation during robot-assisted treadmill walking (RATW), 2) the influence of the type of virtual environment, and 3) the level of motion sickness and enjoyment. Twenty-eight healthy older adults were randomized in two groups: "stimulus rich" Park group (50% male, 61± 6 year) and "stimulus poor" Hallway group (43% male, 62± 5 year). Subjects walked in the Lokomat with immersive virtual reality (VR) with a matched, slow and fast optic flow speed, each lasting 7 minutes. Active participation was measured by continuously assessing the human-machine interaction torques at the hip and knee joints and muscle activity of the Vastus Medialis and Biceps Femoris. Motion sickness and enjoyment were assessed with the Simulator Sickness Questionnaire (SSQ) and Physical Activity Enjoyment Scale (PACES) respectively. In both groups optic flow speed manipulation in both directions led to a decrease in bilateral hip interaction torques towards flexion at the end of the stance phase compared to matched speed. In the Hallway group, walking with slow optic flow elicited 32% more muscle activity of the Vastus Medialis. There were no significant differences between both groups for the SSQ and PACES. Optic flow speed manipulation appears to have only a small effect on the active participation of healthy people during RATW. The type of virtual environment did not affect their activity, motion sickness or enjoyment. However, the addition of immersive VR during RATW was well tolerated and enjoyable. Further research with patients is necessary.

Moving base driving simulators' potential for carsickness research.

We investigated whether motion sickness analogous to carsickness can be studied in a moving base simulator, despite the limited motion envelope. Importantly, to avoid simulator sickness, vision outside the simulator cabin was restricted. Participants (N = 16) were exposed blindfolded to 15-min lateral sinusoidal motion at 0.2 Hz and 0.35 Hz on separate days. These conditions were selected to realize optimal provocativeness of the stimulus given the simulator's maximum displacement and knowledge on frequency-acceleration interactions for motion sickness. Average motion sickness on an 11-point scale was 2.21 ±â€¯1.97 for 0.2 Hz and 1.93 ±â€¯1.94 for 0.35 Hz. The motion sickness increase over time was comparable to that found in studies using actual vehicles. We argue that motion base simulators can be used to incite motion sickness analogous to carsickness, provided considerable restrictions on vision. Future research on carsickness, potentially more prevalent in autonomous vehicles, could benefit from employing simulators.

Deceptive but not open label placebos attenuate motion-induced nausea.

OBJECTIVE: Nausea is a common complaint, known to respond to the placebo effect. Existing research has employed deception when administering placebos for nausea, limiting therapeutic translation on ethical grounds. We therefore examined the potential of non-deceptive open-label placebos (OLPs) to reduce nausea. METHODS: Galvanic Vestibular Stimulation (GVS) and Virtual Reality (VR) were employed to model nausea in healthy volunteers across two experiments. In both experiments nausea was elicited with and without sham treatment (peppermint vapor and brain stimulation, respectively). In Exp. 1, participants (n = 61) were randomized to deceptive placebo, semi-open placebo, fully-open placebo, or control. In Exp. 2, participants (n = 93) were randomized to deceptive placebo, semi-open placebo, or control. RESULTS: Exp. 1 found limited evidence for a placebo effect (F(1, 56) = 1.15, p = .29, ηp2 =0.02), even following deceptive treatment (F(1, 56) = 1.92, p = .17, ηp2=0.03). In Exp. 2, deceptive placebo reduced nausea relative to control (F(1, 89) = 6.91, p = .010, ηp2=0.07) and OLP (F(1, 89) = 5.47, p = .022, ηp2=0.06). Pooled Bayesian analysis across experiments provided strong evidence that deceptive placebos reduce nausea relative to control (BF10 = 30.91) and anecdotal evidence for the benefit of deceptive treatment over non-deceptive (BF10 = 2.46) and no benefit of OLP over control (BF10 = 0.63). CONCLUSIONS: No positive evidence for OLP effects in nausea were observed. However, a deceptive effect in VR was observed. These findings raise questions regarding the efficacy of open-label intervention in nausea.

Tolerable acclimation to the cross-coupled illusion through a 10-day, incremental, personalized protocol.

BACKGROUNDArtificial gravity (AG) has the potential to provide a comprehensive countermeasure mitigating deleterious effects of microgravity. However, the cross-coupled "Coriolis" illusion has prevented using a more feasible and less costly short-radius centrifuge, as compared to large, slowly spinning systems.OBJECTIVEWe assessed tolerability of a personalized, incremental protocol to acclimate humans to the cross-coupled illusion, enabling faster spin rates.METHODSTen subjects were exposed to the illusion by performing roll head tilts while seated upright and spun about an Earth-vertical axis. The spin rate was incremented when head tilts did not subjectively elicit the illusion. Subjects completed one 25-minute session on each of 10 days.RESULTSThe spin rate at which subjects felt no cross-coupled illusion increased in all subjects from an average of 1.8 rotations per minute (RPM) (SD: ±0.9) at the beginning of the protocol to 17.7 RPM (SD: ±9.1) at the end. For off-axis centrifugation producing 1G at the rider's feet, this corresponds to a reduction in the required centrifuge diameter from 552.2 to 5.7 meters. Subjects reported no more than slight motion sickness.CONCLUSIONSAcclimation to the cross-coupled illusion, such as that accomplished here, is critical for feasibility of short-radius centrifugation for AG implementation.

Derealization symptoms according to the subjective visual vertical during unilateral centrifugation in patients with type 2 diabetes mellitus.

BACKGROUND: A recent study has shown variability on the perception of verticality during unilateral centrifugation among patients with type 2 diabetes mellitus; it is yet unknown if it is related to symptoms of unreality. OBJECTIVE: In patients with type 2 diabetes mellitus compared to age matched healthy volunteers, to assess depersonalization/derealization (DD) symptoms before and after unilateral centrifugation, according to the subjective visual vertical (SVV). METHODS: 47 patients with type 2 diabetes mellitus and 50 age matched healthy volunteers participated in the study. They replied to standardized questionnaires of symptoms related to balance, depression, and anxiety. Then, after neuro-otological evaluation, they completed a DD inventory before and after unilateral centrifugation (300°/s, 3.85 cm) with SVV estimation. RESULTS: Right/left asymmetric SVV during centrifugation was identified in 17 patients (36%) and no SVV change during centrifugation was identified in 6 patients (13%). Before centrifugation, patients with asymmetric SVV already reported some of the DD symptoms, while patients with no SVV change reported almost no DD symptoms. Unilateral centrifugation provoked an increase of DD symptoms in both healthy volunteers and the entire group of patients (repeated measures ANOVA, p < 0.01), except in the 6 patients with no SVV change. Before centrifugation, the DD score showed influence from the SVV subgroup and the evidence of depression (MANCoVA, p < 0.01); after centrifugation, which provoked asymmetry of the right/left utricular input, only the influence from depression persisted. No influence was observed from the characteristics of the subjects, including retinopathy, peripheral neuropathy (assessed by electromyography) or weight loss, or from the total score on the questionnaire of symptoms related to balance. CONCLUSIONS: In patients with type 2 diabetes mellitus and healthy volunteers, utricular stimulation by unilateral centrifugation may provoke DD symptoms, with an influence from depression. The results support that the aphysiological utricular input given by unilateral centrifugation may contribute to create a misleading vestibular frame of reference, giving rise to 'unreal' perceptions.

An evaluation for VR glasses system user experience: The influence factors of interactive operation and motion sickness.

As a new type of Virtual Reality (VR) headset, VR glasses rise rapidly in a number of areas. It's essential to understand the importance of user experience (UX) on VR glasses design. This study aimed to develop questionnaires for evaluating VR glasses' UX, as well as to investigate the relationship between various UX variables. With using lab-based usability tests, this study analyzed participants' self-reports and performance based on testing eight VR glasses and seven mobile applications. A nine-item questionnaire and a ten-item questionnaire were successfully developed to measure VR glasses systems' UX quality in terms of hardware and application, respectively. Within a proposed UX evaluation framework, the perceived UX quality relative to VR glasses hardware emerged as a core predictor in predicting interactive operation performance, whereas the application UX perception was a significant predictor of motion sickness.

The effects of habituation and adding a rest-frame on experienced simulator sickness in an advanced mobility scooter driving simulator.

The aim of this article is to investigate the effect of a physical rest-frame, habituation and age on simulator sickness in an advanced mobility scooter driving simulator. Twenty-six young and 34 older adults completed a total of 12 drives in an advanced mobility scooter driving simulator over two visits. A 2x2 crossover design was used to measure the effect of a rest frame that was added to the driving simulator on either the first or second visit. The Simulator Sickness Questionnaire was used to measure simulator sickness symptoms. A significant decrease in simulator sickness was observed between the first and the second visit. Older adults reported more severe simulator sickness symptoms compared to younger participants. No effect of rest-frame could be found. Habituation appears to be the most effective method to reduce simulator sickness in an advanced mobility scooter driving simulator. More research is needed to investigate simulator sickness in patient groups. Practitioner summary: Experiencing simulator sickness is a major problem across all types of simulators. The present experiment investigated the effect of a rest-frame, habituation and age on developing simulator sickness symptoms in an advanced mobility scooter driving simulator. Habituation appeared to be the most effective method to reduce simulator sickness.

Factors Affecting Enjoyment of Virtual Reality Games: A Comparison Involving Consumer-Grade Virtual Reality Technology.

OBJECTIVE: This study investigated psychological responses to playing videogames using a virtual reality (VR) head-mounted display (HMD). We also investigated how cybersickness impacts the sense of presence one feels in the virtual environment, as well as how cybersickness affects enjoyment. MATERIALS AND METHODS: Participants played randomly assigned VR games that varied in the level of sensory conflict they provided: "Lucky's Tale," "Elite: Dangerous," and "Minecraft." Results were compared based on two headset conditions-the Oculus DK2 and the recently released Oculus Rift Consumer Version (CV1). RESULTS: Cybersickness was not reduced by playing games with a VR HMD of higher technological quality-the Oculus Rift CV1. Furthermore, cybersickness responses were significantly different based on the level of sensory conflict in the games. Games with less sensory conflict, such as third-person platformer games, or space and flight simulator games, produce less cybersickness in players than first-person games. Enjoyment of VR games was shown to be directly influenced by a sense of spatial presence, which was affected by interactivity and realism. Findings suggest that the variables that are important to the enjoyment of console, mobile, or motion-based games are consistently important to enjoyment of VR games. CONCLUSION: Better technology does not affect the frequency or severity of cybersickness for players; but sensory conflict has a significant impact on how sick users become. Additionally, we present a model that indicates how enjoyment is produced in VR gaming experiences. These findings bear further investigation as new methods of interacting with VR games are developed.

Motion sickness as metaphor: engaging with diversity in STEM.

Science, technology, engineering, and math (STEM) continue to work to increase the diversity of the fields, yet there are still significant historical and societal hurdles to be overcome before we reach full representation throughout STEM. The concept of science identity has become a point of interest in this process; it has been suggested that development of one's identity as a scientist is critical to persistence in the field. Metaphors that are rooted in bodily experience can provide a starting point to understand abstract concepts, including science identity and how we as STEM educators respond to increasing diversity within our fields. Given the history of STEM being predominantly populated by people who are white and male, disorientation or discomfort with increasing diversity is not unexpected, and many women and people of color report discrimination and marginalization as a part of their experience in STEM. Here I present a neuroscience-based metaphor that can serve as a starting point for understanding some of the potential disorientation or discomfort that we may experience as we engage with the increasing diversity of STEM and acknowledge this experience as a normal but temporary part of the process of growth and development as a field. I encourage the development and use of further discipline-based metaphors to enhance our discussion and understanding of this important work.

Effects of unexpected visual motion on postural sway and motion sickness.

Motion sickness is thought to occur when the brain's assumptions about incoming sensory information do not match the actual signals received. These signals must involve the vestibular system for motion sickness to occur. In this paper, we describe an experiment in which subjects experienced unexpected visual motions, or perturbations, as they navigated a virtual environment (VE) while standing and wearing a head mounted display (HMD) or while viewing a monitor. We found that postural instability, as measured by a balance board, increased with time only when perturbations were present. HMD users exhibited greater sway when exposed to visual perturbations than did monitor users. Yet motion sickness increased only when an HMD was used and occurred with or without participants undergoing perturbations. These results suggest that the postural instability which is generated by unexpected visual perturbation does not necessarily increase the likelihood of motion sickness in a virtual environment.