Characteristics of central cortex and upper-limb flexors synchrony oxygenation during grasping in people with stroke: a controlled trial study protocol.

Background: Upper limb motor impairment is a common consequence of stroke, and the effectiveness and underlying mechanisms of rehabilitation therapy for improving upper limb function remain uncertain. Functional near-infrared spectroscopy, a reliable wearable neuroimaging technique, holds promise for investigating brain activity during functional tasks. This study aims to explore the synchronous oxygenation characteristics of the central cortex and upper-limb flexors during a grasping task and investigate the rehabilitation mechanisms of upper limb motor function in individuals with stroke. Methods: Participants with stroke who demonstrate the ability to grasp and lift cubic wood blocks of different sizes (2.5cm3, 5cm3, and 10cm3) using their affected hand will be divided into three groups: A, B, and C. Each group will consist of twenty stroke patients, resulting in a total of sixty participants with stroke. Additionally, twenty matched healthy subjects will be enrolled as a control group. Comprehensive assessments will be conducted before and after the intervention, including blood oxygen parameter monitoring of the cerebral cortex and upper limb flexors using fNIRS during the grasping task. Other assessments will include MyotonPRO, the Modified Ashworth Scale, the upper extremity section of the Fugl-Meyer Assessment, the Action Research Arm Test, and the Modified Barthel Index. The study will be undertaken between January 2024 and September 2025. Conclusions: The results of this trial will provide an in-depth understanding of the Characteristics of central cortex and upper-limb flexors synchronous oxygenation during grasping task and how it may relate to the rehabilitation mechanism of upper limb motor function in people with stroke. Clinical trial registration: https://www.chictr.org.cn, identifier ChiCTR2400080619.

[Efficiency of computerized cognitive training for prevention of cognitive impairments and stimulation of neuroplasticity.]

Computerized cognitive training (CCT) is a rapidly developing area of cognitive rehabilitation at the intersection of information technology and healthcare, the constantly updated results of which can be successfully translated into practical application in clinical medicine and in particular in gerontology. The basis of CCT, as a non-invasive method of influencing the functional activity of the brain and the processes of neuroplasticity, is software for stimulating cognitive functions in order to improve their productivity. The level of scientific and practical interest in CCP technology is growing rapidly. The article reports on the current state of research on the use of CCT aimed at correcting cognitive impairment. The purpose of this work is to systematize the available scientific data in this area, as well as to promote further integration of research in the field of information technology into clinical practice, in particular, to study the potential of CCT as a promising therapeutic tool in the paradigm of successful aging and prevention of the progression of cognitive impairment. This noninvasive intervention may improve global cognitive function in patients with clinically defined impairments and during normal aging in cognitively healthy older adults. However, new studies with fully comparable protocols are needed to evaluate in more detail the duration of the effect and the effectiveness of CCT in preventing cognitive decline in the long term.

The Simultaneous Application of Transcranial Magnetic Stimulation and Virtual Reality to Treat Cognitive Deficits Among Stroke Patients: A Randomized Controlled Trial.

Background and objective Integrating virtual reality (VR) and transcranial magnetic stimulation (TMS) offers a promising strategy for stroke rehabilitation, as it specifically focuses on reorganizing neural connections and activating brain activity in the cortex. The main goal is to create equitable connections between the brain's two hemispheres to enhance the execution of voluntary movements by stimulating the central executive network (CEN) to strengthen both motor and cognitive abilities. This study aims to propose a therapeutic approach that can improve cognitive recovery and overall quality of life in patients after a stroke. Methods A total of 69 participants were enrolled in the study based on certain inclusion and exclusion criteria. The patients underwent pre-assessment and were randomly allocated into three groups: Group 1 received simultaneous repetitive TMS (rTMS) and virtual reality treatment (VRT), Group 2 received rTMS combined with sham VRT, and Group 3 received sham stimulation with VRT, in a 1:1:1 ratio using opaque, sealed, and stapled envelopes (SNOSE). Post-assessment was carried out using the same measures: the National Institutes of Health Stroke Scale (NIHSS), Addenbrooke's Cognitive Test (ACE III), and Montreal Cognitive Assessment (MOCA). Statistical analysis was conducted to determine the specific outcomes. Data analysis was carried out using IBM SPSS Statistics version 29 (IBM Corp., Armonk, NY), employing student's t-test for within-group comparisons and repeated measures ANOVA for between-group comparisons. The significance level was set at 5%. Results The results demonstrated statistical significance in NIHSS scores across all treatment groups (p<0.001). Regarding cognitive outcomes, improvements were observed in memory, language, and overall cognitive performance (ACE III) within all groups (p<0.05), with significant between-group outcomes (p = 0.009, p = 0.01, p = 0.004, respectively), suggesting variations in treatment effects across cognitive domains. However, no significant differences between groups were found in terms of fluency and visuospatial skills (p = 0.49, p = 0.13), indicating no treatment effects in these domains. Conclusions Based on our findings, the combined intervention involving rTMS and VRT, compared to sham treatments, demonstrates promising outcomes in alleviating stroke severity and improving specific cognitive functions such as memory, language, and overall cognitive performance. Additionally, the combined administration offers a more effective therapy than when they are administered separately.

Immersive virtual reality for interdisciplinary trauma management - initial evaluation of a training tool prototype.

INTRODUCTION: Emergency care of critically ill patients in the trauma room is an integral part of interdisciplinary work in hospitals. Live threatening injuries require swift diagnosis, prioritization, and treatment; thus, different medical specialties need to work together closely for optimal patient care. Training is essential to facilitate smooth performance. This study presents a training tool for familiarization with trauma room algorithms in immersive virtual reality (VR), and a first qualitative assessment. MATERIALS AND METHODS: An interdisciplinary team conceptualized two scenarios and filmed these in the trauma room of the University Medical Center Mainz, Germany in 3D-360°. This video content was used to create an immersive VR experience. Participants of the Department of Anesthesiology were included in the study, questionnaires were obtained and eye movement was recorded. RESULTS: 31 volunteers participated in the study, of which 10 (32,2%) had completed specialist training in anesthesiology. Participants reported a high rate of immersion (immersion(mean) = 6 out of 7) and low Visually Induced Motion Sickness (VIMS(mean) = 1,74 out of 20). Participants agreed that VR is a useful tool for medical education (mean = 1,26; 1 very useful, 7 not useful at all). Residents felt significantly more secure in the matter after training (p < 0,05), specialist showed no significant difference. DISCUSSION: This study presents a novel tool for familiarization with trauma room procedures, which is especially helpful for less experienced residents. Training in VR was well accepted and may be a solution to enhance training in times of low resources for in person training.

Child pedestrian safety training in virtual reality: How quickly do children achieve adult functioning and what individual differences impact learning efficiency?

INTRODUCTION: Pedestrian injuries represent a leading cause of child death globally. One prevention strategy is teaching children street-crossing skills. Virtual reality (VR) has emerged as a strategy to offer repeated street-crossing practice and overcome ethical barriers of training children in live traffic. This study addressed two questions pertinent to implementation of child pedestrian safety training within VR: (a) how much training do children require to achieve adult street-crossing competency, and (b) what individual differences might facilitate children to acquire that competency more efficiently? METHODS: Five hundred 7- and 8-year-olds were recruited. Children completed pedestrian safety training within VR for up to 25 thirty-minute training sessions until they achieved adult levels of mastery. At baseline, four cognitive-perceptual skills (visual memory, visual perception, processing speed, working memory) and parent-reported externalizing symptomatology were assessed. RESULTS: On average, children achieved adult pedestrian safety competency after 10.0 training sessions (SD = 4.8). Just one child (<1%) failed to achieve adult pedestrian functioning after 25 training sessions. In univariate analyses, boys took slightly longer than girls to achieve adult functioning, and visual memory, visual perception, processing speed, working memory, and fewer externalizing symptoms were all positively associated with shorter time to mastery. In a multivariable model, only child age was a statistically significant predictor. CONCLUSION: Almost all participants achieved adult street-crossing skills competency through VR training, although they required about 10 sessions on average. Analysis of predictor variables confirmed that nearly all 7- and 8-year-olds are trainable. PRACTICAL APPLICATION: Implementation of VR pedestrian safety training is recommended, but must be conducted cautiously to ensure children are not permitted to engage independently in traffic until they are assessed and demonstrate sufficient skills.

Understanding Pitfalls and Opportunities of Applying Heuristic Evaluation Methods to VR Training Systems: An Empirical Study.

The usability of virtual reality (VR) training applications is crucial for their success, but examining the usability in the early development stages remains challenging. A realistic and plausible solution would be revisiting and reconciling Heuristics Evaluation (HE) methods among the most widely used usability inspection methods in the human-computer interaction (HCI) domain. While research on studying and using HE methods is growing within the VR domain, few studies have considered the novel VR environment challenges new requirements for fitting HE methods to the context and applying them effectively. To this end, we conducted a user study with 14 evaluators using the standard HE methods to complete two HE sessions for a VR training application. We identified five critical challenges that evaluators encountered in the HE process by observing and interviewing them. Based on our findings, we discuss the importance of considering an easy-to-use heuristic set, how we can facilitate the HE procedures in the VR context, and the opportunities for developing HE-supporting tools.

Virtual reality simulation training in laparoscopic surgery - does it really matter, what simulator to use? Results of a cross-sectional study.

BACKGROUND: Virtual reality simulation training plays a crucial role in modern surgical training, as it facilitates trainees to carry out surgical procedures or parts of it without the need for training "on the patient". However, there are no data comparing different commercially available high-end virtual reality simulators. METHODS: Trainees of an international gastrointestinal surgery workshop practiced in different sequences on LaparoS® (VirtaMed), LapSim® (Surgical Science) and LapMentor III® (Simbionix) eight comparable exercises, training the same basic laparoscopic skills. Simulator based metrics were compared between an entrance and exit examination. RESULTS: All trainees significantly improved their basic laparoscopic skills performance, regardless of the sequence in which they used the three simulators. Median path length was initially 830 cm and 463 cm on the exit examination (p < 0.001), median time taken improved from 305 to 167 s (p < 0.001). CONCLUSIONS: All Simulators trained efficiently the same basic surgery skills, regardless of the sequence or simulator used. Virtual reality simulation training, regardless of the simulator used, should be incorporated in all surgical training programs. To enhance comparability across different types of simulators, standardized outcome metrics should be implemented.

The Impact of Virtual Reality Training Combined with Traditional Chinese Medicine Health Preservation Therapy on Cognitive Function, Neurological Function, and Physical Function of Stroke Patients.

OBJECTIVE: The aim of this study was to investigate the effects of virtual reality training combined with traditional Chinese medicine health preservation therapy on cognitive function, neurological function, and physical function of stroke patients. METHODS: The patients were randomly divided into an experimental group (receiving virtual reality training combined with traditional Chinese medicine health preservation therapy) and a control group (receiving conventional rehabilitation treatment combined with traditional Chinese medicine health preservation therapy). A series of cognitive, neurological, and physical function assessments were conducted to collect and analyze data from both groups before treatment, after treatment, and during follow-up. The application of traditional Chinese medicine health preservation concepts was also explored. RESULTS: After treatment, the experimental group had significantly higher scores in the Mini-Mental State Examination (MMSE) compared to the control group. The overall effective rate of neurological function in the experimental group was higher than that in the control group. The Fugl-Meyer Assessment (FMA) scores for upper limb function in the experimental group were significantly higher than those in the control group. The degree of improvement in the Modified Barthel Index scores after treatment was significantly better in the experimental group compared to the control group (all P < 0.05). CONCLUSION: The results of this study demonstrate that virtual reality training combined with traditional Chinese medicine health preservation therapy significantly improves cognitive function, neurological function, and physical function in stroke patients. This approach provides new insights and methods for stroke rehabilitation therapy and is worthy of promotion.

Comparison of Nonimmersive Virtual Reality and Task-Oriented Circuit Training on Gait, Balance, and Cognition Among Elderly Population: A Single-Blind Randomized Control Trial.

Purpose: The purpose of this study was to determine the effects of nonimmersive virtual reality (VR) and task-oriented circuit training on gait, balance, cognitive domains, and quality of life among the elderly population. Methods: This is a single-blind randomized control trial in which 28 elderly individuals between 60 and 75 years were selected. The participants were divided into two groups, task-oriented circuit training and the other receiving nonimmersive VR treatment, with 14 participants in each group. To analyze the effects of both training on balance and gait time up and go test (TUGT), dynamic gait index (DGI), measures were used and for cognitive domains Montreal cognitive assessment (MoCA) scale was used. Short form 12 (SF-12) (along with two domains, Physical Component Summary and Mental Component Summary) was used for the measurement of quality of life. The treatment duration was 8 weeks for both groups. Both the pre-test and post-test readings were analyzed and compared. Results: The mean age of participants was 66.91 ± 3.79 years. Within-group comparison between the pre-test and post-test indicated that significant differences (P < 0.05) existed in all the outcome measures (TUGT, DGI, MoCA, and SF-12) in both groups. However, between-group comparison, significant differences were only found in TUGT and DGI in nonimmersive VR group. Conclusion: This study concluded that both interventions nonimmersive VR and task-oriented circuit training were beneficial for improving balance, gait, quality of life, and cognitive domains like memory, attention spans, executive functions, and so on in elderly population. However nonimmersive virtual reality training is a more effective, feasible, and safe alternative and can be proposed as a form of fall prevention exercise for the older adults. ClinicalTrials.gov Identifier: NCT05021432.

Efficacy of virtual reality training on motor performance, activity of daily living, and quality of life in patients with Parkinson's disease: an umbrella review comprising meta-analyses of randomized controlled trials.

OBJECTIVE: There are several meta-analyses of randomized controlled trials (RCTs) demonstrating the benefits of virtual reality (VR) training as an intervention for motor performance, activity of daily living (ADL) and quality of life (QoL) outcomes in patients with Parkinson's disease (PD). However, the aggregate evidence collected to date has not been thoroughly evaluated for strength, quality, and reproducibility. An umbrella review from published meta-analyses of RCTs was conducted to evaluate the strength and quality of existing evidence regarding the efficacy of VR training in improving the motor performance, ADL and QoL outcomes of patients with PD. METHODS: PubMed, PsychInfo, Web of Science, and Scopus were searched to identify relevant meta-analysis of RCTs examining the effects of VR training on motor performance and quality of life outcomes in PD patients. We recalculated the effect sizes (Hedges'g) for VR training using DerSimonian and Laird (DL) random effects models. We further assessed between-study heterogeneity, prediction interval (PI), publication bias, small-size studies, and whether the results of the observed positive studies were better than would be expected by chance. Based on these calculations, the quality of evidence for each outcome was assessed by using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria. RESULTS: Four meta-analysis with eight outcomes included in the umbrella review was recalculated effect size. Pooled results found VR training can large improve the basic balance ability, moderate improve the overall balance capacity and moderate improve the stride length in PD patients. For ADL and QoL, the effect sizes were pooled that suggested VR training can moderate improve ADL and QoL for PD patients. However, no statistically clear evidence was found in walking speed, motor function and gait function during VR training. The analyzed meta-analyses showed low-to-moderate methodological quality (AMSTAR2) as well as presented evidence of moderate-to-very low quality (GRADE). Tow adverse reactions were reported in the included meta-analyses. CONCLUSIONS: In this umbrella review, a beneficial correlation between VR and balance ability, stride length, ADL and QoL in PD patients was discovered, especially for the very positive effect of VR on balance because of two of the eight outcomes related to balance ability showed large effect size. The observations were accompanied by moderate- to very low-quality rating evidence, supporting VR training as a practical approach to rehabilitation.

ManiLoco: A VR-Based Locomotion Method for Concurrent Object Manipulation.

The use of virtual reality (VR) in laboratory skill training is rapidly increasing. In such applications, users often need to explore a large virtual environment within a limited physical space while completing a series of hand-based tasks (e.g., object manipulation). However, the most widely used controller-based teleport methods may conflict with the users' hand operation and result in a higher cognitive load, negatively affecting their training experiences. To alleviate these limitations, we designed and implemented a locomotion method called ManiLoco to enable hands-free interaction and thus avoid conflicts and interruptions from other tasks. Users can teleport to a remote object's position by taking a step toward the object while looking at it. We evaluated ManiLoco and compared it with state-of-the-art Point & Teleport in a within-subject experiment with 16 participants. The results confirmed the viability of our foot- and head-based approach and better support concurrent object manipulation in VR training tasks. Furthermore, our locomotion method does not require any additional hardware. It solely relies on the VR head-mounted display (HMD) and our implementation of detecting the user's stepping activity, and it can be easily applied to any VR application as a plugin.

The effect of six week virtual reality training on the improvement of functional balance in women with type-I osteoporosis: A preliminary study.

Purpose: This preliminary study aimed to investigate the effects of exergames in a virtual reality environment to improve functional balance during goal-directed functional tasks in postmenopausal women with osteoporosis. Methods: Twelve volunteer postmenopausal women with osteoporosis were randomly assigned to virtual reality (VRT, n = 6) and conventional multimodal (CMT, n = 6) training groups. The exercise was performed for 6 weeks, 3 days weekly, and 18 sessions. Using a force platform, functional balance assessments were made through four dynamic tasks, including performance-based limits of stability (LOS), curve tracking (CT), sit-to-stand (STS), and turning before and after 18 sessions of treatment. Each task's time-dependent center of pressure (COP) variables was separately calculated via Kistler-Mars software. Results: The COP variables of LOS and CT tasks were significantly improved after 6 weeks of CMT and VRT (P ≤ 0.05). In the VRT group, the rising index (P < 0.00), COP sway velocity in STS, and Turn sway were significantly reduced (P < 0.05). Following the VRT, the mean difference of forwarding maximum COP excursion increased (P = 0.03), and errors in CT (P = 0.03) significantly decreased. Conclusion: The VRT and CMT improved the COP sway parameters during weight-shifting tasks. The VRT was more effective than CMT in increasing the ability to control weight-shifting and dynamic functional tasks in postmenopausal women with osteoporosis. This approach in training has suitable potential to provide convenient error feedback learning.

The effects of combining virtual reality training with aromatherapy on Alzheimer′s disease patients in a nursing home / 中华物理医学与康复杂志

Objective:To explore any effects of combining virtual reality training with aromatherapy in caring for Alzheimer′s disease patients in a nursing home.Methods:Fifty nursing home residents with Alzheimer′s were divided at random into an observation group and a control group, each of 25. Both groups received routine rehabilitation, while the observation group was additionally given 45 minutes of virtual reality training combined with aromatherapy, 3 times a week for 6 months. Both groups′ cognition was then evaluated using the MMSE and an Alzheimer′s cognition assessment scale (ADAS-cog). Psycho-behavioral symptoms were quantified using the Alzheimer′s disease pathological behavior scale (BEHAVE-AD). Motor functioning was quantified using the timed up and go test (TUGT), the 30-second sit-to-stand test (30sCST), the 30-second arm curl test (30sACT) and the sit-and-reach test (CSRT). Ability in the activities of daily living (ADL) and life quality were quantified using the activity of daily living scale and of the quality of life scale for Alzheimer′s disease (QOL-AD) before and after the intervention.Results:After the intervention the average MMSE, ADAS-cog, BEHAVE-AD and ADL scores of both groups had improved significantly, with the average improvement in the observation group significantly greater than that in the control group. The TUGT, 30sCST, 30sACT and CSRT results of both groups were also significantly better, with those of the observation group again significantly superior, on average, to the control group′s results. The average QOL-AD score in the observation was significantly improved after the intervention, and was then significantly better than the control group′s average.Conclusions:Virtual reality training combined with aromatherapy can significantly improve the cognition, psycho-behavioral symptoms, activity in daily living, motor functioning and life quality of Alzheimer′s patients in a nursing home. It is worthy of promotion and application in nursing homes.

Virtual reality training can effectively improve the cognitive functioning and functional fitness of persons with subjective cognitive decline / 中华物理医学与康复杂志

Objective:To observe any effect of virtual reality (VR) training on the cognitive functioning and functional fitness of nursing home residents with subjective cognitive decline (SCD).Methods:Fifty-six of such residents were randomly divided into an observation group and a control group, each of 28. Both groups received health education and routine care, but the observation group was additionally provided with 45 minutes of VR training three times a week for 6 months. The training included Baduanjin, magic, flying bird, supermarket shopping, gravity ball and gym episodes. Both groups′ cognition was evaluated using the subjective cognitive decline questionnaire (SCD-Q), the Montreal cognitive assessment (MoCA), the Rivermead Behavioural Memory Test (second edition) (RBMT-Ⅱ), a digit symbol substitution test (DSST), an animal fluency test (AFT) and trail-making test A-B (TMT A-B). Functional fitness was quantified using the 8-foot up-and-go test (8UGT), a 30-second arm curl test (30sACT), a 30-second chair stand test (30sCST), a back scratching test (BST), the sit-and-reach test (CSRT) and a 2-minute step test (2MST) before and after the 6-month intervention.Results:After the intervention, the average SCD-Q, MoCA, RBMT-Ⅱ, DSST, TMT-A, and TMT-B scores of the observation group were significantly better than before the intervention, and significantly better than the control group′s averages. And except for the back scratching their functional results were also significantly better, on average, than those of the control group.Conclusions:VR training can effectively improve the cognition and functional fitness of nur-sing home residents with SCD. Such training is worthy of promotion and wider application in nursing homes.

A Novel Theory-Based Virtual Reality Training to Improve Patient Safety Culture in the Department of Surgery of a Large Academic Medical Center: Protocol for a Mixed Methods Study.

BACKGROUND: Preventable surgical errors of varying degrees of physical, emotional, and financial harm account for a significant number of adverse events. These errors are frequently tied to systemic problems within a health care system, including the absence of necessary policies/procedures, obstructive cultural hierarchy, and communication breakdown between staff. We developed an innovative, theory-based virtual reality (VR) training to promote understanding and sensemaking toward the holistic view of the culture of patient safety and high reliability. OBJECTIVE: We aim to assess the effect of VR training on health care workers' (HCWs') understanding of contributing factors to patient safety events, sensemaking of patient safety culture, and high reliability organization principles in the laboratory environment. Further, we aim to assess the effect of VR training on patient safety culture, TeamSTEPPS behavior scores, and reporting of patient safety events in the surgery department of an academic medical center in the clinical environment. METHODS: This mixed methods study uses a pre-VR versus post-VR training study design involving attending faculty, residents, nurses, technicians of the department of surgery, and frontline HCWs in the operation rooms at an academic medical center. HCWs' understanding of contributing factors to patient safety events will be assessed using a scale based on the Human Factors Analysis and Classification System. We will use the data frame theory framework, supported by a semistructured interview guide to capture the sensemaking process of patient safety culture and principles of high reliability organizations. Changes in the culture of patient safety will be quantified using the Agency for Healthcare Research and Quality surveys on patient safety culture. TeamSTEPPS behavior scores based on observation will be measured using the Teamwork Evaluation of Non-Technical Skills tool. Patient safety events reported in the voluntary institutional reporting system will be compared before the training versus those after the training. We will compare the Agency for Healthcare Research and Quality patient safety culture scores and patient safety events reporting before the training versus those after the training by using descriptive statistics and a within-subject 2-tailed, 2-sample t test with the significance level set at .05. RESULTS: Ethics approval was obtained in May 2021 from the institutional review board of the University of North Carolina at Chapel Hill (22-1150). The enrollment of participants for this study will start in fall 2022 and is expected to be completed by early spring 2023. The data analysis is expected to be completed by July 2023. CONCLUSIONS: Our findings will help assess the effectiveness of VR training in improving HCWs' understanding of contributing factors of patient safety events, sensemaking of patient safety culture, and principles and behaviors of high reliability organizations. These findings will contribute to developing VR training to improve patient safety culture in other specialties.

Development of CryoVR, a virtual reality training system for hands-on cryoEM operations.

Cryogenic electron microscopy (cryoEM) has emerged as a revolutionary method for solving high-resolution structures and studying the dynamics of macromolecular complexes and viruses in near-native states. However, the availability of the equipment, and the time and cost needed for training, severely limit the opportunities for training. To solve these problems, a virtual reality-based training system, CryoVR, has been developed to prepare trainees before operating real-world cryoEM equipment. This paper describes the design and assessment of CryoVR (available at https://www.purdue.edu/cryoVR), which helps users learn cryoEM experimental procedures in a virtual environment, allowing immersive training with step-by-step tutorials with vivid visual, audio and text guidance. Implemented as a training step before a novice user interacts with the expensive real-world cryoEM equipment, CryoVR can help users to become familiar with hands-on operational procedures through multiple training modules and earning certificates after passing the built-in Exam mode. Qualitative evaluation and feedback of CryoVR from users with various levels of cryoEM experience indicate the substantial value of CryoVR as a tool for a comprehensive cryoEM procedural training.

Neuroendocrine Response and State Anxiety Due to Psychosocial Stress Decrease after a Training with Subject's Own (but Not Another) Virtual Body: An RCT Study.

Previous research involving healthy participants has reported that seeing a moving virtual body from the first person perspective induces the illusion of ownership and agency over that virtual body. When a person is sitting and the virtual body runs, it is possible to measure physiological, behavioral and cognitive reactions that are comparable to those that occur during actual movement. Capitalizing on this evidence, we hypothesized that virtual training could also induce neuroendocrine effects that prompt a decreased psychosocial stress response, as occurs after physical training. While sitting, 26 healthy young adults watched a virtual avatar running for 30 min from the first person perspective (experimental group), while another 26 participants watched the virtual body from the third person perspective (control group). We found a decreased salivary alpha-amylase concentration (a biomarker for the stress response) after the virtual training among the experimental group only, as well as a decreased subjective feeling of state anxiety (but no difference in heart rate). We argue that the virtual illusion of a moving body from the first person perspective can initiate a cascade of events, from the perception of the visual illusion to physiological activation that triggers other biological effects, such as the neuroendocrine stress response.

Personalized virtual reality simulation training system for percutaneous needle insertion and comparison of zSpace and vive.

PURPOSE: In this research, we present a personalized simulation training system for percutaneous needle insertion based on virtual reality (VR). Within this system, surgeons can become more familiar with real surgical procedures, thereby reducing errors that may occur in real surgery. Additionally, different VR technologies, i.e., zSpace and Vive, were compared to provide surgeons with a better surgical training environment. METHODS: and Methods A VR system combined with the treatment planning system was developed to create personalized patient training environment. An evaluation study recruiting twenty novices was performed to demonstrate the system. Each participant performed six independent needle placements using the VR system. Placement time was recorded. Placement error was defined as the distance from the needle tip to the target center. The participants completed a seven-point Likert scale questionnaire after the simulation. RESULTS: Compared with Vive, using zspace reduces the placement time (from 90.32 s to 68.94 s). The placement error using zSpace and Vive was similar (1.27 ± 0.68 mm, 1.56 ± 0.81 mm, respectively). The questionnaire survey results show that most participants are highly satisfied with the training effect of the VR system. Participants prefer the operation mode and convenience of zSpace but think that the immersion of Vive is better. CONCLUSIONS: The personalized virtual reality surgical training system was effective as a training system for percutaneous needle insertion. The system based on zSpace had a shorter placement time while maintaining placement accuracy compared to the system based on Vive. The system based on zSpace achieved higher satisfaction in most aspects except for immersion.

A Virtual Navigation Training Promotes the Remapping of Space in Allocentric Coordinates: Evidence From Behavioral and Neuroimaging Data.

Allocentric space representations demonstrated to be crucial to improve visuo-spatial skills, pivotal in every-day life activities and for the development and maintenance of other cognitive abilities, such as memory and reasoning. Here, we present a series of three different experiments: Experiment 1, Discovery sample (23 young male participants); Experiment 2, Neuroimaging and replicating sample (23 young male participants); and Experiment 3 (14 young male participants). In the experiments, we investigated whether virtual navigation stimulates the ability to form spatial allocentric representations. With this aim, we used a novel 3D videogame (MindTheCity!), focused on the navigation of a virtual town. We verified whether playing at MindTheCity! enhanced the performance on spatial representational tasks (pointing to a specific location in space) and on a spatial memory test (asking participant to remember the location of specific objects). Furthermore, to uncover the neural mechanisms underlying the observed effects, we performed a preliminary fMRI investigation before and after the training with MindTheCity!. Results show that our virtual training enhances the ability to form allocentric representations and spatial memory (Experiment 1). Experiments 2 and 3 confirmed the behavioral results of Experiment 1. Furthermore, our preliminary neuroimaging and behavioral results suggest that the training activates brain circuits involved in higher-order mechanisms of information encoding, triggering the activation of broader cognitive processes and reducing the working load on memory circuits (Experiments 2 and 3).

Is Virtual Reality Training More Effective Than Traditional Physical Training on Balance and Functional Mobility in Healthy Older Adults? A Systematic Review and Meta-Analysis.

Objective: The studies showed the benefits of virtual reality training (VRT) for functional mobility and balance in older adults. However, a large variance in the study design and results is presented. We, thus, completed a systematic review and meta-analysis to quantitatively examine the effects of VRT on functional mobility and balance in healthy older adults. Methods: We systematically reviewed the publications in five databases. Studies that examine the effects of VRT on the measures of functional mobility and balance in healthy older adults were screened and included if eligible. Subgroup analyses were completed to explore the effects of different metrics of the intervention design (e.g., session time) on those outcomes related to functional mobility and balance. Results: Fifteen studies of 704 participants were included. The quality of these studies was good. Compared to traditional physical therapy (TPT), VRT induced greater improvement in TUG (MD = -0.31 s, 95% CI = -0.57 to -0.05, p = 0.02, I 2 = 6.34%) and one-leg stance with open eyes (OLS-O) (MD = 7.28 s, 95% CI = 4.36 to 10.20, p = 0.00, I 2 = 36.22%). Subgroup analyses revealed that immersive VRT with more than 800 min of total intervention time over 8 weeks and at least 120 min per week and/or designed by the two motor-learning principles was optimal for functional mobility and balance. Conclusion: Virtual reality training can significantly improve functional mobility and balance in healthy older adults compared to TPT, and the findings provided critical knowledge of the optimized design of VRT that can inform future studies with more rigorous designs. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021297085].