The Role of Virtual Reality and Artificial Intelligence in Cognitive Pain Therapy: A Narrative Review.

PURPOSE OF REVIEW: This review investigates the roles of artificial intelligence (AI) and virtual reality (VR) in enhancing cognitive pain therapy for chronic pain management. The work assesses current research, outlines benefits and limitations and examines their potential integration into existing pain management methods. RECENT FINDINGS: Advances in VR have shown promise in chronic pain management through immersive cognitive therapy exercises, with evidence supporting VR's effectiveness in symptom reduction. AI's personalization of treatment plans and its support for mental health through AI-driven avatars are emerging trends. The integration of AI in hybrid programs indicates a future with real-time adaptive technology tailored to individual needs in chronic pain management. Incorporating AI and VR into chronic pain cognitive therapy represents a promising approach to enhance management by leveraging VR's immersive experiences and AI's personalized tactics, aiming to improve patient engagement and outcomes. Nonetheless, further empirical studies are needed to standardized methodologies, compare these technologies to traditional therapies and fully realize their clinical potential.

Virtual reality and augmented reality in medical education: an umbrella review.

Objective: This umbrella review aims to ascertain the extent to which immersive Virtual Reality (VR) and Augmented Reality (AR) technologies improve specific competencies in healthcare professionals within medical education and training, in contrast to traditional educational methods or no intervention. Methods: Adhering to PRISMA guidelines and the PICOS approach, a systematic literature search was conducted across major databases to identify studies examining the use of VR and AR in medical education. Eligible studies were screened and categorized based on the PICOS criteria. Descriptive statistics and chi-square tests were employed to analyze the data, supplemented by the Fisher test for small sample sizes or specific conditions. Analysis: The analysis involved cross-tabulating the stages of work (Development and Testing, Results, Evaluated) and variables of interest (Performance, Engagement, Performance and Engagement, Effectiveness, no evaluated) against the types of technologies used. Chi-square tests assessed the associations between these categorical variables. Results: A total of 28 studies were included, with the majority reporting increased or positive effects from the use of immersive technologies. VR was the most frequently studied technology, particularly in the "Performance" and "Results" stages. The chi-square analysis, with a Pearson value close to significance (p = 0.052), suggested a non-significant trend toward the association of VR with improved outcomes. Conclusions: The results indicate that VR is a prevalent tool in the research landscape of medical education technologies, with a positive trend toward enhancing educational outcomes. However, the statistical analysis did not reveal a significant association, suggesting the need for further research with larger sample sizes. This review underscores the potential of immersive technologies to enhance medical training yet calls for more rigorous studies to establish definitive evidence of their efficacy.

On the relationships between auditory and visual factors in a residential environment context: A SEM approach.

To understand the effects of specific elements that may enhance or detract residents' well-being, it is important to explore the relationships between auditory and visual factors, based on people's sensory experiences. Although residential environments provide natural experimental conditions to observe these relationships, the complexity of measuring sensory perceptions and their subsequent interpretation constitutes a challenge. This study aims to identify the influence of socio-demographics and residential location characteristics on three latent variables: noise-Sensitivity, sound-Pleasantness, and visual-Liveability in a Latin American city. The methodology is replicable and relies on a digital survey that displays environments in 360-format video and uses sound immersion techniques; it was applied to a sample of household heads in Quito, Ecuador. Based on an efficient experimental design, we selected different residential environments according to acoustic-visual attributes and the proximity to residential, commercial, and recreational land uses. Structural Equation Models (SEM) were estimated using mediating variables. Our results reveal the influence of noise-Sensitivity on sound-Pleasantness and, indirectly, on visual-Liveability. Further analysis shows that the impact of sound and visual perception changes with different socio-demographics and residential location characteristics.

Influence of Hand Tracking in Immersive Virtual Reality for Memory Assessment.

Few works analyze the parameters inherent to immersive virtual reality (IVR) in applications for memory evaluation. Specifically, hand tracking adds to the immersion of the system, placing the user in the first person with full awareness of the position of their hands. Thus, this work addresses the influence of hand tracking in memory assessment with IVR systems. For this, an application based on activities of daily living was developed, where the user must remember the location of the elements. The data collected by the application are the accuracy of the answers and the response time; the participants are 20 healthy subjects who pass the MoCA test with an age range between 18 to 60 years of age; the application was evaluated with classic controllers and with the hand tracking of the Oculus Quest 2. After the experimentation, the participants carried out presence (PQ), usability (UMUX), and satisfaction (USEQ) tests. The results indicate no difference with statistical significance between both experiments; controller experiments have 7.08% higher accuracy and 0.27 ys. faster response time. Contrary to expectations, presence was 1.3% lower for hand tracking, and usability (0.18%) and satisfaction (1.43%) had similar results. The findings indicate no evidence to determine better conditions in the evaluation of memory in this case of IVR with hand tracking.

Face, content, and construct validity of the virtual immersive operating room simulator for training laparoscopic procedures.

BACKGROUND: The aim of this work is to present the face, content, and construct validation of the virtual immersive operating room simulator (VIORS) for procedural training of surgeons' laparoscopic psychomotor skills and evaluate the immersive training experience. METHODS: The VIORS simulator consists of an HMD Oculus Rift 2016 with a visor on a 1080 × 1200 pixel OLED screen, two positioning sensors with two adapted controls to simulate laparoscopic instruments, and an acrylic base to simulate the conventional laparoscopic setup. The immersion consists of a 360° virtual operating room environment, based on the EndoSuite at Hospital Infantil de Mexico Federico Gomez, which reproduces a configuration of equipment, instruments, and common distractions in the operating room during a laparoscopic cholecystectomy procedure. Forty-five surgeons, residents, and medicine students participated in this study: 27 novices, 13 intermediates, and 5 experts. They completed a questionnaire on the realism and operating room immersion, as well as their capabilities for laparoscopic procedural training, scored in the 5-point Likert scale. The data of instrument movement were recorded and analyzed using 13 movement analysis parameters (MAPs). The experience during training with VIORS was evaluated through NASA-TLX. RESULTS: The participants were enthusiastic about the immersion and sensation levels of the VIORS simulator, with positive scores on the realism and its capabilities for procedural training using VIORS. The results proved that the VIORS simulator was able to differentiate between surgeons with different skill levels. Statistically significant differences were found in nine MAPs, demonstrating their construct validity for the objective assessment of the procedural laparoscopic performance. At cognitive level, the inversion experience proves a moderate mental workload when the laparoscopic procedure is carried out. CONCLUSION: The VIORS simulator has been successfully presented and validated. The VIORS simulator is a useful and effective device for the training of procedural laparoscopic psychomotor skills.

Assessing the Soundscape Appropriateness in the Vicinity of a Heliport in an Urban Park of Quito (Ecuador) Using Immersive Audio-Visual Scenarios.

Heliports are facilities that play a fundamental role in security and emergency operations. Since rotorcrafts do not need much space for take-off and landing, heliports are normally immersed in the urban fabric of our cities. However, they generate high noise levels, which can cause a nuisance, especially in outdoor areas intended for the recreation of citizens. This paper studies how helicopter noise affects the perception of the soundscape appropriateness and landscape quality in the vicinity of a heliport located in an urban park, using semantic differential scales and appraisals on the noise sources. The study area was the "Parque del Bicentenario" in Quito, Ecuador. Immersive Virtual Reality (IVR) laboratory tests using 360-degree videos and spatial audio were preferred to on-site questionnaires, given the difficulty of predicting when helicopter noise events would occur. For the statistical analysis, objective acoustic and psychoacoustic parameters have also been considered. Results show that the soundscape is perceived as more pleasant and less chaotic when there is no helicopter noise. Furthermore, with the same visual stimuli, the appraisals of the landscape are much better in the scenarios without the helicopter noise. Sharpness is the psychoacoustic parameter that best explains the variance of the subjective variables evaluated.

VirtualCPR: Virtual Reality Mobile Application for Training in Cardiopulmonary Resuscitation Techniques.

Deaths due to heart diseases are a leading cause of death in Mexico. Cardiovascular diseases are considered a public health problem because they produce cardiorespiratory arrests. During an arrest, cardiac and/or respiratory activity stops. A cardiorespiratory arrest is rapidly fatal without a quick and efficient intervention. As a response to this problem, the VirtualCPR system was designed in the present work. VirtualCPR is a mobile virtual reality application to support learning and practicing of basic techniques of cardiopulmonary resuscitation (CPR) for experts or non-experts in CPR. VirtualCPR implements an interactive virtual scenario with the user, which is visible by means of employment of virtual reality lenses. User's interactions, with our proposal, are by a portable force sensor for integration with training mannequins, whose development is based on an application for the Android platform. Furthermore, this proposal integrates medical knowledge in first aid, related to the basic CPR for adults using only the hands, as well as technological knowledge, related to development of simulations on a mobile virtual reality platform by three main processes: (i) force measurement and conversion, (ii) data transmission and (iii) simulation of a virtual scenario. An experiment by means of a multifactorial analysis of variance was designed considering four factors for a CPR session: (i) previous training in CPR, (ii) frequency of compressions, (iii) presence of auditory suggestions and (iv) presence of color indicator. Our findings point out that the more previous training in CPR a user of the VirtualCPR system has, the greater the percentage of correct compressions obtained from a virtual CPR session. Setting the rate to 100 or 150 compressions per minute, turning on or off the auditory suggestions and turning the color indicator on or off during the session have no significant effect on the results obtained by the user.

Two new virtual reality tasks for the assessment of spatial orientation Preliminary results of tolerability, sense of presence and usability.

Spatial orientation is a cognitive domain frequently impaired in Alzheimer's Disease and can be one of its earliest symptoms. OBJECTIVE: This paper describes the results of tolerability, sense of presence and usability of two immersive virtual reality tasks for the assessment of spatial orientation, using VR headset in adults. METHODS: 31 healthy adults recruited from university and the local community performed two experimental immersive virtual reality tasks of spatial orientation: the SOIVET-Maze for the assessment of allocentric to egocentric spatial abilities and the SOIVET-Route for the assessment of spatial memory and landmark recognition. Participants completed questionnaires about sense of presence, cybersickness symptoms, technology use profile and motion sickness history. Usability measures were assessed by spontaneous feedback from participants. RESULTS: All participants were able to understand the task instructions and how to interact with the system. Both tasks seemed to induce a strong sense of presence, as assessed by the Witmer and Singer Presence Questionnaires (M=128 and 143 for SOIVET-Maze and SOIVET-Route, respectively). The SOIVET-Route had a small numeric advantage over the SOIVET-Maze tolerability scores assessed by the Cybersickness Questionnaire (M=4.19, SD=5.576 and M=3.52, SD=6.418 for SOIVET-Maze and SOIVET-Route respectively). Also, there were no drop-outs on the SOIVET-Route due to tolerability issues, unlike the SOIVET-Maze, which had two drop-outs. However, this difference was not statistically significant (Z= -.901, p= 0.368, Wilcoxon signed-rank test).

A orientação espacial é um domínio cognitivo freqüentemente comprometido na doença de Alzheimer e pode ser um dos primeiros sintomas manifestados. OBJETIVO: Este artigo descreve os resultados de tolerabilidade, sensação de presença e usabilidade de duas tarefas imersivas de realidade virtual para avaliação da orientação espacial, utilizando óculos de RV em adultos. MÉTODOS: 31 adultos saudáveis, ​​recrutados entre estudantes universitários e da comunidade local, realizaram duas tarefas de realidade virtual imersiva para avaliação da orientação espacial: A tarefa SOIVET-Maze para avaliação da capacidade de transposição da orientação alocêntrica para egocêntrica e a tarefa SOIVET-Route para avaliação da memória espacial e reconhecimento de pontos de referência. Os participantes também responderam questionários sobre Sensação de Presença, Sintomas de cybersickness, Perfil de Uso de Tecnologia e Histórico de cinetose. Feedback espontâneo dos participantes foi utilizado como medida de usabilidade. RESULTADOS: Todos os participantes conseguiram compreender as instruções da tarefa e como interagir com o sistema. Ambas tarefas parecem induzir forte sensação de presença, avaliada pelo Questionário de Presença de Witmer e Singer (M=128 e 143 para SOIVET-Maze e SOIVET-Route, respectivamente). A tarefa SOIVET-Route teve uma pequena vantagem numérica em relação à tarefa SOIVET-Maze na pontuação de tolerabilidade avaliada pelo Questionário de Cybersickness (M=4,19, SD=5,576 e M=3,52, SD=6,418 para SOIVET-Maze e SOIVET-Route respectivamente). Além disso, não houve desistências na SOIVET-Route devido a problemas de tolerabilidade, ao contrário da SOIVET-Maze, que teve dois drop-outs. No entanto, essa diferença não foi estatisticamente significativa (Z= -901, p=0,368, teste de postos sinalizados de Wilcoxon).

Two new virtual reality tasks for the assessment of spatial orientation: preliminary results of tolerability, sense of presence and usability / Duas novas tarefas de realidade virtual para avaliação da orientação espacial: resultados preliminares de tolerabilidade, sensação de presença e usabilidade

Abstract Spatial orientation is a cognitive domain frequently impaired in Alzheimer's Disease and can be one of its earliest symptoms. Objective: This paper describes the results of tolerability, sense of presence and usability of two immersive virtual reality tasks for the assessment of spatial orientation, using VR headset in adults. Methods: 31 healthy adults recruited from university and the local community performed two experimental immersive virtual reality tasks of spatial orientation: the SOIVET-Maze for the assessment of allocentric to egocentric spatial abilities and the SOIVET-Route for the assessment of spatial memory and landmark recognition. Participants completed questionnaires about sense of presence, cybersickness symptoms, technology use profile and motion sickness history. Usability measures were assessed by spontaneous feedback from participants. Results: All participants were able to understand the task instructions and how to interact with the system. Both tasks seemed to induce a strong sense of presence, as assessed by the Witmer and Singer Presence Questionnaires (M=128 and 143 for SOIVET-Maze and SOIVET-Route, respectively). The SOIVET-Route had a small numeric advantage over the SOIVET-Maze tolerability scores assessed by the Cybersickness Questionnaire (M=4.19, SD=5.576 and M=3.52, SD=6.418 for SOIVET-Maze and SOIVET-Route respectively). Also, there were no drop-outs on the SOIVET-Route due to tolerability issues, unlike the SOIVET-Maze, which had two drop-outs. However, this difference was not statistically significant (Z= -.901, p= 0.368, Wilcoxon signed-rank test).

Resumo A orientação espacial é um domínio cognitivo freqüentemente comprometido na doença de Alzheimer e pode ser um dos primeiros sintomas manifestados. Objetivo: Este artigo descreve os resultados de tolerabilidade, sensação de presença e usabilidade de duas tarefas imersivas de realidade virtual para avaliação da orientação espacial, utilizando óculos de RV em adultos. Métodos: 31 adultos saudáveis, ​​recrutados entre estudantes universitários e da comunidade local, realizaram duas tarefas de realidade virtual imersiva para avaliação da orientação espacial: A tarefa SOIVET-Maze para avaliação da capacidade de transposição da orientação alocêntrica para egocêntrica e a tarefa SOIVET-Route para avaliação da memória espacial e reconhecimento de pontos de referência. Os participantes também responderam questionários sobre Sensação de Presença, Sintomas de cybersickness, Perfil de Uso de Tecnologia e Histórico de cinetose. Feedback espontâneo dos participantes foi utilizado como medida de usabilidade. Resultados: Todos os participantes conseguiram compreender as instruções da tarefa e como interagir com o sistema. Ambas tarefas parecem induzir forte sensação de presença, avaliada pelo Questionário de Presença de Witmer e Singer (M=128 e 143 para SOIVET-Maze e SOIVET-Route, respectivamente). A tarefa SOIVET-Route teve uma pequena vantagem numérica em relação à tarefa SOIVET-Maze na pontuação de tolerabilidade avaliada pelo Questionário de Cybersickness (M=4,19, SD=5,576 e M=3,52, SD=6,418 para SOIVET-Maze e SOIVET-Route respectivamente). Além disso, não houve desistências na SOIVET-Route devido a problemas de tolerabilidade, ao contrário da SOIVET-Maze, que teve dois drop-outs. No entanto, essa diferença não foi estatisticamente significativa (Z= -901, p=0,368, teste de postos sinalizados de Wilcoxon)