Concussion can increase the risk of visually induced motion sickness.

Concussion can lead to various symptoms such as balance problems, memory impairments, dizziness, and/or headaches. It has been previously suggested that during self-motion relevant tasks, individuals with concussion may rely heavily on visual information to compensate for potentially less reliable vestibular inputs and/or problems with multisensory integration. As such, concussed individuals may also be more sensitive to other visually-driven sensations such as visually induced motion sickness (VIMS). To investigate whether concussed individuals are at elevated risk of experiencing VIMS, we exposed participants with concussion (n = 16) and healthy controls (n = 15) to a virtual scene depicting visual self-motion down a grocery store aisle at different speeds. Participants with concussion were further separated into symptomatic and asymptomatic groups. VIMS was measured with the SSQ before and after stimulus exposure, and visual dependence, self-reported dizziness, and somatization were recorded at baseline. Results showed that concussed participants who were symptomatic demonstrated significantly higher SSQ scores after stimulus presentation compared to healthy controls and those who were asymptomatic. Visual dependence was positively correlated with the level of VIMS in healthy controls and participants with concussion. Our results suggest that the presence of concussion symptoms at time of testing significantly increased the risk and severity of VIMS. This finding is of relevance with regards to the use of visual display devices such as Virtual Reality applications in the assessment and rehabilitation of individuals with concussion.

Measuring vection: a review and critical evaluation of different methods for quantifying illusory self-motion.

The sensation of self-motion in the absence of physical motion, known as vection, has been scientifically investigated for over a century. As objective measures of, or physiological correlates to, vection have yet to emerge, researchers have typically employed a variety of subjective methods to quantify the phenomenon of vection. These measures can be broadly categorized into the occurrence of vection (e.g., binary choice yes/no), temporal characteristics of vection (e.g., onset time/latency, duration), the quality of the vection experience (e.g., intensity rating scales, magnitude estimation), or indirect (e.g., distance travelled) measures. The present review provides an overview and critical evaluation of the most utilized vection measures to date and assesses their respective merit. Furthermore, recommendations for the selection of the most appropriate vection measures will be provided to assist with the process of vection research and to help improve the comparability of research findings across different vection studies.

Beyond the Eye: Multisensory Contributions to the Sensation of Illusory Self-Motion (Vection).

Vection is typically defined as the embodied illusion of self-motion in the absence of real physical movement through space. Vection can occur in real-life situations (e.g., 'train illusion') and in virtual environments and simulators. The vast majority of vection research focuses on vection caused by visual stimulation. Even though visually induced vection is arguably the most compelling type of vection, the role of nonvisual sensory inputs, such as auditory, biomechanical, tactile, and vestibular cues, have recently gained more attention. Non-visual cues can play an important role in inducing vection in two ways. First, nonvisual cues can affect the occurrence and strength of vection when added to corresponding visual information. Second, nonvisual cues can also elicit vection in the absence of visual information, for instance when observers are blindfolded or tested in darkness. The present paper provides a narrative review of the literature on multimodal contributions to vection. We will discuss both the theoretical and applied relevance of multisensory processing as related to the experience of vection and provide design considerations on how to enhance vection in various contexts.

Exploring neurophysiological correlates of visually induced motion sickness using electroencephalography (EEG).

Visually induced motion sickness (VIMS) is a common phenomenon when using visual devices such as smartphones and virtual reality applications, with symptoms including nausea, fatigue, and headache. To date, the neuro-cognitive processes underlying VIMS are not fully understood. Previous studies using electroencephalography (EEG) delivered mixed findings, with some reporting an increase in delta and theta power, and others reporting increases in alpha and beta frequencies. The goal of the study was to gain further insight into EEG correlates for VIMS. Participants viewed a VIMS-inducing visual stimulus, composed of moving black-and-white vertical bars presented on an array of three adjacent monitors. The EEG was recorded during visual stimulation and VIMS ratings were recorded after each trial using the Fast Motion Sickness Scale. Time-frequency analyses were conducted comparing neural activity of participants reporting minimal VIMS (n = 21) and mild-moderate VIMS (n = 12). Results suggested a potential increase in delta power in the centro-parietal regions (CP2) and a decrease in alpha power in the central regions (Cz) for participants experiencing mild-moderate VIMS compared to those with minimal VIMS. Event-related spectral perturbations (ERSPs) suggested that group differences in EEG activity developed with increasing duration of a trial. These results support the hypothesis that the EEG might be sensitive to differences in information processing in VIMS and minimal VIMS contexts, and indicate that it may be possible to identify neurophysiological correlate of VIMS. Differences in EEG activity related to VIMS may reflect differential processing of conflicting visual and vestibular sensory information.

Exploring the merits of research performance measures that comply with the San Francisco Declaration on Research Assessment and strategies to overcome barriers of adoption: qualitative interviews with administrators and researchers.

BACKGROUND: In prior research, we identified and prioritized ten measures to assess research performance that comply with the San Francisco Declaration on Research Assessment, a principle adopted worldwide that discourages metrics-based assessment. Given the shift away from assessment based on Journal Impact Factor, we explored potential barriers to implementing and adopting the prioritized measures. METHODS: We identified administrators and researchers across six research institutes, conducted telephone interviews with consenting participants, and used qualitative description and inductive content analysis to derive themes. RESULTS: We interviewed 18 participants: 6 administrators (research institute business managers and directors) and 12 researchers (7 on appointment committees) who varied by career stage (2 early, 5 mid, 5 late). Participants appreciated that the measures were similar to those currently in use, comprehensive, relevant across disciplines, and generated using a rigorous process. They also said the reporting template was easy to understand and use. In contrast, a few administrators thought the measures were not relevant across disciplines. A few participants said it would be time-consuming and difficult to prepare narratives when reporting the measures, and several thought that it would be difficult to objectively evaluate researchers from a different discipline without considerable effort to read their work. Strategies viewed as necessary to overcome barriers and support implementation of the measures included high-level endorsement of the measures, an official launch accompanied by a multi-pronged communication strategy, training for both researchers and evaluators, administrative support or automated reporting for researchers, guidance for evaluators, and sharing of approaches across research institutes. CONCLUSIONS: While participants identified many strengths of the measures, they also identified a few limitations and offered corresponding strategies to address the barriers that we will apply at our organization. Ongoing work is needed to develop a framework to help evaluators translate the measures into an overall assessment. Given little prior research that identified research assessment measures and strategies to support adoption of those measures, this research may be of interest to other organizations that assess the quality and impact of research.

DORA-compliant measures of research quality and impact to assess the performance of researchers in biomedical institutions: Review of published research, international best practice and Delphi survey.

OBJECTIVE: The San Francisco Declaration on Research Assessment (DORA) advocates for assessing biomedical research quality and impact, yet academic organizations continue to employ traditional measures such as Journal Impact Factor. We aimed to identify and prioritize measures for assessing research quality and impact. METHODS: We conducted a review of published and grey literature to identify measures of research quality and impact, which we included in an online survey. We assembled a panel of researchers and research leaders, and conducted a two-round Delphi survey to prioritize measures rated as high (rated 6 or 7 by ≥ 80% of respondents) or moderate (rated 6 or 7 by ≥ 50% of respondents) importance. RESULTS: We identified 50 measures organized in 8 domains: relevance of the research program, challenges to research program, or productivity, team/open science, funding, innovations, publications, other dissemination, and impact. Rating of measures by 44 panelists (60%) in Round One and 24 (55%) in Round Two of a Delphi survey resulted in consensus on the high importance of 5 measures: research advances existing knowledge, research plan is innovative, an independent body of research (or fundamental role) supported by peer-reviewed research funding, research outputs relevant to discipline, and quality of the content of publications. Five measures achieved consensus on moderate importance: challenges to research productivity, potential to improve health or healthcare, team science, collaboration, and recognition by professional societies or academic bodies. There was high congruence between researchers and research leaders across disciplines. CONCLUSIONS: Our work contributes to the field by identifying 10 DORA-compliant measures of research quality and impact, a more comprehensive and explicit set of measures than prior efforts. Research is needed to identify strategies to overcome barriers of use of DORA-compliant measures, and to "de-implement" traditional measures that do not uphold DORA principles yet are still in use.

Measuring the susceptibility to visually induced motion sickness and its relationship with vertigo, dizziness, migraine, syncope and personality traits.

The widespread use of visual technologies such as Virtual Reality increases the risk of visually induced motion sickness (VIMS). Previously, the 6-item short version of the Visually Induced Motion Sickness Susceptibility Questionnaire (VIMSSQ short form) has been validated for predicting individual variation in VIMS. The aim of the current study was to investigate how the susceptibility to VIMS is correlated with other relevant factors in the general population. A total of 440 participants (201 M, 239F), mean age 33.6 (SD 14.8) years, completed an anonymous online survey of various questionnaires including the VIMSSQ, Motion Sickness Susceptibility Questionnaire (MSSQ), Vertigo in City questionnaire (VIC), Migraine (scale), Social & Work Impact of Dizziness (SWID), Syncope (faintness), and Personality ('Big Five' TIPI). The VIMSSQ correlated positively with the MSSQ (r = 0.50), VIC (r = 0.45), Migraine (r = 0.44), SWID (r = 0.28), and Syncope (r = 0.15). The most efficient Multiple Linear Regression model for the VIMSSQ included the predictors MSSQ, Migraine, VIC, and Age and explained 40% of the variance. Factor analysis of strongest correlates with VIMSSQ revealed a single factor loading with VIMSSQ, MSSQ, VIC, Migraine, SWID, and Syncope, suggesting a common latent variable of sensitivity. The set of predictors for the VIMSSQ in the general population has similarity with those often observed in patients with vestibular disorders. Based on these correlational results, we suggest the existence of continuum of underlying risk factors for sensitivity, from healthy population to patients with extreme visual vertigo and perhaps Persistent Postural-Perceptual Dizziness.

The Visually Induced Motion Sickness Susceptibility Questionnaire (VIMSSQ): Estimating Individual Susceptibility to Motion Sickness-Like Symptoms When Using Visual Devices.

OBJECTIVE: Two studies were conducted to develop and validate a questionnaire to estimate individual susceptibility to visually induced motion sickness (VIMS). BACKGROUND: VIMS is a common side-effect when watching dynamic visual content from various sources, such as virtual reality, movie theaters, or smartphones. A reliable questionnaire predicting individual susceptibility to VIMS is currently missing. The aim was to fill this gap by introducing the Visually Induced Motion Sickness Susceptibility Questionnaire (VIMSSQ). METHODS: A survey and an experimental study were conducted. Survey: The VIMSSQ investigated the frequency of nausea, headache, dizziness, fatigue, and eyestrain when using different visual devices. Data were collected from a survey of 322 participants for the VIMSSQ and other related phenomena such as migraine. Experimental study: 23 participants were exposed to a VIMS-inducing visual stimulus. Participants filled out the VIMSSQ together with other questionnaires and rated their level of VIMS using the Simulator Sickness Questionnaire (SSQ). RESULTS: Survey: The most prominent symptom when using visual devices was eyestrain, and females reported more VIMS than males. A one-factor solution with good scale reliability was found for the VIMSSQ. Experimental study: Regression analyses suggested that the VIMSSQ can be useful in predicting VIMS (R2 = .34) as measured by the SSQ, particularly when combined with questions pertaining to the tendency to avoid visual displays and experience syncope (R2 = .59). CONCLUSION: We generated normative data for the VIMSSQ and demonstrated its validity. APPLICATION: The VIMSSQ can become a valuable tool to estimate one's susceptibility to VIMS based on self-reports.

Enhanced vection in older adults: Evidence for age-related effects in multisensory vection experiences.

The illusion of self-motion (vection) is a multisensory phenomenon elicited by visual, auditory, tactile, or other sensory cues. Aging is often associated with changes in sensory acuity, visual motion perception, and multisensory integration, processes which may influence vection perception. However, age-related differences in vection have received little study to date. Thus, the objective of the present study was to investigate age-related differences in vection during multisensory stimulation. Nineteen younger adults and 19 older adults were exposed to rotating visual, auditory, and tactile stimuli (separately or in combination) at a speed of 45°/s inside a VR laboratory inducing circular vection. The size of the field-of-view (FOV) was large (240°), medium (75°), small (30°), or contained no visuals. Vection intensity and duration were reported verbally after each trial. Overall, older adults experienced significantly stronger and longer vection compared to younger adults. Additionally, there were main effects of FOV and sensory cues, such that larger FOVs and the presence of auditory and tactile stimulation increased vection ratings for both age groups. These findings support the idea that vection is a multisensory experience that can be elicited by visual, auditory, and tactile stimuli and demonstrates these effects for the first time in older adults.

Detecting and predicting visually induced motion sickness with physiological measures in combination with machine learning techniques.

Visually induced motion sickness (VIMS) is a common sensation when using visual displays such as smartphones or Virtual Reality. In the present study, we investigated whether Machine Learning (ML) techniques in combination with physiological measures (ECG, EDA, EGG, respiration, body and skin temperature, and body movements) could be used to detect and predict the severity of VIMS in real-time, minute-by-minute. A total of 43 healthy younger adults (25 female) were exposed to a 15-minute VIMS-inducing video. VIMS severity was subjectively measured during the video using the Fast Motion Sickness Scale (FMS) as well as before and after the video using the Simulator Sickness Questionnaire (SSQ). Thirty-one participants (72%) experienced VIMS in the present study. Results showed that changes in facial skin temperature and body movement had the strongest relationship with VIMS. On a minute-by-minute basis, ML models revealed a medium correlation between the physiological measures and the FMS scores. An acceptable classification score distinguishing between sick and non-sick participants was found. Our findings suggest that physiological measures may be useful for measuring VIMS, but they are not a reliable standalone method to detect or predict VIMS severity in real-time.

Motion sickness: current concepts and management.

PURPOSE OF REVIEW: Motion sickness is an ancient phenomenon that affects many people. Nausea, vomiting, disorientation, sweating, fatigue, and headache are just few of the many signs and symptoms that are commonly experienced during an episode of motion sickness. In the present review, we will provide an overview of the current research trends and topics in the domain of motion sickness, including theoretical considerations, physiological and neural mechanisms, individual risk factors, and treatment options, as well as recommendations for future research directions. RECENT FINDINGS: More recently, motion sickness has been in the focus of attention in the context of two global technological trends, namely automated vehicles and virtual reality. Both technologies bear the potential to revolutionize our daily lives in many ways; however, motion sickness is considered a serious concern that threatens their success and acceptance. The majority of recent research on motion sickness focuses on one of these two areas. SUMMARY: Aside from medication (e.g. antimuscarinics, antihistamines), habituation remains the most effective nonpharmacological method to reduce motion sickness. A variety of novel techniques has been investigated with promising results, but an efficient method to reliably prevent or minimize motion sickness has yet to emerge.

Virtual Hand Illusion in younger and older adults.

INTRODUCTION: Embodiment involves experiencing ownership over our body and localizing it in space and is informed by multiple senses (visual, proprioceptive and tactile). Evidence suggests that embodiment and multisensory integration may change with older age. The Virtual Hand Illusion (VHI) has been used to investigate multisensory contributions to embodiment, but has never been evaluated in older adults. Spatio-temporal factors unique to virtual environments may differentially affect the embodied perceptions of older and younger adults. METHODS: Twenty-one younger (18-35 years) and 19 older (65+ years) adults completed the VHI paradigm. Body localization was measured at baseline and again, with subjective ownership ratings, following synchronous and asynchronous visual-tactile interactions. RESULTS: Higher ownership ratings were observed in the synchronous relative to the asynchronous condition, but no effects on localization/drift were found. No age differences were observed. Localization accuracy was biased in both age groups when the virtual hand was aligned with the real hand, indicating a visual mislocalization of the virtual hand. CONCLUSIONS: No age-related differences in the VHI were observed. Mislocalization of the hand in VR occurred for both groups, even when congruent and aligned; however, tactile feedback reduced localization biases. Our results expand the current understanding of age-related changes in multisensory embodiment within virtual environments.

Multisensory Effects on Illusory Self-Motion (Vection): the Role of Visual, Auditory, and Tactile Cues.

A critical component to many immersive experiences in virtual reality (VR) is vection, defined as the illusion of self-motion. Traditionally, vection has been described as a visual phenomenon, but more recent research suggests that vection can be influenced by a variety of senses. The goal of the present study was to investigate the role of multisensory cues on vection by manipulating the availability of visual, auditory, and tactile stimuli in a VR setting. To achieve this, 24 adults (Mage = 25.04) were presented with a rotating stimulus aimed to induce circular vection. All participants completed trials that included a single sensory cue, a combination of two cues, or all three cues presented together. The size of the field of view (FOV) was manipulated across four levels (no-visuals, small, medium, full). Participants rated vection intensity and duration verbally after each trial. Results showed that all three sensory cues induced vection when presented in isolation, with visual cues eliciting the highest intensity and longest duration. The presence of auditory and tactile cues further increased vection intensity and duration compared to conditions where these cues were not presented. These findings support the idea that vection can be induced via multiple types of sensory inputs and can be intensified when multiple sensory inputs are combined.

Motion sickness diagnostic criteria: Consensus Document of the Classification Committee of the Bárány Society.

We present diagnostic criteria for motion sickness, visually induced motion sickness (VIMS), motion sickness disorder (MSD), and VIMS disorder (VIMSD) to be included in the International Classification of Vestibular Disorders. Motion sickness and VIMS are normal physiological responses that can be elicited in almost all people, but susceptibility and severity can be high enough for the response to be considered a disorder in some cases. This report provides guidelines for evaluating signs and symptoms caused by physical motion or visual motion and for diagnosing an individual as having a response that is severe enough to constitute a disorder.   The diagnostic criteria for motion sickness and VIMS include adverse reactions elicited during exposure to physical motion or visual motion leading to observable signs or symptoms of greater than minimal severity in the following domains: nausea and/or gastrointestinal disturbance, thermoregulatory disruption, alterations in arousal, dizziness and/or vertigo, headache and/or ocular strain. These signs and/or symptoms occur during the motion exposure, build as the exposure is prolonged, and eventually stop after the motion ends. Motion sickness disorder and VIMSD are diagnosed when recurrent episodes of motion sickness or VIMS are reliably triggered by the same or similar stimuli, severity does not significantly decrease after repeated exposure, and signs/symptoms lead to activity modification, avoidance behavior, or aversive emotional responses.   Motion sickness/MSD and VIMS/VIMSD can occur separately or together. Severity of symptoms in reaction to physical motion or visual motion stimuli varies widely and can change within an individual due to aging, adaptation, and comorbid disorders. We discuss the main methods for measuring motion sickness symptoms, the situations conducive to motion sickness and VIMS, and the individual traits associated with increased susceptibility. These additional considerations will improve diagnosis by fostering accurate measurement and understanding of the situational and personal factors associated with MSD and VIMSD.

The role of cognitive factors and personality traits in the perception of illusory self-motion (vection).

Vection is a perceptual phenomenon that describes the visually induced subjective sensation of self-motion in the absence of physical motion. Previous research has discussed the potential involvement of top-down cognitive mechanisms on vection. Here, we quantified how cognitive manipulations such as contextual information (i.e., expectation) and plausibility (i.e., chair configuration) alter vection. We also explored how individual traits such as field dependence, depersonalization, anxiety, and social desirability might be related to vection. Fifty-one healthy adults were exposed to an optic flow stimulus that consisted of horizontally moving black-and-white bars presented on three adjacent monitors to generate circular vection. Participants were divided into three groups and given experimental instructions designed to induce either strong, weak, or no expectation with regard to the intensity of vection. In addition, the configuration of the chair (rotatable or fixed) was modified during the experiment. Vection onset time, duration, and intensity were recorded. Results showed that expectation altered vection intensity, but only when the chair was in the rotatable configuration. Positive correlations for vection measures with field dependence and depersonalization, but no sex-related effects were found. Our results show that vection can be altered by cognitive factors and that individual traits can affect the perception of vection, suggesting that vection is not a purely perceptual phenomenon, but can also be affected by top-down mechanisms.

Examining potential effects of arousal, valence, and likability of music on visually induced motion sickness.

The present study investigated how valence, arousal, and subjective liking of music affect visually induced motion sickness (VIMS). VIMS is a common side effect when interacting with virtual environments, resulting in discomfort, dizziness, and/or nausea. Music has previously been shown to reduce VIMS, but the precise nature of this effect remains unknown. Eighty participants watched a video of a bicycle ride filmed from a first-person perspective. First, participants (n = 40) were randomly assigned to one of four groups that listened to pre-selected, classical music excerpts varying in valence and arousal (happy, peaceful, agitated, sad) while watching the video. Second, the level of subjective liking of music was maximized by asking participants to select their favourite music (n = 20), which was then played during the video. A control group (n = 20) watched the video without music. VIMS was measured using the Fast Motion Sickness Scale (FMS) and the Simulator Sickness Questionnaire (SSQ). No effects of valence or arousal on VIMS symptoms were found. Instead, we found that VIMS was significantly reduced when music liking was maximized: Participants who listened to their favourite music reported less VIMS compared to those who did not listen to music at all or to pre-selected music that they liked less. Music that is highly liked can, under certain circumstances, successfully reduce VIMS. These effects appear to be independent of the valence and arousal characteristics of the music.

Neuropsychological Approaches to Visually-Induced Vection: an Overview and Evaluation of Neuroimaging and Neurophysiological Studies.

Moving visual stimuli can elicit the sensation of self-motion in stationary observers, a phenomenon commonly referred to as vection. Despite the long history of vection research, the neuro-cognitive processes underlying vection have only recently gained increasing attention. Various neuropsychological techniques such as functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) have been used to investigate the temporal and spatial characteristics of the neuro-cognitive processing during vection in healthy participants. These neuropsychological studies allow for the identification of different neuro-cognitive correlates of vection, which (a) will help to unravel the neural basis of vection and (b) offer opportunities for applying vection as a tool in other research areas. The purpose of the current review is to evaluate these studies in order to show the advances in neuropsychological vection research and the challenges that lie ahead. The overview of the literature will also demonstrate the large methodological variability within this research domain, limiting the integration of results. Next, we will summarize methodological considerations and suggest helpful recommendations for future vection research, which may help to enhance the comparability across neuropsychological vection studies.

Sigmoid Wake Probability Model for High-Resolution Detection of Drowsiness Using Electroencephalogram.

An efficient and reliable method to detect drowsiness can reduce accidents and injuries related to drowsy driving. However, existing systems for detecting drowsiness are often of low-resolution, expensive, and dependent on external parameters. Therefore, the goal of this study is to develop a high-resolution and efficient drowsiness detection algorithm using relatively less noisy sleep study data. To this end, we recorded electroencephalogram (EEG) from 53 subjects during a sleep study and leveraged the EEG frequency band changes at sleep onset to develop a model for drowsiness detection. The model devised herein provided a likelihood of wakefulness for 3-s signal segments. By choosing appropriate thresholds of the model output, we have identified three clusters that represent wakefulness, drowsiness, and, sleep. The proposed scheme has been validated using arousals which are cases of alertness and deep sleep segments, cluster quality evaluation metrics, graphical, and statistical analyses. The results presented in this work suggest that spectral properties of EEG can be utilized for high-resolution drowsiness detection in sleep study. Upon its successful validation in a driving study, the proposed model can lead to the development of an efficient drowsy driving monitoring system.

The Rubber Hand Illusion in Healthy Younger and Older Adults.

Percepts about our body's position in space and about body ownership are informed by multisensory feedback from visual, proprioceptive, and tactile inputs. The Rubber Hand Illusion (RHI) is a multisensory illusion that is induced when an observer sees a rubber hand being stroked while they feel their own, spatially displaced, and obstructed hand being stroked. When temporally synchronous, the visual-tactile interactions can create the illusion that the rubber hand belongs to the observer and that the observer's real hand is shifted in position towards the rubber hand. Importantly, little is understood about whether these multisensory perceptions of the body change with older age. Thus, in this study we implemented a classic RHI protocol (synchronous versus asynchronous stroking) with healthy younger (18-35) and older (65+) adults and measured the magnitude of proprioceptive drift and the subjective experience of body ownership. As an adjunctive objective measure, skin temperature was recorded to evaluate whether decreases in skin temperature were associated with illusory percepts, as has been shown previously. The RHI was observed for both age groups with respect to increased drift and higher ratings of ownership following synchronous compared to asynchronous stroking. Importantly, no effects of age and no interactions between age and condition were observed for either of these outcome measures. No effects were observed for skin temperature. Overall, these results contribute to an emerging field of research investigating the conditions under which age-related differences in multisensory integration are observed by providing insights into the role of visual, proprioceptive, and tactile inputs on bodily percepts.

The efficacy of airflow and seat vibration on reducing visually induced motion sickness.

Visually induced motion sickness (VIMS) is a well-known sensation in virtual environments and simulators, typically characterized by a variety of symptoms such as pallor, sweating, dizziness, fatigue, and/or nausea. Numerous methods to reduce VIMS have been previously introduced; however, a reliable countermeasure is still missing. In the present study, the effect of airflow and seat vibration to alleviate VIMS was investigated. Eighty-two participants were randomly assigned to one of four groups (airflow, vibration, combined airflow and vibration, and control) and then exposed to a 15 min long video of a bicycle ride shot from first-person view. VIMS was measured using the Fast Motion Sickness Scale (FMS) and the Simulator Sickness Questionnaire (SSQ). Results showed that the exposure of airflow significantly reduced VIMS, whereas the presence of seat vibration, in contrast, did not have an impact on VIMS. Additionally, we found that females reported higher FMS scores than males, however, this sex difference was not found in the SSQ scores. Our findings demonstrate that airflow can be an effective and easy-to-apply technique to reduce VIMS in virtual environments and simulators, while vibration applied to the seat is not a successful method.