How different text display patterns affect cybersickness in augmented reality.

Cybersickness remains a pivotal factor that impacts user experience in Augmented Reality (AR). Research probing into the relationship between AR reading tasks and cybersickness, particularly focusing on text display patterns and user characteristics, has been scant. Moreover, the influence of cybersickness on searching ability and the broader spectrum of user experience has not been rigorously tested. Recent investigations have aimed to pinpoint the variables that contribute to cybersickness during AR reading sessions. In one such study, 40 participants underwent a series of controlled experiments with randomized text display patterns, including variations in text speed and text movement modes. Post-experiment, participants completed a questionnaire that helped quantify their experiences and the degree of cybersickness encountered. The data highlighted that satiety, text speed, and text movement mode are significant contributors to cybersickness. When participants experienced higher levels of cybersickness, font color stood out as a particularly influential factor, whereas gender differences seemed to affect the onset of cybersickness more noticeably at lower levels. This study also drew attention to the impact of cybersickness on search ability within AR environments. It was noted that as cybersickness intensity increased, search ability was markedly compromised. In sum, the research underscores the importance of text display patterns and user characteristics, such as past AR experience, in understanding cybersickness and its detrimental effects on user experience and search ability, particularly under conditions of intense cybersickness.

Investigating cortical activity during cybersickness by fNIRS.

This study investigated brain responses during cybersickness in healthy adults using functional near-infrared spectroscopy (fNIRS). Thirty participants wore a head-mounted display and observed a virtual roller coaster scene that induced cybersickness. Cortical activation during the virtual roller coaster task was measured using fNIRS. Cybersickness symptoms were evaluated using a Simulator Sickness Questionnaire (SSQ) administered after the virtual rollercoaster. Pearson correlations were performed for cybersickness symptoms and the beta coefficients of hemodynamic responses. The group analysis of oxyhemoglobin (HbO) and total hemoglobin (HbT) levels revealed deactivation in the bilateral angular gyrus during cybersickness. In the Pearson correlation analyses, the HbO and HbT beta coefficients in the bilateral angular gyrus had a significant positive correlation with the total SSQ and disorientation. These results indicated that the angular gyrus was associated with cybersickness. These findings suggest that the hemodynamic response in the angular gyrus could be a biomarker for evaluating cybersickness symptoms.

Evaluation of power wheelchair driving performance in simulator compared to driving in real-life situations: the SIMADAPT (simulator ADAPT) project-a pilot study.

OBJECTIVE: The objective of this study was to evaluate users' driving performances with a Power Wheelchair (PWC) driving simulator in comparison to the same driving task in real conditions with a standard power wheelchair. METHODS: Three driving circuits of progressive difficulty levels (C1, C2, C3) that were elaborated to assess the driving performances with PWC in indoor situations, were used in this study. These circuits have been modeled in a 3D Virtual Environment to replicate the three driving task scenarios in Virtual Reality (VR). Users were asked to complete the three circuits with respect to two testing conditions during three successive sessions, i.e. in VR and on a real circuit (R). During each session, users completed the two conditions. Driving performances were evaluated using the number of collisions and time to complete the circuit. In addition, driving ability by Wheelchair Skill Test (WST) and mental load were assessed in both conditions. Cybersickness, user satisfaction and sense of presence were measured in VR. The conditions R and VR were randomized. RESULTS: Thirty-one participants with neurological disorders and expert wheelchair drivers were included in the study. The driving performances between VR and R conditions were statistically different for the C3 circuit but were not statistically different for the two easiest circuits C1 and C2. The results of the WST was not statistically different in C1, C2 and C3. The mental load was higher in VR than in R condition. The general sense of presence was reported as acceptable (mean value of 4.6 out of 6) for all the participants, and the cybersickness was reported as acceptable (SSQ mean value of 4.25 on the three circuits in VR condition). CONCLUSION: Driving performances were statistically different in the most complicated circuit C3 with an increased number of collisions in VR, but were not statistically different for the two easiest circuits C1 and C2 in R and VR conditions. In addition, there were no significant adverse effects such as cybersickness. The results show the value of the simulator for driving training applications. Still, the mental load was higher in VR than in R condition, thus mitigating the potential for use with people with cognitive disorders. Further studies should be conducted to assess the quality of skill transfer for novice drivers from the simulator to the real world. Trial registration Ethical approval n ∘ 2019-A001306-51 from Comité de Protection des Personnes Sud Mediterranée IV. Trial registered the 19/11/2019 on ClinicalTrials.gov in ID: NCT04171973.

CyPVICS: A framework to prevent or minimise cybersickness in immersive virtual clinical simulation.

Cybersickness is a global issue affecting users of immersive virtual reality. However, there is no agreement on the exact cause of cybersickness. Taking into consideration how it can differ greatly from one person to another, it makes it even more difficult to determine the exact cause or find a solution. Because cybersickness excludes so many prospective users, including healthcare professionals, from using immersive virtual reality as a learning tool, this research sought to find solutions in existing literature and construct a framework that can be used to prevent or minimise cybersickness during immersive virtual clinical simulation (CyPVICS). The Bestfit Framework by Carrol and authors were used to construct the CyPVICS framework. The process started by conducting two separate literature searchers using the BeHEMoTh (for models, theories, and frameworks) and SPIDER (for primary research articles) search techniques. Once the literature searches were completed the models, theories and framework were used to construct a priori framework. The models' theories and frameworks were analysed to determine aspects relevant to causes, reducing, eliminating, and detecting cybersickness. The priori framework was expanded by, first coding the findings of the primary research study into the existing aspects of the priori framework. Once coded the aspects that could not be coded were added in the relevant category, for example causes. After reviewing 1567 abstracts and titles as part of the BeHEMoTh search string,19 full text articles, a total of 15 papers containing models, theories, and frameworks, were used to construct the initial CyPVICS framework. Once the initial CyPVICS was created, a total 904 primary research studies (SPIDER) were evaluated, based on their titles and abstracts, of which 100 were reviewed in full text. In total, 67 articles were accepted and coded to expand the initial CyPVICS framework. This paper presents the CyPVICS framework for use, not only in health professions' education, but also in other disciplines, since the incorporated models, theories, frameworks, and primary research studies were not specific to virtual clinical simulation.

Analysis of cybersickness in virtual nursing simulation: a German longitudinal study.

BACKGROUND: Innovative educational approaches such as simulation-based nursing education using virtual reality (VR) technologies provide new opportunities for nursing education. However, there is a lack of information on side effects, especially health-related side effects, of head-mounted displays (HMDs) on the human body when using VR devices for nursing simulation. This study aims to validate the German version of the Virtual Reality Sickness Questionnaire (VRSQ) and to evaluate its associations with sex and age, as reflected in the VRSQG scores (total score, oculomotor, and disorientation) over time. METHODS: A longitudinal-sectional study was conducted. In addition to the VRSQG (pre-, post-, and 20 min post-intervention), participants (all nursing students) completed data on personal characteristics. Participants completed a VR simulation of a blood draw. Confirmatory factor analysis (CFA) was used to evaluate whether the measured construct was consistent with the original. In addition to the validity, internal consistency was analyzed and generalized linear models (GLMs) were used for data analysis. RESULTS: A total of 38 nursing students (mean age 26.8 years; SD = 7.1, 79.0% female) participated. The mean time spent in the VR simulation was 21 min. All participants completed the entire simulation. The CFA indicates (CFI = 0.981, SRMR = 0.040) VRSQG structure is given. Internal consistency showed low values for the subdomain Oculomotor (Cronbach alpha 0.670). For Disorientation and the Total score values showed a sufficient internal consistency. GLMs showed significant between subject associations with age over time with VRSQG total score, oculomotor, and disorientation. Older nursing students start with higher VRSQG-Scores. Over time, an approximation occurs, so that all participants reach a similar level by the final measurement point. No associations were found between sex (male/female) and VRSQG scores. CONCLUSIONS: The VRSQG is a reliable and valid self-assessment for measuring cybersickness in VR based nursing simulations, with cybersickness symptoms positively associated with age. However, in depth-evaluation regarding age-associations with cybersickness should be done. As well as studies to explore additional associations and emphasizes the importance of establishing cut-off values to assess the clinical relevance of the scores.

Cybersickness in People with Multiple Sclerosis Exposed to Immersive Virtual Reality.

Together with the wide range of possible benefits for the rehabilitation/training of people with multiple sclerosis (pwMS) and other neurologic conditions, exposure to immersive virtual reality (VR) has often been associated with unpleasant symptoms, such as transient dizziness, headache, nausea, disorientation and impaired postural control (i.e., cybersickness). Since these symptoms can significantly impact the safety and tolerability of the treatment, it appears important to correctly estimate their presence and magnitude. Given the existing data scarcity, this study aims to assess the existence and severity of possible adverse effects associated with exposure to immersive VR in a cohort of pwMS using both objective measurements of postural control effectiveness and subjective evaluations of perceived symptoms. To this aim, postural sway under upright quiet posture (in the presence and absence of visual input) of 56 pwMS with an Expanded Disability Status Scale score (EDSS) in the range of 0-6.5 (mean EDSS 2.3) and 33 unaffected individuals was measured before and after a 10-min immersive VR session and at 10 min follow-up on the basis of center of pressure (COP) trajectories. The severity of cybersickness symptoms associated with VR exposure was also self-rated by the participants using the Italian version of the Simulator Sickness Questionnaire (SSQ). Temporary impairments of postural control in terms of significantly increased sway area were observed after the VR session only in pwMS with mild-moderate disability (i.e., EDSS in the range of 2.5-6.5) in the presence of visual input. No changes were observed in pwMS with low disability (EDSS 0-2) and unaffected individuals. In contrast, when the visual input was removed, there was a decrease in sway area (pwMS with mild-moderate disability) and COP path length relating to the use of VR (pwMS with mild-moderate disability and unaffected individuals), thus suggesting a sort of "balance training effect". Even in this case, the baseline values were restored at follow-up. All participants, regardless of their status, experienced significant post-VR side effects, especially in terms of blurred vision and nausea. Taken together, the findings of the present study suggest that a short immersive VR session negatively (eyes open) and positively (eyes closed) impacts the postural control of pwMS and causes significant disorientation. However, such effects are of limited duration. While it is reasonable to state that immersive VR is sufficiently safe and tolerable to not be contraindicated in the rehabilitation/training of pwMS, in order to reduce possible negative effects and maximize the efficacy, safety and comfort of the treatment, it appears necessary to develop specific guidelines that consider important factors like individual susceptibility, maximum exposure time according to the specific features of the simulation, posture to adopt and protocols to assess objective and perceived effects on participants.

Immersive Virtual Reality-Based Methods for Assessing Executive Functioning: Systematic Review.

BACKGROUND: Neuropsychological assessments traditionally include tests of executive functioning (EF) because of its critical role in daily activities and link to mental disorders. Established traditional EF assessments, although robust, lack ecological validity and are limited to single cognitive processes. These methods, which are suitable for clinical populations, are less informative regarding EF in healthy individuals. With these limitations in mind, immersive virtual reality (VR)-based assessments of EF have garnered interest because of their potential to increase test sensitivity, ecological validity, and neuropsychological assessment accessibility. OBJECTIVE: This systematic review aims to explore the literature on immersive VR assessments of EF focusing on (1) EF components being assessed, (2) how these assessments are validated, and (3) strategies for monitoring potential adverse (cybersickness) and beneficial (immersion) effects. METHODS: EBSCOhost, Scopus, and Web of Science were searched in July 2022 using keywords that reflected the main themes of VR, neuropsychological tests, and EF. Articles had to be peer-reviewed manuscripts written in English and published after 2013 that detailed empirical, clinical, or proof-of-concept studies in which a virtual environment using a head-mounted display was used to assess EF in an adult population. A tabular synthesis method was used in which validation details from each study, including comparative assessments and scores, were systematically organized in a table. The results were summed and qualitatively analyzed to provide a comprehensive overview of the findings. RESULTS: The search retrieved 555 unique articles, of which 19 (3.4%) met the inclusion criteria. The reviewed studies encompassed EF and associated higher-order cognitive functions such as inhibitory control, cognitive flexibility, working memory, planning, and attention. VR assessments commonly underwent validation against gold-standard traditional tasks. However, discrepancies were observed, with some studies lacking reported a priori planned correlations, omitting detailed descriptions of the EF constructs evaluated using the VR paradigms, and frequently reporting incomplete results. Notably, only 4 of the 19 (21%) studies evaluated cybersickness, and 5 of the 19 (26%) studies included user experience assessments. CONCLUSIONS: Although it acknowledges the potential of VR paradigms for assessing EF, the evidence has limitations. The methodological and psychometric properties of the included studies were inconsistently addressed, raising concerns about their validity and reliability. Infrequent monitoring of adverse effects such as cybersickness and considerable variability in sample sizes may limit interpretation and hinder psychometric evaluation. Several recommendations are proposed to improve the theory and practice of immersive VR assessments of EF. Future studies should explore the integration of biosensors with VR systems and the capabilities of VR in the context of spatial navigation assessments. Despite considerable promise, the systematic and validated implementation of VR assessments is essential for ensuring their practical utility in real-world applications.

Influence of Normal Aging and Multisensory Data Fusion on Cybersickness and Postural Adaptation in Immersive Virtual Reality.

Immersive Virtual Reality (VR) systems are expanding as sensorimotor readaptation tools for older adults. However, this purpose may be challenged by cybersickness occurrences possibly caused by sensory conflicts. This study aims to analyze the effects of aging and multisensory data fusion processes in the brain on cybersickness and the adaptation of postural responses when exposed to immersive VR. METHODS: We repeatedly exposed 75 participants, aged 21 to 86, to immersive VR while recording the trajectory of their Center of Pressure (CoP). Participants rated their cybersickness after the first and fifth exposure. RESULTS: The repeated exposures increased cybersickness and allowed for a decrease in postural responses from the second repetition, i.e., increased stability. We did not find any significant correlation between biological age and cybersickness scores. On the contrary, even if some postural responses are age-dependent, a significant postural adaptation occurred independently of age. The CoP trajectory length in the anteroposterior axis and mean velocity were the postural parameters the most affected by age and repetition. CONCLUSIONS: This study suggests that cybersickness and postural adaptation to immersive VR are not age-dependent and that cybersickness is unrelated to a deficit in postural adaptation or age. Age does not seem to influence the properties of multisensory data fusion.

Classification of Emotional and Immersive Outcomes in the Context of Virtual Reality Scene Interactions.

The constantly evolving technological landscape of the Metaverse has introduced a significant concern: cybersickness (CS). There is growing academic interest in detecting and mitigating these adverse effects within virtual environments (VEs). However, the development of effective methodologies in this field has been hindered by the lack of sufficient benchmark datasets. In pursuit of this objective, we meticulously compiled a comprehensive dataset by analyzing the impact of virtual reality (VR) environments on CS, immersion levels, and EEG-based emotion estimation. Our dataset encompasses both implicit and explicit measurements. Implicit measurements focus on brain signals, while explicit measurements are based on participant questionnaires. These measurements were used to collect data on the extent of cybersickness experienced by participants in VEs. Using statistical methods, we conducted a comparative analysis of CS levels in VEs tailored for specific tasks and their immersion factors. Our findings revealed statistically significant differences between VEs, highlighting crucial factors influencing participant engagement, engrossment, and immersion. Additionally, our study achieved a remarkable classification performance of 96.25% in distinguishing brain oscillations associated with VR scenes using the multi-instance learning method and 95.63% in predicting emotions within the valence-arousal space with four labels. The dataset presented in this study holds great promise for objectively evaluating CS in VR contexts, differentiating between VEs, and providing valuable insights for future research endeavors.

Socially Acquired Nocebo Effects Generalize but Are Not Attenuated by Choice.

BACKGROUND: Socially observing a negative treatment-related experience has been shown to modulate our own experience with the same intervention, leading to worsened health outcomes. However, whether this social learning generalizes to similar but distinct interventions has not been explored nor what manipulations can reduce these effects. PURPOSE: To determine whether socially acquired nocebo effects can be generated by observing a negative experience with a similar, but distinct intervention, and whether choice can reduce these effects. METHODS: Across three experiments, a community sample of healthy adults (N = 336) either watched a confederate report cybersickness to the same Virtual Reality (VR) activity they were assigned to (Social Modeling: Consistent); a similar, but different VR activity (Social Modeling: Inconsistent); or did not view the confederate (No Social Modeling). Participants were either given choice over the VR (Choice) or assigned by the experimenter (No Choice). RESULTS: Across the experiments, there was significantly greater cybersickness in both Social Modeling groups relative to No Social Modeling, while the two Social Modeling groups did not differ. There was no significant effect of Choice or a Choice by Social Modeling interaction. Social Modeling elicited greater anxiety and expectancies for cybersickness. Furthermore, these mechanisms mediated the association between social modeling and cybersickness. CONCLUSIONS: Socially acquired side-effects were demonstrated to generalize to similar, but distinct interventions, highlighting the diffuse and robust effect social modeling can have on our experiences. However, choice did not attenuate the experience of cybersickness, highlighting the need for alternative methods to counteract the effect of social modeling.

Witnessing someone experience cybersickness during Virtual Reality (VR) generated a nocebo effect in the observer, exacerbating their own symptoms when subsequently encountering VR. The nocebo effect was not specific to the VR activity witnessed, but generalized across different VR experiences, demonstrating that socially acquired nocebo effects are likely to spread rapidly. Choice of VR environment did not reduce the nocebo effect elicited in the observer.

Corrigendum: Design guidelines for limiting and eliminating virtual reality-induced symptoms and effects at work: a comprehensive, factor-oriented review.

[This corrects the article DOI: 10.3389/fpsyg.2023.1161932.].

Frequency-Dependent Reduction of Cybersickness in Virtual Reality by Transcranial Oscillatory Stimulation of the Vestibular Cortex.

Virtual reality (VR) applications are pervasive of everyday life, as in working, medical, and entertainment scenarios. There is yet no solution to cybersickness (CS), a disabling vestibular syndrome with nausea, dizziness, and general discomfort that most of VR users undergo, which results from an integration mismatch among visual, proprioceptive, and vestibular information. In a double-blind, controlled trial, we propose an innovative treatment for CS, consisting of online oscillatory imperceptible neuromodulation with transcranial alternating current stimulation (tACS) at 10 Hz, biophysically modelled to reach the vestibular cortex bilaterally. tACS significantly reduced CS nausea in 37 healthy subjects during a VR rollercoaster experience. The effect was frequency-dependent and placebo-insensitive. Subjective benefits were paralleled by galvanic skin response modulation in 25 subjects, addressing neurovegetative activity. Besides confirming the role of transcranially delivered oscillations in physiologically tuning the vestibular system function (and dysfunction), results open a new way to facilitate the use of VR in different scenarios and possibly to help treating also other vestibular dysfunctions.

In too deep? A systematic literature review of fully-immersive virtual reality and cybersickness among older adults.

BACKGROUND: Virtual reality technology holds great promise in improving the health and well-being of older adults; however, this technology is associated with potential risks that may outweigh the benefits. The purpose of this systematic review is to synthesize and critique the existing literature on fully-immersive virtual reality interventions for older adults and the associated risk of cybersickness. METHODS: We searched eight databases for studies that utilized fully-immersive virtual reality, stated the population as older adults, provided outcomes related to cybersickness, and were written or translated into the English language. Our search generated 332 articles, 39 of which were selected for inclusion in this systematic synthesis and appraisal. RESULTS: We found that the majority of studies utilized a one-time session. The studies generally had weak sample generalizability and methodological design, but strong data collection and participant retention. The studies nearly all used the Simulator Sickness Questionnaire to measure cybersickness, but the scoring for the Simulator Sickness Questionnaire varied or was not mentioned. Most included studies reported only minor cybersickness among older adult participants. CONCLUSION: Researchers might conclude that the benefits of virtual reality interventions outweigh the risk of cybersickness in this population. Going forward, researchers should concentrate on the efficacy of virtual reality interventions among older adults, using larger samples and randomized controlled study design, along with measuring dosage effects.

Tolerance of immersive head-mounted virtual reality among older nursing home residents.

Introduction: Virtual Reality (VR) is a tool that is increasingly used in the aging population. Head-Mounted Displays (HMDs) are stereoscopic vision devices used for immersive VR. Cybersickness is sometimes reported after head-mounted display (HMD) VR exposure. Cybersickness severity and anxiety state reflect VR low tolerance. We aimed to evaluate HMD VR tolerance among older nursing home residents through cybersickness and anxiety state. Methods: A total of 36 participants were included in this preliminary study, 33 of whom (mean age: 89.33 ± 5.48) underwent three individual HMD VR sessions with three different contents. Cybersickness occurrence and severity were scored by the Simulator Sickness Questionnaire (SSQ) after each session. Anxiety state was assessed by the State-Trait Anxiety Inventory form Y-A before and after each session. Anxiety trait (using State-Trait Anxiety Inventory form Y-B) was also evaluated before and after the experiment. In total, 92% (33/36) of patients completed all three sessions, of which 61% (20/33) did not report any cybersickness symptoms (SSQ = 0). Six participants reported significant cybersickness (defined by an SSQ score ⩾10) in at least one session. Discussion: Only two participants stopped the study after the first exposure because of cybersickness. Age, cognitive function, anxiety trait, and well-being were not associated with cybersickness. The mean anxiety state decreased significantly from pre- to post-session. This immersive HMD VR experience was well tolerated among nursing home dwellers. Further larger studies in this population aiming to identify CS determinants are needed in order to use HMD VR on a standard basis.

Frequency-dependent tuning of the human vestibular "sixth sense" by transcranial oscillatory currents.

OBJECTIVE: The vestibular cortex is a multisensory associative region that, in neuroimaging investigations, is activated by slow-frequency (1-2 Hz) galvanic stimulation of peripheral receptors. We aimed to directly activate the vestibular cortex with biophysically modeled transcranial oscillatory current stimulation (tACS) in the same frequency range. METHODS: Thirty healthy subjects and one rare patient with chronic bilateral vestibular deafferentation underwent, in a randomized, double-blind, controlled trial, to tACS at slow (1 or 2 Hz) or higher (10 Hz) frequency and sham stimulations, over the Parieto-Insular Vestibular Cortex (PIVC), while standing on a stabilometric platform. Subjective symptoms of motion sickness were scored by Simulator Sickness Questionnaire and subjects' postural sways were monitored on the platform. RESULTS: tACS at 1 and 2 Hz induced symptoms of motion sickness, oscillopsia and postural instability, that were supported by posturographic sway recordings. Both 10 Hz-tACS and sham stimulation on the vestibular cortex did not affect vestibular function. As these effects persisted in a rare patient with bilateral peripheral vestibular areflexia documented by the absence of the Vestibular-Ocular Reflex, the possibility of a current spread toward peripheral afferents is unlikely. Conversely, the 10 Hz-tACS significantly reduced his chronic vestibular symptoms in this patient. CONCLUSIONS: Weak electrical oscillations in a frequency range corresponding to the physiological cortical activity of the vestibular system may generate motion sickness and postural sways, both in healthy subjects and in the case of bilateral vestibular deafferentation. SIGNIFICANCE: This should be taken into account as a new side effect of tACS in future studies addressing cognitive functions. Higher frequencies of stimulation applied to the vestibular cortex may represent a new interventional option to reduce motion sickness in different scenarios.

Prediction and detection of virtual reality induced cybersickness: a spiking neural network approach using spatiotemporal EEG brain data and heart rate variability.

Virtual Reality (VR) allows users to interact with 3D immersive environments and has the potential to be a key technology across many domain applications, including access to a future metaverse. Yet, consumer adoption of VR technology is limited by cybersickness (CS)-a debilitating sensation accompanied by a cluster of symptoms, including nausea, oculomotor issues and dizziness. A leading problem is the lack of automated objective tools to predict or detect CS in individuals, which can then be used for resistance training, timely warning systems or clinical intervention. This paper explores the spatiotemporal brain dynamics and heart rate variability involved in cybersickness and uses this information to both predict and detect CS episodes. The present study applies deep learning of EEG in a spiking neural network (SNN) architecture to predict CS prior to using VR (85.9%, F7) and detect it (76.6%, FP1, Cz). ECG-derived sympathetic heart rate variability (HRV) parameters can be used for both prediction (74.2%) and detection (72.6%) but at a lower accuracy than EEG. Multimodal data fusion of EEG and sympathetic HRV does not change this accuracy compared to ECG alone. The study found that Cz (premotor and supplementary motor cortex) and O2 (primary visual cortex) are key hubs in functionally connected networks associated with both CS events and susceptibility to CS. F7 is also suggested as a key area involved in integrating information and implementing responses to incongruent environments that induce cybersickness. Consequently, Cz, O2 and F7 are presented here as promising targets for intervention.

Anticholinergic Versus Antihistaminic Treatment for Simulator Sickness Prevention.

Flight simulators have an essential role in aircrew training. Occasionally, symptoms of motion sickness, defined as simulator sickness, develop during these sessions. Preventive methods for motion sickness have been investigated thoroughly; however, only a few studies have examined preventive treatments for simulator sickness. The aim of this study was to examine the efficacy of scopolamine (an anticholinergic drug) compared with cinnarizine (an antihistaminic drug) for helicopter simulator sickness prevention. A validated simulator sickness questionnaire (SSQ) score was used to determine the severity of simulator sickness symptoms in this study. Preliminary SSQ scores and SSQ scores after each sortie were calculated. Each participant was given scopolamine, cinnarizine, or a placebo in a double-blind randomized manner before the first sortie of each training day. Forty-one helicopter pilots participated in the trial. The average age was 30.5 ± 7.1 years. SSQ values significantly improved from an average of 73.30 in the preliminary SSQ questionnaire to an average of 30.92 after 2 hours following the administration of cinnarizine (P = .012, 95%CI 8.071-76.703). Scopolamine was found to be less effective than both cinnarizine and the placebo in the alleviation of simulator sickness symptoms. This study is the first to compare scopolamine with cinnarizine for simulator sickness prevention. Based on the results of this study, we recommend the use of cinnarizine over scopolamine for simulator sickness prevention.

Subjective Visual Vertical test with the 3D virtual reality system: effective factors and cybersickness.

BACKGROUND: 3D Virtual Reality (VR) offers new opportunities in vestibular science. It also presents new challenges and problems. AIMS/OBJECTIVES: The study aimed to evaluate the effective factors in the 3D VR Subjective Visual Vertical (SVV) test and the impact of cybersickness on the test results. MATERIAL AND METHODS: The effect of the foam surface, head position in the yaw axis, moving background, and arm position holding the controller was tested. Cybersickness was evaluated using the Simulator Sickness Questionnaire (SSQ). RESULTS: The head position and controller holding style significantly affected the results. The foam surface and the moving background did not have a significant effect. Although 61.4% of the patients fell into the bad category according to the symptoms of the SSQ score, cybersickness did not significantly affect the SVV results. CONCLUSIONS AND SIGNIFICANCE: In 3D VR SVV, additional factors should be considered: the headset's weight, head position, and how we hold the controller. The A-effect emerged when the head was 45 degrees turned on the yaw axis. A significant shift was detected in the test, with the arm holding the controller at 90 degrees. Most subjects felt cybersickness at a considerable level. Cybersickness should always be taken into account in VR when planning new applications.

Design guidelines for limiting and eliminating virtual reality-induced symptoms and effects at work: a comprehensive, factor-oriented review.

Virtual reality (VR) can induce side effects known as virtual reality-induced symptoms and effects (VRISE). To address this concern, we identify a literature-based listing of these factors thought to influence VRISE with a focus on office work use. Using those, we recommend guidelines for VRISE amelioration intended for virtual environment creators and users. We identify five VRISE risks, focusing on short-term symptoms with their short-term effects. Three overall factor categories are considered: individual, hardware, and software. Over 90 factors may influence VRISE frequency and severity. We identify guidelines for each factor to help reduce VR side effects. To better reflect our confidence in those guidelines, we graded each with a level of evidence rating. Common factors occasionally influence different forms of VRISE. This can lead to confusion in the literature. General guidelines for using VR at work involve worker adaptation, such as limiting immersion times to between 20 and 30 min. These regimens involve taking regular breaks. Extra care is required for workers with special needs, neurodiversity, and gerontechnological concerns. In addition to following our guidelines, stakeholders should be aware that current head-mounted displays and virtual environments can continue to induce VRISE. While no single existing method fully alleviates VRISE, workers' health and safety must be monitored and safeguarded when VR is used at work.