Thematic analysis of stakeholder perceptions for co-creative healthcare XR resource design and development; traversing a minefield of opportunities.

Introduction: The expansive curricular volume of healthcare education makes a necessity the incorporation of innovative methods and immersive media in it. The core challenge in such approaches is the timely development of relevant immersive content such as Virtual, Augmented or Mixed Reality (VR/AR/MR) resources for healthcare topics. There is currently significant interest in the use of co-creative methods for streamlining immersive content development. Methods: A core research pursuit in this translational research field is the formulation of evidence-based, optimized workflows that streamline immersive content creation allowing for rapid expansion of innovative educational approaches in healthcare curricula. The purpose of this paper is to aggregate the perceptions of healthcare technologists and educators who participated in a series of co-creation sessions in order to elicit their best practice insights for design and development of XR educational resources using co-creative methods. Results: According to our thematic analysis, findings of the qualitative study demonstrated that a rigorous organizational approach is required to maintain a constructive exchange of information and to keep the design process alive for both content and technical experts. In addition, rapid prototype and display of co-created features can empower their contributions and help them design more efficiently. Discussion: Co-creative content production can benefit from adaption of existing frameworks and lightweight authoring environments that can facilitate generalized XR content development use cases.

The impact of virtual reality on student engagement in the classroom-a critical review of the literature.

Objective: The purpose of this review is to identify the impact of virtual reality (VR) technology on student engagement, specifically cognitive engagement, behavioral engagement, and affective engagement. Methods: A comprehensive search of databases such as Google, Scopus, and Elsevier was conducted to identify English-language articles related to VR and classroom engagement for the period from 2014 to 2023. After systematic screening, 33 articles were finally reviewed. Results: The use of VR in the classroom is expected to improve student engagement and learning outcomes, and is particularly effective for students with learning disabilities. However, introducing VR into middle school education poses several challenges, including difficulties in the education system to keep up with VR developments, increased demands on students' digital literacy, and insufficient proficiency of teachers in using VR. Conclusion: To effectively utilize VR to increase student engagement, we advocate for educational policymakers to provide training and technical support to teachers to ensure that they can fully master and integrate VR to increase student engagement and instructional effectiveness.

Evaluating tactile feedback in addition to kinesthetic feedback for haptic shape rendering: a pilot study.

In current virtual reality settings for motor skill training, only visual information is usually provided regarding the virtual objects the trainee interacts with. However, information gathered through cutaneous (tactile feedback) and muscle mechanoreceptors (kinesthetic feedback) regarding, e.g., object shape, is crucial to successfully interact with those objects. To provide this essential information, previous haptic interfaces have targeted to render either tactile or kinesthetic feedback while the effectiveness of multimodal tactile and kinesthetic feedback on the perception of the characteristics of virtual objects still remains largely unexplored. Here, we present the results from an experiment we conducted with sixteen participants to evaluate the effectiveness of multimodal tactile and kinesthetic feedback on shape perception. Using a within-subject design, participants were asked to reproduce virtual shapes after exploring them without visual feedback and with either congruent tactile and kinesthetic feedback or with only kinesthetic feedback. Tactile feedback was provided with a cable-driven platform mounted on the fingertip, while kinesthetic feedback was provided using a haptic glove. To measure the participants' ability to perceive and reproduce the rendered shapes, we measured the time participants spent exploring and reproducing the shapes and the error between the rendered and reproduced shapes after exploration. Furthermore, we assessed the participants' workload and motivation using well-established questionnaires. We found that concurrent tactile and kinesthetic feedback during shape exploration resulted in lower reproduction errors and longer reproduction times. The longer reproduction times for the combined condition may indicate that participants could learn the shapes better and, thus, were more careful when reproducing them. We did not find differences between conditions in the time spent exploring the shapes or the participants' workload and motivation. The lack of differences in workload between conditions could be attributed to the reported minimal-to-intermediate workload levels, suggesting that there was little room to further reduce the workload. Our work highlights the potential advantages of multimodal congruent tactile and kinesthetic feedback when interacting with tangible virtual objects with applications in virtual simulators for hands-on training applications.

A comparative study of stereo-dependent SSVEP targets and their impact on VR-BCI performance.

Steady-state visual evoked potential brain-computer interfaces (SSVEP-BCI) have attracted significant attention due to their ease of deployment and high performance in terms of information transfer rate (ITR) and accuracy, making them a promising candidate for integration with consumer electronics devices. However, as SSVEP characteristics are directly associated with visual stimulus attributes, the influence of stereoscopic vision on SSVEP as a critical visual attribute has yet to be fully explored. Meanwhile, the promising combination of virtual reality (VR) devices and BCI applications is hampered by the significant disparity between VR environments and traditional 2D displays. This is not only due to the fact that screen-based SSVEP generally operates under static, stable conditions with simple and unvaried visual stimuli but also because conventional luminance-modulated stimuli can quickly induce visual fatigue. This study attempts to address these research gaps by designing SSVEP paradigms with stereo-related attributes and conducting a comparative analysis with the traditional 2D planar paradigm under the same VR environment. This study proposed two new paradigms: the 3D paradigm and the 3D-Blink paradigm. The 3D paradigm induces SSVEP by modulating the luminance of spherical targets, while the 3D-Blink paradigm employs modulation of the spheres' opacity instead. The results of offline 4-object selection experiments showed that the accuracy of 3D and 2D paradigm was 85.67 and 86.17% with canonical correlation analysis (CCA) and 86.17 and 91.73% with filter bank canonical correlation analysis (FBCCA), which is consistent with the reduction in the signal-to-noise ratio (SNR) of SSVEP harmonics for the 3D paradigm observed in the frequency-domain analysis. The 3D-Blink paradigm achieved 75.00% of detection accuracy and 27.02 bits/min of ITR with 0.8 seconds of stimulus time and task-related component analysis (TRCA) algorithm, demonstrating its effectiveness. These findings demonstrate that the 3D and 3D-Blink paradigms supported by VR can achieve improved user comfort and satisfactory performance, while further algorithmic optimization and feature analysis are required for the stereo-related paradigms. In conclusion, this study contributes to a deeper understanding of the impact of binocular stereoscopic vision mechanisms on SSVEP paradigms and promotes the application of SSVEP-BCI in diverse VR environments.

Extended reality in cranial and spinal neurosurgery - a bibliometric analysis.

PURPOSE: This bibliometric analysis of the top 100 cited articles on extended reality (XR) in neurosurgery aimed to reveal trends in this research field. Gender differences in authorship and global distribution of the most-cited articles were also addressed. METHODS: A Web of Science electronic database search was conducted. The top 100 most-cited articles related to the scope of this review were retrieved and analyzed for trends in publications, journal characteristics, authorship, global distribution, study design, and focus areas. After a brief description of the top 100 publications, a comparative analysis between spinal and cranial publications was performed. RESULTS: From 2005, there was a significant increase in spinal neurosurgery publications with a focus on pedicle screw placement. Most articles were original research studies, with an emphasis on augmented reality (AR). In cranial neurosurgery, there was no notable increase in publications. There was an increase in studies assessing both AR and virtual reality (VR) research, with a notable emphasis on VR compared to AR. Education, surgical skills assessment, and surgical planning were more common themes in cranial studies compared to spinal studies. Female authorship was notably low in both groups, with no significant increase over time. The USA and Canada contributed most of the publications in the research field. CONCLUSIONS: Research regarding the use of XR in neurosurgery increased significantly from 2005. Cranial research focused on VR and resident education while spinal research focused on AR and neuronavigation. Female authorship was underrepresented. North America provides most of the high-impact research in this area.

[Recent advances in the virtual reality technology for treating children with autism spectrum disorder]. / è™šæ‹ŸçŽ°å®žæŠ€æœ¯åœ¨å­¤ç‹¬ç—‡è°±ç³»éšœç¢å„¿ç«¥å¹²é¢„ä¸­çš„ç ”ç©¶è¿›å±•.

Autism spectrum disorder (ASD) is one of the neurodevelopmental disorders in children, and there are currently no specific treatments, with the main interventions focusing on educational training and behavioral correction. Virtual reality, as an emerging technology, is a computer-based environmental simulation system that achieves interactive dynamics and immersive experiences by integrating information from multiple sources. In recent years, it has been gradually applied in intervention training for children with ASD. This paper reviews the recent studies on the effects of virtual reality intervention on emotional cognition, social skills, daily living skills, motor skills, and specific phobias in children with ASD, offering a new direction for ASD intervention training.

Clustering user preferences for personalized teleoperation control schemes via trajectory similarity analysis.

Successful operation of a teleoperated robot depends on a well-designed control scheme to translate human motion into robot motion; however, a single control scheme may not be suitable for all users. On the other hand, individual personalization of control schemes may be infeasible for designers to produce. In this paper, we present a method by which users may be classified into groups with mutually compatible control scheme preferences. Users are asked to demonstrate freehand motions to control a simulated robot in a virtual reality environment. Hand pose data is captured and compared with other users using SLAM trajectory similarity analysis techniques. The resulting pairwise trajectory error metrics are used to cluster participants based on their control motions, without foreknowledge of the number or types of control scheme preferences that may exist. The clusters identified for two different robots shows that a small number of clusters form stably for each case, each with its own control scheme paradigm. Survey data from participants validates that the clusters identified through this method correspond to the participants' control scheme rationales, and also identify nuances in participant control scheme descriptions that may not be obvious to designers relying only on participant explanations of their preferences.

Virtual reality interventions designed to support parents during and throughout the first year after birth: A scoping review.

Objective: Virtual reality (VR) has become increasingly popular in clinical and health settings where it has been used for a wide range of purposes. A recent scoping review explored VR applications to assist pregnant women and found that VR was a useful method to be used for a range of different purposes in both pregnancy and labour. However, no such review exists for the period after birth. Method: We aimed to search for studies that used VR to support parents during birth and in the first year postpartum (Population) in different settings (Context), and finally provided data on the characteristics, reported effectiveness and experience of VR interventions (Concept). Two hundred and fifty-one studies were identified, of which ten were eligible. Two authors independently extracted data including study design, participants and results. Results: Findings indicate that VR has been used effectively in this context to alleviate depression anxiety, and multiple domains of pain and to improve childbirth satisfaction. The majority of the studies explored the use of VR technology on outcomes such as pain and anxiety during labour and birth. The studies included used a broad range of VR hardware and software. All of the studies reported positive experiences of using VR. Conclusions: Across these studies, VR was found to be effective in terms of both physiological and psychological outcomes. There are many unexplored maternal and infant focused applications of VR which warrant further investigation as emerging evidence indicates this is becoming an increasingly accessible method to improve maternal and infant health outcomes from pregnancy through to parenthood.

Effects of active exergames on physical performance in older people: an overview of systematic reviews and meta-analysis.

This overview assessed the available body of published peer-reviewed systematic reviews and meta-analyses related to the effects of active exergames compared with active/passive control on physical performance outcomes in older people. The methodological quality and certainty of evidence were assessed using PRISMA, AMSTAR 2, and GRADE. The protocol was registered in PROSPERO (code: CRD42023391694). The main outcomes indicate that 4,477 records, five systematic reviews, and 10 meta-analyses were included. The AMSTAR-2 reported six meta-analyses with high methodological quality, four moderate quality, two systematic reviews with low quality, and three very-low quality. Meta-analysis was performed on balance using the Berg Balance Scale (BBS) and Timed Up-and-Go (TUG) tests, on cardiorespiratory fitness using the 6-min walk test, and on upper and lower limbs muscle strength using the handgrip strength, knee extension, and 30-s chair stand tests. Significant differences in favor of the active exergames groups concerning active/passive groups were reported in BBS (SMD = 0.85; 95% CI = 0.12-1.58; I2 = 96%; p = 0.02), TUG (SMD = 1.44; 95% CI = 0.71-2.16; I2 = 97%; p < 0.0001), and 30-s chair stand test (SMD = 0.79; 95% CI = 0.33-1.25; I2 = 88%; p = 0.0008). However, no significant differences were reported in favor of the active exergames groups in 6-min walk (SMD = 0.93; 95% CI = -0.64 to 2.50; I2 = 95%; p = 0.24), handgrip strength (SMD = 0.67; 95% CI = -0.04 to 1.38; I2 = 84%; p = 0.06), and knee extension tests (SMD = 0.20; 95% CI = -0.05 to 0.44; I2 = 95%; p = 0.12) compared to active/passive control. However, it was impossible to perform a meta-analysis for the variables of walking speed as a fall risk due to the diversity of instruments and the small number of systematic reviews with meta-analysis. In conclusion, interventions utilizing active exergames have shown significant improvements in the static and dynamic balance and lower limb muscle strength of apparently healthy older people, compared to control groups of active/inactive participants, as measured by BBS, TUG, and 30-s chair stand tests. However, no significant differences were found in the 6-min walk, HGS, and knee extension tests. Systematic review registration: PROSPERO, CRD42023391694.

Effects of Virtual Reality Therapy Combined With Conventional Rehabilitation on Pain, Kinematic Function, and Disability in Patients With Chronic Neck Pain: Randomized Controlled Trial.

BACKGROUND: Neck pain is a common condition that leads to neck motor dysfunction and subsequent disability, with a significant global health care burden. As a newly emerging tool, virtual reality (VR) technology has been employed to address pain and reduce disability among patients with neck pain. However, there is still a lack of high-quality studies evaluating the efficacy of VR therapy combined with conventional rehabilitation for patients with chronic neck pain, particularly in terms of kinematic function. OBJECTIVE: This study aims to investigate the effect of VR therapy combined with conventional rehabilitation on pain, kinematic function, and disability in patients with chronic neck pain. METHODS: We conducted an assessor-blinded, allocation-concealed randomized controlled trial. Sixty-four participants experiencing chronic neck pain were randomly allocated into the experimental group that underwent VR rehabilitation plus conventional rehabilitation or the control group receiving the same amount of conventional rehabilitation alone for 10 sessions over 4 weeks. Pain intensity, disability, kinematic function (cervical range of motion, proprioception, and mean and peak velocity), degree of satisfaction, and relief of symptoms were evaluated at 3 timepoints (baseline, postintervention, and at 3 months follow-up). A 2*3 mixed repeated measures analysis of variance was utilized for analyzing the difference across indicators, with a significant difference level of .05. RESULTS: Both groups demonstrated significant improvements in pain, disability, and kinematic functions (P<.05) at postintervention and at 3-month follow-up. The experimental group showed superior therapeutic outcomes compared to the control group in pain reduction (mean difference from the baseline: 5.50 vs 1.81 at posttreatment; 5.21 vs 1.91 at the 3-month follow-up, respectively; P<.001), disability improvement (mean difference from baseline: 3.04 vs 0.50 at posttreatment; 3.20 vs 0.85 at the 3-month follow-up, respectively; P<.001), and enhanced kinematic functions (P<.05). Moreover, participants in the experimental group reported better satisfaction and relief of symptoms than the control group (P<.05), with better initiative for exercising during the follow-up period. However, there was no between-group difference of improvement in proprioception. No adverse events were reported or observed in our research. CONCLUSIONS: The findings of our study support the efficacy of combining VR therapy with conventional rehabilitation in alleviating pain, enhancing kinematic function, and reducing disability of patients with chronic neck pain. Future research should focus on refining the therapeutic protocols and dosages for VR therapy as well as on optimizing its application in clinical settings for improved convenience and effectiveness. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000040132; http://www.chictr.org.cn/showproj.aspx?proj=64346.

Taking consciousness for real: Increasing the ecological validity of the study of conscious vs. unconscious processes.

The study of consciousness has developed well-controlled, rigorous methods for manipulating and measuring consciousness. Yet, in the process, experimental paradigms grew farther away from everyday conscious and unconscious processes, which raises the concern of ecological validity. In this review, we suggest that the field can benefit from adopting a more ecological approach, akin to other fields of cognitive science. There, this approach challenged some existing hypotheses, yielded stronger effects, and enabled new research questions. We argue that such a move is critical for studying consciousness, where experimental paradigms tend to be artificial and small effect sizes are relatively prevalent. We identify three paths for doing so-changing the stimuli and experimental settings, changing the measures, and changing the research questions themselves-and review works that have already started implementing such approaches. While acknowledging the inherent challenges, we call for increasing ecological validity in consciousness studies.

Development and feasibility assessment of a virtual reality-based aerobic exercise program with real-time pulse rate monitoring on hemodynamic and arterial stiffness in healthy people: a pilot study.

Introduction: Virtual reality (VR) exercises are reportedly beneficial as a physical activity tool for health promotion and rehabilitation, and can also help individuals exercise under professional supervision. We developed and investigated the potential feasibility of a VR-based aerobic exercise program using the XBOX ONE console and Kinect sensor with real-time pulse rate monitoring. The VR setting consisted of two-dimensional (2D) environments via computer, laptop, or television screens. In addition, the study investigated the potential feasibility of the VR-based exercise program on hemodynamic response and arterial stiffness in healthy participants of various ages. Methods: Healthy participants (n = 30) aged > 18 years were enrolled in the VR exercise-based program. All participants were required to wear a polar heart rate (HR) monitor set for moderate-intensity exercise, targeting 40%-59% of their HR reserve. Hemodynamic and arterial stiffness (pulse wave velocity) were noninvasively measured. The Borg scale rate of perceived exertion (RPE) was also assessed. Results: Following a VR-guided exercise routine, all participants performed moderate-intensity exercise with no adverse health outcomes during or after the exercise. The effects of VR-based aerobic exercise extended beyond enhanced central hemodynamic and arterial stiffness. However, neither hemodynamic nor arterial stiffness showed significant differences before and after the VR exercise, except for a higher RPE response following the exercise program. Conclusion: VR-based aerobic exercise with pulse rate monitoring is a promising physical activity tool to induce physiological changes and impact dyspnea scales and is also feasible for administration to healthy populations.

Anodal Electrical Taste Stimulation to the Chin Enhances the Salt Taste Perception in Subarachnoid Hemorrhage Patients.

Aneurysmal subarachnoid hemorrhage (SAH) is a critical condition associated with high mortality rates. Hypertension is a significant risk factor for SAH development and recurrence following coil embolization for a ruptured aneurysm. While reduction of salt consumption is crucial for managing hypertension, it often compromises food taste. Anodal electrical taste stimulation (ETS) has been proposed to enhance taste perception without altering salt content. We present the case of a 69-year-old female SAH patient with a ruptured aneurysm at the anterior communicating artery who underwent coil embolization and in whom we tested ETS's efficacy in enhancing the salt taste perception on day 42 after the procedure. ETS effectively enhanced the salt taste perception threshold and perceived concentration; the threshold for salt taste without electrical stimulation was 0.8% of salt-impregnated filter paper, whereas that with electrical stimulation was 0.6%. The perception of salt taste was enhanced: 0.8% and 1.0% of filter papers were perceived as 0.6% and 0.8% without electrical stimulation and 1.0% and 1.2% with electrical stimulation, respectively. This is the first report describing the salt perception-enhancing effect of ETS in an actual patient. Further studies involving actual patients are required to determine how ETS affects habitual salt intake and blood pressure trends.

Efficacy of Amblyopia Treatments in Children Up to Seven Years Old: A Systematic Review.

Amblyopia is a neurodevelopmental disorder of the visual system that impairs the vision of millions of children worldwide. Amblyopia is best treated within the sensitive period of visual development when a child is up to seven years of age. Currently, the gold standard for early treatment of childhood amblyopia is patching, with new treatments emerging in recent years. We aim to evaluate the effectiveness of these newly developed treatments for amblyopia in children aged seven years and younger while comparing them to the current industry standard of patching. We searched online databases including PubMed, Google Scholar, and Cochrane Library for randomized controlled trials (RCTs), systematic reviews, meta-analyses, and narrative reviews relating to amblyopia treatment in children aged seven and younger. We only included articles and studies completed within the last five years and those written in the English language. After compiling a list of 297 articles, we removed duplicates, articles without an available full text, and those not relevant to our topic. Of the remaining 51 articles, we were left with 22 after reading abstracts and removing further irrelevant articles. We did a quality assessment on the remaining 22 articles and were left with 14 articles for our systematic review after removing eight low-quality articles. Of the 14 articles, we had eight RCTs, two systematic reviews, one comparative interventional study, and three narrative reviews. Seven of the articles contained data reinforcing the effectiveness of patching while comparing it to other treatment modalities. Three of the articles had data supporting spectacle correction, including a novel form called alternative flicker glass which delivers occlusion therapy via a spectacle frame with unique lenses, and ultimately deemed it at least as effective or more than patching. Data from three articles supported the use of surgery to successfully correct the angle of strabismus. Findings from five articles backed the use of pharmacologic therapy, specifically atropine when used alongside patching as a more effective alternative to patching solely. However, levodopa plus patching had no advantage over patching alone. Additionally, seven articles addressed the use of virtual reality (VR) and dichoptic therapy as prospective treatments for childhood amblyopia. VR therapy proved beneficial when used within one week after strabismus surgery. Dichoptic training was also effective in improving amblyopic-eye visual acuity when used on its own or in conjunction with spectacles. Furthermore, dichoptic movie therapy was found to be more effective than patching. Thus, we found multiple highly effective treatments for childhood amblyopia that are as effective or more than patching. Future studies should consider prescribing these treatments to larger cohorts while also performing a cost-benefit analysis for each treatment. In addition, more needs to be learned about the potential adverse side effects of these treatments, especially for pharmaceutical therapy.

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.

Virtual reality-based cognitive-behavioural therapy for the treatment of anxiety in patients with acute myocardial infarction: a randomised clinical trial.

Background: The presence of mental health conditions is pervasive in patients who experienced acute myocardial infarction (AMI), significantly disrupting their recovery. Providing timely and easily accessible psychological interventions using virtual reality-based cognitive-behavioural therapy (VR-CBT) could potentially improve both acute and long-term symptoms affecting their mental health. Aims: We aim to examine the effectiveness of VR-CBT on anxiety symptoms in patients with AMI who were admitted to the intensive care unit (ICU) during the acute stage of their illness. Methods: In this single-blind randomised clinical trial, participants with anxiety symptoms who were admitted to the ICU due to AMI were continuously recruited from December 2022 to February 2023. Patients who were Han Chinese aged 18-75 years were randomly assigned (1:1) via block randomisation to either the VR-CBT group to receive VR-CBT in addition to standard mental health support, or the control group to receive standard mental health support only. VR-CBT consisted of four modules and was delivered at the bedside over a 1-week period. Assessments were done at baseline, immediately after treatment and at 3-month follow-up. The intention-to-treat analysis began in June 2023. The primary outcome measure was the changes in anxiety symptoms as assessed by the Hamilton Anxiety Rating Scale (HAM-A). Results: Among 148 randomised participants, 70 were assigned to the VR-CBT group and 78 to the control group. The 1-week VR-CBT intervention plus standard mental health support significantly reduced the anxiety symptoms compared with standard mental health support alone in terms of HAM-A scores at both post intervention (Cohen's d=-1.27 (95% confidence interval (CI): -1.64 to -0.90, p<0.001) and 3-month follow-up (Cohen's d=-0.37 (95% CI: -0.72 to -0.01, p=0.024). Of the 70 participants who received VR-CBT, 62 (88.6%) completed the entire intervention. Cybersickness was the main reported adverse event (n=5). Conclusions: Our results indicate that VR-CBT can significantly reduce post-AMI anxiety at the acute stage of the illness; the improvement was maintained at the 3-month follow-up. Trial registration number: The trial was registered at www.chictr.org.cn with the identifier: ChiCTR2200066435.

Location-based electrotactile feedback localizes hitting point in virtual-reality table tennis game.

Learning new motor skills is often challenged by sensory mismatches. For reliable sensory information, people have actively employed sensory intervention methods. Visual assistance is the most popular method to provide sensory information, which is equivalent to the knowledge of performance (KP) in motor tasks. However, its efficacy is questionable because of visual-proprioceptive mismatch as well as heavy intrinsic visual and cognitive engagement in motor tasks. Electrotactile intervention is a promising technique to address the current limitations, as it provides KP using tactile feedback that has a close neurophysiological association with proprioception. To test its efficacy, we compared the effects of visual and electrotactile assistance on hitting point localization of the table-tennis racket during virtual-reality table-tennis game. Experimental results suggest that location-based electrotactile feedback outperforms visual assistance in localizing the hitting point on a table-tennis racket during virtual-reality table-tennis game. Our study showed the potential of electrotactile intervention for improving the efficacy of new motor skill training.

Visual Feedback and Guided Balance Training in an Immersive Virtual Reality Environment for Lower Extremity Rehabilitation.

Balance training is essential for physical rehabilitation procedures, as it can improve functional mobility and enhance cognitive coordination. However, conventional balance training methods may have limitations in terms of motivation, real-time objective feedback, and personalization, which a virtual reality (VR) setup may better provide. In this work, we present an immersive VR training environment for lower extremity balance rehabilitation with real-time guidance and feedback. The VR training environment immerses the user in a 3D ice rink model where a virtual coach (agent) leads them through a series of balance poses, and the user controls a trainee avatar with their own movements. We developed two coaching styles: positive-reinforcement and autonomous-supportive, and two viewpoints of the trainee avatar: first-person and third-person. The proposed environment was evaluated in a user study with healthy, non-clinical participants (n = 16, 24.4 ± 5.7 years old, 9 females). Our results show that participants showed stronger performance in the positive-reinforcement style compared to the autonomous-supportive style. Additionally, in the third-person viewpoint, the participants exhibited more stability in the positive-reinforcement style compared to the autonomous-supportive style. For viewpoint, participants exhibited stronger performance in the first-person viewpoint compared to third-person in the autonomous-supportive style, while they were comparable in the positive-reinforcement style. We observed no significant effects on the foot height and number of mistakes. Furthermore, we report the analysis of user performance with balance training poses and subjective measures based on questionnaires to assess the user experience, usability, and task load. The proposed VR balance training could offer an interactive, adaptive, and engaging environment and open new potential research directions for lower extremity rehabilitation.

The Dual Importance of Virtual Reality Usability in Rehabilitation: A Focus on Therapists and Patients.

Virtual reality (VR) has advanced in medical education and rehabilitation from basic graphical applications due to its ability to generate a virtual three-dimensional (3D) environment. This environment is mostly used to practice professional skills, plan surgery procedures, simulate surgeries, display 3D anatomy, and rehabilitate various disorders. VR has transformed the field of rehabilitation therapy by providing immersive and engaging experiences that go beyond traditional bounds, significantly improving patient care and therapeutic results. Considering the direct impact of VR on the efficacy of the treatment for both therapists and patients, its dual significance for usability and user experience cannot be overstated. The purpose of this article is to determine the synergistic association between VR accessibility and the rehabilitation process, highlighting the significance of VR technology in designing the future of rehabilitation therapy and demonstrating how advancing VR technology can improve therapeutic outcomes despite overcoming obstacles encountered during VR usage. In conclusion, VR offers a personalized, efficient, interesting, and engaging rehabilitative environment for patients, while also assisting therapists in cultivating empathy and efficiency and encouraging innovative approaches in treatment procedures.

Transformative Frontiers: A Comprehensive Review of Emerging Technologies in Modern Healthcare.

The rapid evolution of emerging technologies in healthcare is reshaping the field of medical practices and patient outcomes, ushering in an era of unprecedented innovation. This narrative review touches upon the transformative impacts of various technologies, including virtual reality (VR), augmented reality (AR), the internet of medical things (IoMT), remote patient monitoring (RPM), financial technology (fintech) integration, cloud migration, and the pivotal role of machine learning (ML). It emphasizes the collaborative impact of these technologies, which is reshaping the healthcare landscape. Virtual reality and AR revolutionize medical training, IoMT extends healthcare boundaries, RPM facilitates proactive care, and fintech integration enhances financial processes. Cloud migration ensures scalable and efficient data management, while ML harnesses algorithms for diagnostic precision and personalized treatment.