Exploration of Immersive Virtual Reality in Teaching Veterinary Orthopedics.

The COVID-19 pandemic has catalyzed the use of novel teaching modalities to enhance the provision of remote veterinary education. In this study, we describe the use of immersive virtual reality (iVR) as a teaching aid for veterinary medicine students during their orthopedics clinical rotation. Student sentiments were assessed using voluntary electronic surveys taken by veterinary students before and after the rotation. The most noteworthy benefits students reported were improved engagement with the course content, information retention, radiographic interpretation, and clinical reasoning skills. Obstacles encountered during the initial stages of the program included financial and temporal investment in equipment and content development, technical troubleshooting, and motion sickness. Though it is unlikely that iVR will ever fully replace hands-on learning experiences, it presents an educational opportunity to supplement traditional learning methods, motivate students, and fill information gaps. As iVR technology continues to evolve and improve, potential applications in the veterinary curriculum grow, making the modality's use progressively more advantageous. Although this study describes its application in an orthopedic setting, the versatility of the iVR modality lends the potential for it to be implemented in a number of clinical and didactic settings.

Facial Affect Recognition in Depression Using Human Avatars

This research assesses facial emotion recognition in depressed patients using a novel dynamic virtual face (DVF) collection. The participant sample comprised 54 stable depressed patients against 54 healthy controls. The experiment entailed a non-immersive virtual reality task of recognizing emotions with DVFs representing the six basic emotions. Depressed patients exhibited a deficit in facial affect recognition in comparison to healthy controls. The average recognition score for healthy controls was 88.19%, while the score was 75.17% for the depression group. Gender and educational level showed no influence on the recognition rates in depressed patients. As for age, the worst results were found in older patients as compared to other cohorts. The average recognition rate for the younger group was 84.18%, 78.63% for the middle-aged group, and 61.97% for the older group, with average reaction times of 4.00 s, 4.07 s, and 6.04 s, respectively.

The Restorative Effects of Virtual Reality Forests on Elderly Individuals During the COVID-19 Lockdown

This study focuses on the restorative effects of immersive virtual reality (VR) forest experiences on elderly people during the COVID-19 lockdown. A field experiment with 63 elderly participants was conducted in an elderly care institution in China. The results showed that a five-minute VR forest experience with three minutes of subsequent reliving can bring immediate psychological improvements (i.e., increased positive affect, decreased negative affect, and enhanced stress recovery) to elderly individuals. The negative affect decrease and stress recovery enhancement were more obvious among introverted individuals. Furthermore, participating in three VR forest experiences over 3 consecutive days can bring continuous psychological improvements. Moreover, short VR forest experiences were unable to significantly decrease the blood pressure of participants. The effects of three VR experiences over 3 days on blood pressure improvement were also nonsignificant. Additionally, VR forest experiences can increase elderly participants' intentions to undertake real forest therapy.

Fully Immersive Virtual Reality Using 360° Videos to Manage Well-Being in Older Adults: A Scoping Review.

OBJECTIVE: The development of negative behavioral and psychosocial factors (depression, anxiety, apathy, etc) is associated with poor well-being, which can contribute to health issues in ageing, especially in the context of COVID-19. Despite its relative novelty, fully immersive virtual reality (VR) interventions through 360° immersive videos are becoming more accessible and flexible and constitute an emerging method to potentially enhance well-being. The aim of this scoping review is to assess the effectiveness of 360° interventions on well-being in older adults with or without cognitive impairment, as well as cybersickness and attitudes toward this technology. DESIGN: Scoping review. SETTING AND PARTICIPANTS: Older adults with or without cognitive impairment. METHODS: The PRISMA-SR guideline was followed. Four databases were used, and we selected articles published until April 2022. We have analyzed the effect of 360° videos on the well-being of older adults with respect to the study design, the population, the contents, the duration of intervention, and the outcomes. RESULTS: A total of 2262 articles were screened, of which 10 articles were finally included in this review. Most of them are pilot studies and used mixed methods including scales and interviews. The material and content of VR are diversified. Many behavioral and psychological outcomes were assessed, including anxiety, apathy, loneliness, depression, social engagement, quality of life, and emotions. The results were positive or mixed, according to the outcomes. We recorded few adverse events, and the interviews show contrasting results concerning the participants' feelings (ie, degree of immersion, familiarity with technology, and VR content). CONCLUSIONS AND IMPLICATIONS: The use of VR 360° videos seems feasible in community-dwelling older adults or residential aged care facilities, as they are safe and provide enjoyment. It constitutes an emerging and promising therapeutic tool to manage psychosocial disorders. This review provides key considerations for the design and implementation of interventions using VR 360° video in clinical practice.

Non-Immersive Virtual Reality Umrah Simulation: A Functionality Test

Umrah is an Islamic pilgrimage that Muslims can perform at any time. Umrah will take place at the holy place, Mecca. Usually, before performing the umrah, the pilgrims will attend umrah courses to learn how to practice step-by-step procedures. However, the Covid-19 outbreak stopped the pilgrims from attending the live umrah course. This scenario causes difficulty for pilgrims to visualize the umrah practice. Therefore, we have developed a Non-Immersive Virtual Reality Umrah Simulation (NIVRUS) to help the pilgrimage visualize the umrah practice. This study has implemented a Waterfall Model as a development methodology in which phases are divided into sequential phases. Each phase must be completed before proceeding to the next phase. In this present study, the focus is on evaluating NIVRUS through a functionality test. The findings indicate that all the functions in NIVRUS properly function as expected. © 2022 IEEE.

Developing an Immersive Virtual Reality Training System to Enrich Social Interaction and Communication Skills for Children With Autism Spectrum Disorder

Virtual Reality systems take an important place in training and rehabilitation of children with psychological problems. This paper proposes developing an Immersive Virtual Reality Training System in Unity software to enrich social interaction and communication skills for children with Autism Spectrum Disorder. Individuals with ASD have trouble with social interaction, adaptation to new surroundings and communication. In this system the behavior of the virtual trainer changes depending on the mood and actions of the patients. The face and speech recognition uses an integration of Artificial Intelligent algorithms with Virtual Reality in Unity software which is implemented in C# programming language. Virtual characters and objects of the training system are designed in Autodesk Maya software. Integration with Virtual Reality carried out using wireless VR headset Oculus Quest2. Earlier research works found that applications with virtual reality have the potential to provide useful clinical treatments for people with autism. The proposed VR Training system will be an innovative solution for the rehabilitation of children with Autism Spectrum Disorder. This system is offered to users with a high degree of interactivity and practicing various social situations in a safe and controlled environment. With the start of the COVID-19 pandemic, the integration of virtual reality training systems has become extremely important. The use of such high-tech solutions allows patients who need the treatment to receive therapy without leaving home. This development of the Immersive Virtual Reality Training System is the first experience of treating children with autism in Kazakhstan. © 2022 IEEE.

Design elements in immersive virtual reality: the impact of object presence on health-related outcomes

Purpose>Immersive virtual reality (IVR) has been frequently proposed as a promising tool for learning. However, researchers have commonly implemented a plethora of design elements in these IVR systems, which makes the specific aspects of the system that are necessary to achieve beneficial outcomes unclear. Against this background, this study aims to combine the literature on presence with learning theories to propose that the ability of IVR to present 3D objects to users improves the presence of these objects in the virtual environment compared with 2D objects, leading to increased learning performance.Design/methodology/approach>To test this study's hypotheses, the authors conducted a 2 (training condition: approach vs avoid) x 2 (object presence: high vs low) between-subjects laboratory experiment that used IVR with 83 female participants.Findings>The results support this study's hypotheses and show that training with high object presence leads to greater reactions to cues (chocolate cravings) and improved health behaviour (chocolate consumption).Originality/value>This study shows that increased object presence leads to unique experiences for users, which help reinforce training effects. Moreover, this work sheds further light on how immersive computer technologies can affect user attitudes and behaviour. Specifically, this work contributes to IVR research by showing that learning effects can be enhanced through an increased degree of object presence.

An immersive virtual reality-based application for treating ADHD: A remote evaluation of acceptance and usability.

Introduction: Virtual reality (VR) is a digital technology currently considered to implement rehabilitation programs for children with ADHD, a disorder characterised by inattention, overactivity and impulsiveness. This study presents the results of the acceptance and usability of a VR application developed for children with ADHD aiming to provide an environment capable of supporting the development of the different attentional components. Due to COVID-19 restrictions, this study had the secondary aim of assessing whether a remote evaluation was feasible and meaningful. Methods: A sample of 20 clinical experts (neuro and psychomotor therapists of the developmental age) was involved in assessing the proposed environment. Two different tools have been applied: the Technology Acceptance Model (TAM-3) questionnaire and a semi-structured interview were self-administered. Six sessions were planned in total, and each one lasted 30 min. Results: With respect to the acceptance of the system, the mean of the answers given is for most of the constructs greater than 4, showing agreement among experts. Cronbach alpha and correlations of subscales seem to confirm the reliability of measures. According to results from the interviews, the developed application has shown versatility in being able to be applied to the heterogeneity of the disorder and it was also possible to obtain valuable insights on possible additional features and functionalities. Regarding the secondary aim, the collected outcomes were positive: all the participants were satisfied with what they could perceive about the application. Conclusions: The results of this work pave the way for a future validation study with children due to the active participation of clinicians and their unanimous positive judgement confirming that the application was considered user-friendly and well accepted.

Physical Therapist Impressions of Telehealth and Virtual Reality Needs Amidst a Pandemic

Most physical therapists would agree that physical rehabilitation is difficult to perform remotely. Consequently, the global COVID-19 pandemic has forced many physical therapists and their clients to adapt to telehealth, especially with video conferencing. In this article, we ask: How has telehealth for physical rehabilitation evolved with the global pandemic and what are the largest technological needs, treatment methodologies, and patient barriers? With the increased widespread use of telehealth for physical therapy, we present a qualitative study towards examining the shortcomings of current physical therapy mediums and how to steer future virtual reality technologies to promote remote patient evaluation and rehabilitation. We interviewed 130 physical rehabilitation professionals across the United States through video conferencing during the COVID19 pandemic from July—August 2020. Interviews lasted 30–45 min using a semi-structured template developed from an initial pilot of 20 interviews to examine potential barriers, facilitators, and technological needs. Our findings suggest that physical therapists utilizing existing telehealth solutions have lost their ability to feel their patients’ injuries, easily assess range of motion and strength, and freely move about to examine their movements when using telehealth. This makes it difficult to fully evaluate a patient and many feel that they are more of a “life coach” giving advice to a patient rather than a traditional in-person rehabilitation session. The most common solutions that emerged during the interviews include: immersive technologies which allow physical therapists and clients 1) to remotely walk around each other in 3D, 2) enable evidence-based measures, 3) automate documentation, and 4) provider clinical practice operation through the cloud. We conclude with a discussion on opportunities for immersive virtual reality towards telehealth for physical rehabilitation. Copyright © 2022 Elor, Conde, Powell, Robbins, Chen and Kurniawan.

Towards a Social VR-based Exergame for Elderly Users: An Exploratory Study of Acceptance, Experiences and Design Principles

For many elderly individuals, the aging experience is associated with a lack of social interaction and physical exercise that may negatively affect their health. To address these issues, researchers have designed experiences based on immersive virtual reality (VR) and 2D screen-based exergames. However, very few have studied the use of social VR for elderly, in which users can interact remotely through avatars in a single, shared, immersive virtual environment, using a head-mounted display. Additionally, there is limited research on the experience of elderly in performing interactive activities, especially game-based activities, in social VR. We conducted an exploratory study with 10 elderly people who never experienced VR before, to evaluate an avatar-mediated interaction-based social VR game prototype. Based on a mixed-methods approach, our study presents new insights into the usability, acceptance, and gameplay experience of elderly in a social VR game. Moreover, our study reflects upon design principles that should be considered when developing social VR games for elderly to ensure an engaging and safe user experience. Our results suggest that such games have a potential among the user group. Direct hand manipulation, based on hand tracking for interaction with 3D objects, presented an engaging and intuitive interaction paradigm, and the social game activity in VR was found to be enjoyable. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Place-based education through immersive virtual experiences — preparing biology students for the field

Virtual field trips are transforming education in biology and other place-based disciplines – and not just since Covid-19 has imposed social distancing constraints. Efficient methods for content creation, combined with affordable immersive technology, provide the opportunity to integrate immersive experiences into ever-larger classes. However, many aspects of how immersive experiences can enrich and improve learning in place-based education are still not well understood. We present an empirical study, conducted in a large undergraduate ecology class, comparing students, that experienced an immersive virtual version of a field trip to a biological preserve as preparation for a later actual field trip to the site, with a control group that visited the real site but without having had the virtual experience. Within the virtual experience group, we also varied the quality of the headset. The VR field trip was well received for raising spatial awareness and also motivation and interest. Students ranked it higher than any traditional means with regard to achieving a high level of preparedness for the actual field trip. In contrast, no statistically significant evidence was found for differences in perceived learning outcome and enjoyment of the actual field trip. [ FROM AUTHOR] Copyright of Journal of Biological Education (Routledge) is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Conventional Cervical Exercises Compared with a Mixed-Reality-Based Game in Asymptomatic Subjects: An Exploratory Crossover Pilot Study

Mixed reality presents itself as a potential technological tool for the management of people with musculoskeletal disorders, without having as many adverse side effects as immersive virtual reality. The objective of this study was to explore the possibilities of a mixed-reality game, performing task-oriented cervical exercises compared to conventional therapeutic exercises in sensorimotor outcome measures in asymptomatic subjects. A randomized crossover pilot study was performed with two intervention groups: a mixed-reality group (MRG) and a conventional exercise group (CEG). The cervical joint position error test (CJPET) and deep cervical flexor endurance test (DCFET) were measured as sensorimotor outcomes. Statistically significant differences were found in the pre–post comparison in the DCFET for both groups (MRG: t = −3.87, p < 0.01;CEG: t = −4.01, p < 0.01) and in the extension of the CJPET for the MRG (t = 3.50, p < 0.01). The rest of the measurements showed no significant differences comparing both groups pre- and postintervention (p > 0.05). Mixed reality has apparently the same positive effects as conventional exercises in sensorimotor outcomes in asymptomatic subjects. These results could help in future studies with mixed virtual reality in the management of people with musculoskeletal disorders.

Motivating Ethnic Minority Students in Hong Kong to Learn Chinese Culture with EduVenture VR

This paper presents our initiative for leveraging SV-IVR (spherical video-based immersive virtual reality) to give Hong Kong ethnic minority students exposure to local Chinese culture via EduVenture VR-an interactive learner-immersed virtual interactive learning application. The work was conducted in the COVID-19 pandemic context;outdoor fieldwork-based learning was not recommended in the circumstance. The research participants were 63 ethnic minority students (from Grade 7 to Grade 9) from a Hong Kong secondary school. The ARCS model of instructional motivation was employed to evaluate the motivational effectiveness of the Chinese culture learning activity supported by EduVenture VR. In the study, we obtained positive results in terms of the 4 motivational dimensions: "Attention," "Relevance," "Confidence' and "Satisfaction."

Predictive Shoulder Kinematics of Rehabilitation Exercises through Immersive Virtual Reality

Objective: The adoption of telehealth rapidly accelerated due to the global COVID19 pandemic disrupting communities and in-person healthcare practices. While telehealth had initial benefits in enhancing accessibility for remote treatment, physical rehabilitation has been heavily limited due to the loss of hands-on evaluation tools. This paper presents an immersive virtual reality (iVR) pipeline for replicating physical therapy success metrics through applied machine learning of patient observation. Methods: We demonstrate a method of training gradient boosted decision-trees for kinematic estimation to replicate mobility and strength metrics with an off-the-shelf iVR system. During a two-month study, training data was collected while a group of users completed physical rehabilitation exercises in an iVR game. Utilizing this data, we trained on iVR based motion capture data and OpenSim biomechanical simulations. Results: Our final model indicates that upper-extremity kinematics from OpenSim can be accurately predicted using the HTC Vive head-mounted display system with a Mean Absolute Error less than 0.78 degrees for joint angles and less than 2.34 Nm for joint torques. Additionally, these predictions are viable for run-time estimation, with approximately a 0.74 ms rate of prediction during exercise sessions. Conclusion: These findings suggest that iVR paired with machine learning can serve as an effective medium for collecting evidence-based patient success metrics in telehealth. Significance: Our approach can help increase the accessibility of physical rehabilitation with off-the-shelf iVR head-mounted display systems by providing therapists with metrics needed for remote evaluation. Author

When Will Immersive Virtual Reality Have Its Day? Challenges to IVR Adoption in the Home as Exposed in Studies with Teenagers, Parents, and Experts

In response to the pandemic, many countries have had multiple lockdowns punctuated by par tial freedoms limiting physically being together. In 2020–2021, during the COVID-19 pandemic, parents were stressed and exhausted by the challenges of work, home schooling, and barriers to typical childcare arrangements. Children were missing one another, their social lives, and the variety of experiences that the world beyond the home brings. Immersive Vir tual Reality (IVR) offers tried and tested ways to enable children to maintain beyond-household family activities and dynamics. However, it is not viewed as a solution. Instead, as demonstrated through a multiple method study involving a Rapid Evidence Assessment, workshops with 91 teenagers, interviews with 15 exper ts, a Delphi study with 21 exper ts, 402 parent questionnaires pre-pandemic, 232 parent questionnaires during the pandemic, and longitudinal interviews with 13 parents during the first UK lockdown in 2020, IVR is not viewed as having value in the home beyond gaming. Results highlight limited consideration of IVR as a way to enhance family life or the home, with a lack of evidence and direction from current research, innovation, and policy. The ar ticle empirically demonstrates that exper ts, teenagers, and parents have limited expectations for VR. Fur ther, with parental resistance to adoption and a lack of ideas or innovations in how IVR could be used, the likelihood of VR-headset adoption remains low as does its potential as a means of educating, enter taining, and socially engaging children and teenagers. © 2021 by the Massachusetts Institute of Technology.

Enabling Immersive Exercise Activities for Older Adults: A Comparison of Virtual Reality Exergames and Traditional Video Exercises

Participating in cognitive and physical activities can help older adults to live a healthy and independent life. However, with the ongoing pandemic, face-to-face training options became unavailable or limited, yielding a need for alternatives. In this paper, we conducted a user study with older adults (N = 25) to compare a traditional, recorded 2D gymnastics video with an immersive virtual reality (VR) exergame. We evaluated the movement and heart rate of the participants, as well as their enjoyment, attention to the task, and perceived workload. In the VR condition, we additionally assessed their feeling of cybersickness. Finally, qualitative feedback about their preferences was collected. The results indicate that our immersive VR exergame can be a suitable alternative, but not a replacement for traditional 2D video-based exercise activities. Furthermore, the cognitive aspect of exergames can lead to the feeling of physical workload, even if easy movements are performed. Finally, we discuss the implications of our results for future VR exergames and point out advantages and disadvantages of the systems.

Immersive Virtual Reality to Improve Outcomes in Veterans With Stroke: Protocol for a Single-Arm Pilot Study.

BACKGROUND: Over the last decade, virtual reality (VR) has emerged as a cutting-edge technology in stroke rehabilitation. VR is defined as a type of computer-user interface that implements real-time simulation of an activity or environment allowing user interaction via multiple sensory modalities. In a stroke population, VR interventions have been shown to enhance motor, cognitive, and psychological recovery when utilized as a rehabilitation adjunct. VR has also demonstrated noninferiority to usual care therapies for stroke rehabilitation. OBJECTIVE: The proposed pilot study aims to (1) determine the feasibility and tolerability of using a therapeutic VR platform in an inpatient comprehensive stroke rehabilitation program and (2) estimate the initial clinical efficacy (effect size) associated with the VR platform using apps for pain distraction and upper extremity exercise for poststroke neurologic recovery. METHODS: This study will be conducted in the Comprehensive Integrated Inpatient Rehabilitation Program at the James A Haley Veterans' Hospital. Qualitative interviews will be conducted with 10 clinical staff members to assess the feasibility of the VR platform from the clinician perspective. A prospective within-subject pretest-posttest pilot design will be used to examine the tolerability of the VR platform and the clinical outcomes (ie, upper extremity neurologic recovery, hand dexterity, pain severity) in 10 veteran inpatients. A VR platform consisting of commercially available pain distraction and upper extremity apps will be available at the participants' bedside for daily use during their inpatient stay (approximately 4-6 weeks). Clinician interviews will be analyzed using qualitative descriptive analysis. Cohen d effect sizes with corresponding 95% CIs will be calculated for upper extremity neurologic recovery, hand dexterity, and pain. The proportion of participants who achieve minimal clinically important difference after using the VR platform will be calculated for each clinical outcome. RESULTS: This study was selected for funding in August 2020. Institutional review board approval was received in October 2020. The project start date was December 2020. The United States Department has issued a moratorium on in-person research activities secondary to COVID-19. Data collection will commence once this moratorium is lifted. CONCLUSIONS: Our next step is to conduct a large multi-site clinical trial that will incorporate the lessons learned from this pilot feasibility study to test the efficacy of a VR intervention in inpatient rehabilitation and transition to home environments. When VR is used in patients' rooms, it serves to provide additional therapy and may reduce clinician burden. VR also presents an opportunity similar to home-based practice exercises. VR can be implemented in both clinical settings and people's own homes, where engagement in ongoing self-management approaches is often most challenging. This unique experience offers the potential for seamless transition from inpatient rehabilitation to the home. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/26133.