Transforming experience: The potential of augmented reality and virtual reality for enhancing personal and clinical change

During life, many personal changes occur. These include changing house, school, work, and even friends and partners. However, the daily experience shows clearly that, in some situations, subjects are unable to change even if they want to. The recent advances in psychology and neuroscience are now providing a better view of personal change, the change affecting our assumptive world: (a) the focus of personal change is reducing the distance between self and reality (conflict); (b) this reduction is achieved through (1) an intense focus on the particular experience creating the conflict or (2) an internal or external reorganization of this experience; (c) personal change requires a progression through a series of different stages that however happen in discontinuous and non-linear ways; and (d) clinical psychology is often used to facilitate personal change when subjects are unable to move forward. Starting from these premises, the aim of this paper is to review the potential of virtuality for enhancing the processes of personal and clinical change. First, the paper focuses on the two leading virtual technologies - augmented reality (AR) and virtual reality (VR) - exploring their current uses in behavioral health and the outcomes of the 28 available systematic reviews and meta-analyses. Then the paper discusses the added value provided by VR and AR in transforming our external experience by focusing on the high level of personal efficacy and self-reflectiveness generated by their sense of presence and emotional engagement. Finally, it outlines the potential future use of virtuality for transforming our inner experience by structuring, altering, and/or replacing our bodily self-consciousness. The final outcome may be a new generation of transformative experiences that provide knowledge that is epistemically inaccessible to the individual until he or she has that experience, while at the same time transforming the individual's worldview

The effects of virutal reality on procedural pain and anxiety in pediatrics: A systematic review and meta-analysis

Distraction and procedural preparation techniques are frequently used to manage pain and anxiety in children undergoing medical procedures. An increasing number of studies have indicated that Virtual Reality (VR) can be used to deliver these interventions, but treatment effects vary greatly. The present study is a systematic review and meta-analysis of studies that have used VR to reduce procedural pain and anxiety in children. It is the first meta-analytic assessment of the potential influence of technical specifications (immersion) and degree of user-system interactivity on treatment effects. 65 studies were identified, of which 42 reported pain outcomes and 35 reported anxiety outcomes. Results indicate large effect sizes in favor of VR for both outcomes. Larger effects were observed in dental studies and studies that used non-interactive VR. No relationship was found between the degree of immersion or participant age and treatment effects. Most studies were found to have a high risk of bias and there are strong indications of publication bias. The results and their implications are discussed in context of these limitations, and modified effect sizes are suggested. Finally, recommendations for future investigations are provided

Development Of A Virtual Environment Based On The Perceived Characteristics Of Pain In Patients With Fibromyalgia

Fibromyalgia (FM) is a disorder characterized by chronic phys ical pain.The perception of this pain has psychological effects on mood, anxiety, and the degree of perceived control. In turn, these factors may increase the experience of pain. This study aims to develop a new virtual environment for the treatment of FM in order to enhance the therapeutic effects of traditional interventions. The first phase included a sample of 19 patients in order to identify common characteristics of the representation of pain and absence of pain, through drawing. The results showed that patients used different colors and different physical states to depict pain (red, motionless) and the absence of pain (blue, in motion). These features were then included in a 3D representation of the human body. ANOVA analysis showed that the degree of anxiety and depression influenced the perceived characteristic of movement

Attention and Social Cognition in Virtual Reality:The effect of engagement mode and character eye-gaze

Technical developments in virtual humans are manifest in modern character design. Specifically, eye gaze offers a significant aspect of such design. There is need to consider the contribution of participant control of engagement. In the current study, we manipulated participants’ engagement with an interactive virtual reality narrative called Coffee without Words. Participants sat over coffee opposite a character in a virtual café, where they waited for their bus to be repaired. We manipulated character eye-contact with the participant. For half the participants in each condition, the character made no eye-contact for the duration of the story. For the other half, the character responded to participant eye-gaze by making and holding eye contact in return. To explore how participant engagement interacted with this manipulation, half the participants in each condition were instructed to appraise their experience as an artefact (i.e., drawing attention to technical features), while the other half were introduced to the fictional character, the narrative, and the setting as though they were real. This study allowed us to explore the contributions of character features (interactivity through eye-gaze) and cognition (attention/engagement) to the participants’ perception of realism, feelings of presence, time duration, and the extent to which they engaged with the character and represented their mental states (Theory of Mind). Importantly it does so using a highly controlled yet ecologically valid virtual experience

Unlocking VR Magic: Duration of Anxiety Relief for Pediatric Needle Procedures

There have been various studies that show the effectiveness of virtual reality (VR) being used as a non-pharmacologic and distraction method on school-aged children ranging from 6-12 years old. Despite this research, there has not been a follow-up with the use of VR and its duration of effect between each patient visit within this certain population. This study focuses on measuring the participants’ anxiety and pain levels during the needle-related procedure. The assessment tools that will be used to measure these important variables are the Children’s Fear Scale and Wong-Baker’s FACES scale. The participants of this study will be placed into two groups: VR intevention and standard care (SC) group. The SC group will be followed for the first month and after their trial, the VR group will also be going through the same process for the second. Statistical analysis will also be used to see correlation coefficients. The goal of this study is to evaluate the duration of effectiveness for VR being used in an outpatient setting. Ethical considerations are highly important for the safety and privacy of the participants in the study

The Effects of Virtual Reality on Procedural Pain and Anxiety in Pediatrics

Distraction and procedural preparation techniques are frequently used to manage pain and anxiety in children undergoing medical procedures. An increasing number of studies have indicated that Virtual Reality (VR) can be used to deliver these interventions, but treatment effects vary greatly. The present study is a systematic review and meta-analysis of studies that have used VR to reduce procedural pain and anxiety in children. It is the first meta-analytic assessment of the potential influence of technical specifications (immersion) and degree of user-system interactivity on treatment effects. 65 studies were identified, of which 42 reported pain outcomes and 35 reported anxiety outcomes. Results indicate large effect sizes in favor of VR for both outcomes. Larger effects were observed in dental studies and studies that used non-interactive VR. No relationship was found between the degree of immersion or participant age and treatment effects. Most studies were found to have a high risk of bias and there are strong indications of publication bias. The results and their implications are discussed in context of these limitations, and modified effect sizes are suggested. Finally, recommendations for future investigations are provided

Wii-Workouts on Chronic Pain, Physical Capabilities and Mood of Older Women: A Randomized Controlled Double Blind Trial

Chronic Low Back Pain (CLBP) is a public health problem and older women have higher incidence of this symptom, which affect body balance, functional capacity and behavior. The purpose of this study was to verifying the effect of exercises with Nintendo Wii on CLBP, functional capacity and mood of elderly. Thirty older women (68 ± 4 years; 68 ± 12 kg; 154 ± 5 cm) with CLBP participated in this study. Elderly individuals were divided into a Control Exercise Group (n = 14) and an Experimental Wii Group (n = 16). Control Exercise Group did strength exercises and core training, while Experimental Wii Group did ones additionally to exercises with Wii. CLBP, balance, functional capacity and mood were assessed pre and post training by the numeric pain scale, Wii Balance Board, sit to stand test and Profile of Mood States, respectively. Training lasted eight weeks and sessions were performed three times weekly. MANOVA 2 x 2 showed no interaction on pain, siting, stand-up and mood (P = 0.53). However, there was significant difference within groups (P = 0.0001). ANOVA 2 x 2 showed no interaction for each variable (P > 0.05). However, there were significant differences within groups in these variables (P 0.01). Capacity to Sit improved only in Experimental Wii Group (P = 0.04). In conclusion, physical exercises with Nintendo Wii Fit Plus additional to strength and core training were effective only for sitting capacity, but effect size was small

Bodily resonance: Exploring the effects of virtual embodiment on pain modulation and the fostering of empathy toward pain sufferers

Globally, around 20% of people suffer from chronic pain, an illness that cannot be cured and has been linked to numerous physical and mental conditions. According to the BioPsychoSocial model of pain, chronic pain presents patients with biological, psychological, and social challenges and difficulties. Immersive virtual reality (VR) has shown great promise in helping people manage acute and chronic pain, and facilitating empathy of vulnerable populations. Therefore, the first research trajectory of this dissertation targets chronic pain patients’ biological and psychological sufferings to provide VR analgesia, and the second research trajectory targets healthy people to build empathy and reduce patients’ social stigma. Researchers have taken the attention distraction approach to study how acute pain patients can manage their condition in VR, while the virtual embodiment approach has mostly been studied with healthy people exposed to pain stimulus. My first research trajectory aimed to understand how embodied characteristics affect users’ sense of embodiment and pain. Three studies have been carried out with healthy people under heat pain, complex regional pain syndrome patients, and phantom limb pain patients. My findings indicate that for all three studies, when users see a healthy or intact virtual body or body parts, they experience significant reductions in their self-reported pain ratings. Additionally, I found that the appearance of a virtual body has a significant impact on pain, whereas the virtual body’s motions do not. Despite the prevalence of chronic pain, public awareness of it is remarkably low, and pain patients commonly experience social stigma. Thus, having an embodied perspective of chronic pain patients is critical to understand their social stigma. Although there is a growing interest in using embodied VR to foster empathy towards gender or racial bias, few studies have focused on people with chronic pain. My second trajectory explored how researchers can foster empathy towards pain patients in embodied VR. To conclude, this dissertation uncovers the role of VR embodiment and dissects embodied characteristics in pain modulation and empathy generation. Finally, I summarized a novel conceptual design framework for embodied VR applications with design recommendations and future research directions

A mixed-methods investigation into the acceptability, usability and perceived effectiveness of active and passive virtual reality scenarios in managing pain under experimental conditions

Burns patients often suffer excruciating pain during clinical procedures, even with analgesia. Virtual Reality as an adjunct to pharmacological therapy has proved promising in the management of burn pain. More evidence is needed regarding specific forms of Virtual Reality. This mixed-method study examined the impact of active and passive Virtual Reality scenarios in experimental conditions, gathering data relating to user experience, acceptability and effectiveness in managing pain. Four scenarios were developed or selected following a consultative workshop with burns survivors and clinicians. Each was trialled using a cold pressor test with 15 University students. Data were gathered regarding pain threshold and tolerance at baseline and during each exposure. Short interviews were conducted afterwards. The two active scenarios were ranked highest and significantly extended participants pain threshold and tolerance times compared to passive and baseline conditions. Passive scenarios offered little distraction and relief from pain. Active scenarios were perceived to be engaging, challenging, distracting and immersive. They reduced subjective awareness of pain, though suggestions were made for further improvements. Results suggested that active Virtual Reality was acceptable and enjoyable as a means of helping to control experimental pain. Following suggested improvements, scenarios should now be tested in the clinical environment

Wii-Workouts on Chronic Pain, Physical Capabilities and Mood of Older Women: A Randomized Controlled Double Blind Trial

Chronic Low Back Pain (CLBP) is a public health problem and older women have higher incidence of this symptom, which affect body balance, functional capacity and behavior. The purpose of this study was to verifying the effect of exercises with Nintendo Wii on CLBP, functional capacity and mood of elderly. Thirty older women (68 ± 4 years; 68 ± 12 kg; 154 ± 5 cm) with CLBP participated in this study. Elderly individuals were divided into a Control Exercise Group (n = 14) and an Experimental Wii Group (n = 16). Control Exercise Group did strength exercises and core training, while Experimental Wii Group did ones additionally to exercises with Wii. CLBP, balance, functional capacity and mood were assessed pre and post training by the numeric pain scale, Wii Balance Board, sit to stand test and Profile of Mood States, respectively. Training lasted eight weeks and sessions were performed three times weekly. MANOVA 2 x 2 showed no interaction on pain, siting, stand-up and mood (P = 0.53). However, there was significant difference within groups (P = 0.0001). ANOVA 2 x 2 showed no interaction for each variable (P > 0.05). However, there were significant differences within groups in these variables (P 0.01). Capacity to Sit improved only in Experimental Wii Group (P = 0.04). In conclusion, physical exercises with Nintendo Wii Fit Plus additional to strength and core training were effective only for sitting capacity, but effect size was small