The use of virtual reality in the study, assessment, and treatment of body image in eating disorders and nonclinical samples: A review of the literature

This article reviews research into the use of virtual reality in the study, assessment, and treatment of body image disturbances in eating disorders and nonclinical samples. During the last decade, virtual reality has emerged as a technology that is especially suitable not only for the assessment of body image disturbances but also for its treatment. Indeed, several virtual environment-based software systems have been developed for this purpose. Furthermore, virtual reality seems to be a good alternative to guided imagery and in vivo exposure, and is therefore very useful for studies that require exposure to life-like situations but which are difficult to conduct in the real world. Nevertheless, review highlights the lack of published controlled studies and the presence of methodological drawbacks that should be considered in future studies. This article also discusses the implications of the results obtained and proposes directions for future research

Duration and exposure to virtual environments: Sickness curves during and across sessions

Although simulator sickness is known to increase with protracted exposure and to diminish with repeated sessions, limited systematic research has been performed in these areas. This study reviewed the few studies with sufficient information available to determine the effect-that exposure duration and repeated exposure have on motion sickness. This evaluation confirmed that longer exposures produce more symptoms and that total sickness subsides over repeated exposures. Additional evaluation was performed to investigate the precise form of this relationship and to determine whether the same form was generalizable across varied simulator environments. The results indicated that exposure duration and repeated exposures are significantly linearly related to sickness outcomes (duration being positively related and repetition negatively related to total sickness). This was true over diverse systems and large subject pools. This result verified the generalizability of-the relationships among sickness, exposure duration, and repeated exposures. Additional research is indicated to determine the optimal length of a single exposure and the optimal intersession interval to facilitate adaptation

From presence to consciousness through virtual reality

Immersive virtual environments can break the deep, everyday connection between where our senses tell us we are and where we are actually located and whom we are with. The concept of 'presence' refers to the phenomenon of behaving and feeling as if we are in the virtual world created by computer displays. In this article, we argue that presence is worthy of study by neuroscientists, and that it might aid the study of perception and consciousness

A review of virtual reality technologies in the field of communication disability: implications for practice and research.

BACKGROUND: Technology devices and applications including virtual reality (VR) are increasingly used in healthcare research and practice as tools to promote health and wellbeing. However, there is limited research examining the potential for VR to enable improved communication for people with communication disability. AIMS: To review: (a) current research using VR in speech-language pathology; and (b) the ethical and safety considerations of VR research, to inform an agenda for future research applying VR in the field of speech-language pathology. MAIN CONTRIBUTION: This review reveals that there is an emergent body of literature applying VR to improve or develop physical, psychological and communication interventions. Use of non-immersive virtual environments to provide speech-language pathology assessment or intervention for people with communication disability has demonstrated positive outcomes, with emerging evidence of the transfer of functional communication skills from virtual to real-world environments. However, the use of VR technology and immersive virtual environments in communication disability practice and research introduces safety and ethical issues that must be carefully considered. CONCLUSIONS: Research employing VR is in its infancy in the field of speech-language pathology. Early evidence from other healthcare disciplines suggests that VR is an engaging means of delivering immersive and interactive training to build functional skills that can be generalized to the real world. While the introduction of new technology requires careful consideration of research ethics and patient safety, future VR communication research could proceed safely with adequate engagement of interdisciplinary teams and technology specialists. Implications for rehabilitation Immersive virtual reality may be used in rehabilitation to simulate natural environments to practice and develop communication skills. The sense of immersion that can be achieved using virtual reality may promote the generalization of skills learnt during clinical rehabilitation to real-world situations. Ethical and safety considerations, including cybersecurity and cybersickness, must be carefully monitored during all virtual reality research

Configural Scoring of Simulator Sickness, Cybersickness and Space Adaptation Syndrome: Similarities and Differences?

From a survey of ten U.S. Navy flight simulators a large number (N > 1,600 exposures) of self-reports of motion sickness symptomatology were obtained. Using these data, scoring algorithms were derived, which permit examination of groups of individuals that can be scored either for 1) their total sickness experience in a particular device; or, 2) according to three separable symptom clusters which emerged from a Factor Analysis. Scores from this total score are found to be proportional to other global motion sickness symptom checklist scores with which they correlate (r = 0.82). The factors that surfaced from the analysis include clusters of symptoms referable as nausea, oculomotor disturbances, and disorientation (N, 0, and D). The factor scores may have utility in differentiating the source of symptoms in different devices. The present chapter describes our experience with the use of both of these types of scores and illustrates their use with examples from flight simulators, space sickness and virtual environments

The Effect of Cervical Muscle Fatigue on Postural Stability during Immersion Virtual Reality

The visual system is part of the nervous system that enables an individual to scan their environment and assess distance to and from objects. The information captured form our navigating environment is communicated to the brain, which in turn makes the decision on how we respond to spatial orientation. This is particularly useful in helping with balance and determining direction of movement. Our posture and visual stability rely heavily on an efficient and processing of visual, vestibular, and proprioception afferent input. Erroneous sensory information from defective sensory organs may cause a person to experience feelings of lightheadedness, spinning and whirling sensations, and difficulty in maintaining straight posture. Few studies have examined the synergy between cervical spine proprioception and the vestibular ocular reflex (VOR) and as such, their impact on human VOR is less understood. The purpose of this study therefore was to investigate how motion sensitivity is impacted by neck muscle fatigue in normal healthy participants. The overall aim of the present work was to investigate whether impaired somatosensory information from the cervical spine, caused by neck muscle fatigue, would negatively impact postural stability in healthy young participants. Results indicated that healthy young participants who were fatigued had significantly poorer postural stability than those who were not fatigued (p\u3c 0.001). In Conclusion, our research suggests that when assessing motion sensitivity in patients complaining of dizziness with a history of neck trauma, one may consider that VOR dysfunction could have a cervical origin due to somatosensory disturbance, which may lead to poor postural stability

Cybersickness as a virtual reality side effect : a retrospective study

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022Numa nova era acompanhada com a restrição pandémica que vivemos face à COVID-19, a indústria da realidade virtual beneficiou com uma maior procura por parte dos utilizadores em fugir à sua própria realidade para um mundo imersivo, um mundo por explorar, sem sair das suas próprias casas. Não só para usufruto pessoal em entretenimento, a realidade virtual é, hoje em dia, uma nova ferramenta que evolui a cada dia que passa, sobretudo na área Medicina na sua prática e no seu ensino (cirurgias laparoscópicas e outras técnicas cirúrgicas, encurtar curvas de aprendizagem, ensino da anatomia, tratamento de perturbações e doenças psiquiátricas). Uma das limitações mais importantes ao uso da realidade virtual, passa pela doença do movimento, que neste contexto é denominada de “cybersickness”. Esta condição limitante não é mais do que o enjoo de movimento em ambientes imersivos estacionários, especialmente em realidade virtual gerada por computadores e ecrãs montados na cabeça, sem movimento real. Sendo uma limitação importante ao uso da realidade virtual, é importante identificar padrões que aumentem estes efeitos não desejados e de alguma forma trabalhar neles, para que sejam o menos limitante possível. Este estudo retrospetivo foi realizado através de um questionário online, distribuído por várias plataformas utilizando dois grandes questionários certificados nesta área. O principal objetivo é quantificar a prevalência e o grau de sintomas de doença de movimento em utilizadores saudáveis do Oculus Quest 2, um ecrã montado na cabeça, em diferentes posições, desequilíbrio de género na suscetibilidade à doença do movimento e também determinar fatores predisponentes ou potenciais de risco que possam contribuir para ela, utilizando como base o jogo "Epic Roller Coasters". Foi possível encontrar uma relação estatisticamente significativa entre a predisposição, género feminino, a posição de pé, a frequência e o tempo de jogo. Não foi possível relacionar o fator idade com os sintomas de enjoo de movimento reportados. Estes resultados são importantes para que, em estudos no futuro ou na aplicabilidade da realidade virtual, sejam incluídos estes fatores que potenciam os efeitos adversos, em todos os contextos.In a new era, accompanied with the pandemic restriction we are living in the face of COVID-19, the virtual reality industry has benefited from a greater demand by users to escape their own reality to an immersive world, a world to explore without leaving their own homes. Not only for personal use in entertainment, virtual reality is nowadays a new tool that evolves every day, especially in medicine in its practice and teaching (laparoscopic surgeries and other surgical techniques, shortening learning curves, teaching anatomy, treating psychiatric disorders and diseases). One of the most important limitations to the use of virtual reality is Motion Sickness, which in this context is called cybersickness. This limiting condition is nothing but MS in stationary immersive environments, especially in virtual reality generated by computers and head-mounted displays, without real movement. Being an important limitation to the use of virtual reality, it is important to identify patterns that increase these unwanted effects and somehow work on them to make them as less limiting as possible. This retrospective study was conducted through an online questionnaire, distributed across several platforms using two large certified questionnaires in this area. Its main objective is to quantify the prevalence and degree of motion sickness symptoms in healthy VR users of Oculus Quest 2, a head mounted display, in different positions (sitting down vs standing up), as gender imbalance in the susceptibility to simulator sickness and as well as determining predisposing or potential risk factors that may contribute to it using the game "Epic Roller Coasters" as basis. It was possible to find a statistically significant relationship between predisposition, female gender, standing position, frequency and time of playing. It was not possible to relate the Age factor with the reported symptoms of Motion Sickness. These results are important so that in future studies or in the applicability of virtual reality, these factors that potentiate adverse effects should be included, in all contexts

Microgravitational effects on the neurovestibular system and countermeasures to facilitate safe and effective adaptation to changes in gravity during future Mars explorations

1.1 Introduction With the Artemis program National Aeronautics and Space Administration (NASA) plans to land humans on the moon to prepare for the next giant leap, Mars. In order to achieve this ambitious goal, lots of medical and physiological obstacles have to be overcome to ensure a safe voyage. A common but manageable issue with space travel has been neurovestibular dysfunction and altered sensorimotor functions, resulting in symptoms of space motion sickness (SMS) and spatial disorientation. With increasing spaceflight duration and adaptation to various gravities, this hurdle becomes more prominent and will require effective countermeasures. 1.2 Purpose of the study The purpose of this study is to get a closer look at how microgravity affects the neurovestibular system, and to consider which countermeasures that can assist in a safe and effective adaptations to gravitational changes. 1.3 Material and method By executing a systematical literature search through the databases PubMed and MEDLINE, articles were found and included in the thesis based on carefully selected criteria. The main search in PubMed resulted in 1780 articles, which first went through a filtration to exclude articles in other languages than English, published before 2011 and with no available abstract or full text. 132 articles’ title and abstract were then reviewed for relevance based on the selection criteria. 94 articles were excluded, and the remaining 36 articles were read in full text. Of these, 19 articles were relevant and contributed to the purpose of the study, and therefore included in the thesis. To cover articles not found in PubMed, another search was carried out in MEDLINE, providing an additional 4 articles.  1.4 Results Studies has shown that space motion sickness and spatial disorientation mainly affect astronauts during and right after gravitational transitioning. When being exposed to microgravity for longer durations, adaptation mechanisms are activated and leads to utricular deconditioning with synaptic plasticity and decreased ocular counter-roll reflex. Susceptibility to space motion sickness seems to be higher in females, astronauts with a visual-depended orientation preference and increased otolith mass asymmetry. Pharmaceuticals, especially scopolamine and promethazine, are widely used to prevent or to ease symptoms of SMS. The effect of these drugs is highly variating. Scopalamine has been found to be quite efficient in lower the symptoms, but has shown side effects of drowsiness, which could be counteracted by combining scopolamine with dextroamphetamine (ScopeDex). Artificial gravity (AG) is suggested as a possible and effective countermeasure against vestibular deconditioning and intermittent exposures has been proven to be more tolerable. Virtual reality has been tested and showed promising results in modifying orientation preference to be less depended on visual cues. Galvanic vestibular stimulation is an analog creating similar altered vestibular inputs as microgravity and can be used in preflight adaptation training. 1.5 Conclusion Microgravity can induce space motion sickness and spatial disorientation in astronauts, especially during gravitational transitioning. Long-duration exposure also leads to utricular deconditioning with synaptic plasticity and decreased ocular counter-roll reflex, which contributes to reentry symptoms. Susceptibility to SMS variates and can be mapped with Motion Sickness Susceptibility Questionnaire, as well as vestibular and visual tests. Females seems to be more susceptible, due to their orientation preference being more visual-dependent. The sensory conflict, which leads to SMS, has been shown to increase in astronauts with marked otolith mass asymmetry. Countermeasures include the use of pharmaceuticals, with individual and limited effect, and preflight training to aid adaptation through galvanic vestibular stimulations, virtual reality and artificial gravity. There is a call for future research to develop countermeasures that are both effective and affordable