Trends in virtual reality technologies for the learning patient

NextMed convened the Medicine Meets Virtual Reality 22 (MMVR 22) conference in 2016. Since 1992, the conference has brought together a diverse group of researchers to share creative solutions for the evolving challenge of integrating virtual reality tools into medical education. Virtual reality (VR) and its enabling technologies utilize hardware and software to simulate environments and encounters where users can interact and learn. The MMVR 22 symposium proceedings contain projects that support a variety of learners: medical students, practitioners, soldiers, and patients. This report will contemplate the trends in virtual reality technologies for patients navigating their medical and healthcare learning. The learning patient seeks more than intervention; they seek prevention. From virtual humans and environments to motion sensors and haptic devices, patients are surrounded by increasingly rich and transformative data-driven tools. Applied data enables VR applications to simulate experience, predict health outcomes, and motivate new behavior. The MMVR 22 presents investigations into the usability of wearable devices, the efficacy of avatar inclusion, and the viability of multi-player gaming. With increasing need for individualized and scalable programming, only committed open source efforts will align instructional designers, technology integrators, trainers, and clinicians. Curriculum and InstructionCurriculum and Instructio

Head-mounted virtual reality and mental health: critical review of current research

Background: eHealth interventions are becoming increasingly used in public health, with virtual reality (VR) being one of the most exciting recent developments. VR consists of a three-dimensional, computer-generated environment viewed through a head-mounted display. This medium has provided new possibilities to adapt problematic behaviors that affect mental health. VR is no longer unaffordable for individuals, and with mobile phone technology being able to track movements and project images through mobile head-mounted devices, VR is now a mobile tool that can be used at work, home, or on the move. Objective: In line with recent advances in technology, in this review, we aimed to critically assess the current state of research surrounding mental health. Methods: We compiled a table of 82 studies that made use of head-mounted devices in their interventions. Results: Our review demonstrated that VR is effective in provoking realistic reactions to feared stimuli, particularly for anxiety; moreover, it proved that the immersive nature of VR is an ideal fit for the management of pain. However, the lack of studies surrounding depression and stress highlight the literature gaps that still exist. Conclusions: Virtual environments that promote positive stimuli combined with health knowledge could prove to be a valuable tool for public health and mental health. The current state of research highlights the importance of the nature and content of VR interventions for improved mental health. While future research should look to incorporate more mobile forms of VR, a more rigorous reporting of VR and computer hardware and software may help us understand the relationship (if any) between increased specifications and the efficacy of treatment

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

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

Virtual reality and behaviour management in paediatric dentistry: a systematic review

Background: Virtual reality (VR) has emerged as an innovative tool in medicine and dentistry, improving anxiety and pain management in children. The immersive and interactive environments of VR technology facilitate positive engagement of young patients during dental procedures via distraction, potentially reducing anxiety levels and improving treatment experience. The aim of this review was to provide current evidence-based guidance on the usage of VR in the clinical practice of paediatric dentistry. Methods: A systematic review was conducted according to the PRISMA guidelines with the following research question using the PICO format: Does VR (I) effectively manage anxiety and pain (O) during a paediatric dental consultation (P) compared to alternative behavioural control techniques (C)? PubMed/Medline®, SCOPUS and Web of Science databases were searched and analysed. Results: A total of 22 randomised control trials were included in this review. These studies have shown that VR is a highly effective method of behaviour management, successfully alleviating pain and anxiety in children during dental treatment, surpassing traditional tools. Selected studies included participants with a large age range and dental procedures varied greatly, from first consultations to infiltration of local anaesthetic and other invasive procedures. VR was mostly used during treatment delivery and different immersive VR techniques were considered. Behaviour, anxiety and pain scales were used to determine efficacy and patient satisfaction. Conclusions: VR offers an engaging and immersive experience, effectively diverting patients' attention away from the clinical environment, fostering a positive and enjoyable treatment experience. However, it is important to acknowledge the limitations of existing studies and the need for further research to enhance the understanding of VR's full potential in paediatric dentistry.info:eu-repo/semantics/publishedVersio

An interactive 3-D application for pain management: Results from a pilot study in spinal cord injury rehabilitation

This is the post-print version of the Article. The official published version can be accessed from the link below - Copyright @ 2012 ElevierResearch on pain following spinal cord injury (SCI) has revealed that patients not only experience several types of pain that could prove to be challenging to address, but also that each individual can interpret such pain in different subjective ways. In this paper we introduce a 3-D system for facilitating the efficient management of pain, and thus, supporting clinicians in overcoming the aforementioned challenges. This system was evaluated by a cohort of 15 SCI patients in a pilot study that took place between July and October 2010. Participants reported their experiences of using the 3-D system in an adapted version of the System Usability Scale (SUS) questionnaire. Statistically significant results were obtained with regards to the usability and efficiency of the 3-D system, with the majority of the patients finding it particularly useful to report their pain. Our findings suggest that the 3-D system can be an efficient tool in the efforts to better manage the pain experience of SCI patients

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USING VIRTUAL REALITY TO REDUCE STATE ANXIETY AND STRESS IN UNIVERSITY STUDENTS: AN EXPERIMENT

Background/Objectives: Anxiety is common in the general population and also among university students, affecting their performance. Virtual reality (VR) devices can theoretically help alleviate anxiety pressures faced, by immersing participants in an interactive synthetic environment that is calming. The current study examined whether using a mobile VR device would support this theoretical position and help reduce anxiety levels in university studentsMethods: The study randomly assigned 30 participating university students to two groups: one experimental (VR) group and the other a control (reading task – RT) group. All participants first completed initial surveys (demographics, depression anxiety and stress scale –DASS-21 and a social desirability scale – SDS) and then were administered in turn the Trier Social Stress Test (TSST) to increase stress levels and the State – trait anxiety inventory (STAI-Y) scale to assess the anxiety-stress levels); followed by random allocation into either the VR experimental group engaged in a virtual tour of Hawaii or the RT group which read neutral extracts from a magazine). Following this, STAI-Y was again administered. Results: There was a significant difference between the VR and the RT groups with highly significant reductions in stress levels being associated with the VR group Conclusion:  The study demonstrated that anxiety levels could be reduced significantly through the use of VR technology. Further studies are needed in terms of suitable intervention scenarios, equipment quality, and in application to other mental health areas and to different community groups

StableHand VR: a virtual reality serious game for hand rehabilitation

Dissertação de mestrado integrado em Biomedical Engineering Medical InformaticsA third of all injuries at work are sustained to the hand, and hand and wrist injuries are estimated to account between 10% to 30% of all Emergency Department (ED) attendances. In 2017, there were approximately 18 million hand and wrist fractures, 2 million thumb amputations and 4 million non-thumb digit amputations worldwide. Several injuries, disabilities and diseases can affect manual motor control. Hand physiotherapy is indispensable to restore hand functionality. However, this process is often a strenuous and cognitively demanding experience. This work proposes a Virtual Reality (VR) serious game to improve conventional physiotherapy in hand rehabilitation. It focuses on resolving recurring limitations reported in most technological solutions to the problem, namely the limited diversity support of movements and exercises, complicated calibrations, and exclusion of patients with open wounds or other disfigurements of the hand. Concepts such as mixed reality, serious games for health, and hand rehabilitation are addressed in this dissertation to provide the reader with a background for the project. The latest developments of digital games and technologies in the hand rehabilitation field, specifications, requirements, general game characteristics and the most relevant details of the game implementation process are also presented in this dissertation. The system was assessed in two mid-term validations to test its viability and adjust the development. The first validation was performed with eight able-bodied participants and the second with four health professionals working in the rehabilitation field. The validations were performed following ten minutes of guided functional task practices followed by a Semi-Structured Interview for the first validation and an online questionnaire for the second validation. The questions made in the interview and online questionnaire focused on the participants’ familiarity with videogames, opinion about the Oculus Quest and its hand tracking system, and the StableHand VR game. The System Usability Scale (SUS) scores obtained and the participants’ positive feedback showed the potential of both conceptual and technological approaches adopted for this game as a viable complement to conventional hand rehabilitation. The project’s main objectives were achieved, and several relevant topics for further research were identified.Um terço de todos os ferimentos no trabalho afetam a mão e estima-se que 10% a 30% de todos os atendimentos nas Urgências se devem a ferimentos na mão e no pulso. Em 2017, houve aproximadamente 18 milhões de fraturas da mão e do pulso, 2 milhões de amputações do polegar e 4 milhões de amputações de dígitos não polegares em todo o mundo. Vários ferimentos, deficiências e doenças podem afetar o controlo motor manual. A fisioterapia é indispensável para recuperar a funcionalidade da mão. No entanto, este processo é frequentemente uma experiência extenuante e cognitivamente exigente. Este trabalho propõe um jogo sério em Realidade Virtual para melhorar a fisioterapia convencional na reabilitação da mão. O trabalho desenvolvido concentra-se na resolução de recorrentes limitações relatadas na maioria das soluções tecnológicas para o problema, nomeadamente o apoio limitado de diversidade de movimentos e exercícios, calibrações complicadas e exclusão de pacientes com feridas abertas ou outras desfigurações da mão. Esta dissertação aborda conceitos como a realidade mista, jogos sérios para a saúde e reabilitação para fornecer ao leitor contextualização para o projeto. Os últimos desenvolvimentos de jogos digitais e tecnologias no campo da reabilitação da mão são também apresentados nesta dissertação, assim como especificações, requisitos, características gerais do jogo e o processo de implementação do mesmo. O sistema foi avaliado através de dois ensaios realizados durante o processo de desenvolvimento, para testar a viabilidade e proceder a ajustes da solução especificada. A primeira validação foi conduzida com oito participantes saudáveis e a segunda validação com quatro profissionais de saúde que trabalham em reabilitação. As validações foram realizadas após dez minutos de práticas funcionais orientadas, seguidas de uma Entrevista Semiestruturada, no caso da primeira validação, ou de um questionário online, no caso da segunda validação. As perguntas feitas na entrevista e no questionário online centraram-se na familiaridade dos participantes com os videojogos, opinião sobre o Oculus Quest e o seu sistema de localização de mãos e o jogo StableHand VR. As pontuações obtidas no System Usability Scale e o feedback positivo dos participantes demostrou o potencial das abordagens conceptuais e tecnológicas adotadas para que este jogo fosse visto como um complemento viável para a reabilitação convencional das mãos. Os principais objetivos do projeto foram alcançados, tendo também sido identificado um conjunto de tópicos relevantes de investigação futura

Virtual reality application for rehabilitation

Aquest projecte té com a objectiu desenvolupar una aplicació de Realitat Virtual funcional per a la rehabilitació i el benestar de la gent gran en residències d’avis. El que es pretén és complementar el tractament de rehabilitació dels pacients mitjançant jocs de Realitat Virtual que els permetin realitzar moviments repetitius mentre es mouen per un entorn natural immersiu.Este proyecto tiene como objetivo desarrollar una aplicación de Realidad Virtual funcional para la rehabilitación y el bienestar de las personas mayores en residencias de ancianos. Lo que se pretende es complementar el tratamiento de rehabilitación de los pacientes mediante juegos de Realidad Virtual que les permitan realizar movimientos repetitivos mientras se mueven por un entorno natural inmersivo.This project aims to develop a functional Virtual Reality application for the rehabilitation and well-being of older adults in nursing homes. It intends to engage the patient in the rehabilitation treatment by means of Virtual Reality games. To play these games, the patient must execute repetitive movements while moving around in an immersive natural environment.Objectius de Desenvolupament Sostenible::3 - Salut i Benesta