PHYSICAL ACTIVITY IN VIRTUAL REALITY

The purpose of this conference is to discuss about research on human physical activity based on Virtual Reality (VR). VR 1) offers a unique compromise between control and ecological property of the studied situation, 2) enables to enrich/modify the physical environment, 3) provides control on the multisensory feedback given to the user, 4) and has the potential to enhance motivation and increase the number of repetition in motor skills training. Recent democratisation of immersive technologies, with the development of cheap interactive devices for videogames, has encouraged research in this domain. In this conference, we will address examples of perception-action coupling analysis based on VR, will analyse how technical choices could affect the behaviour of the studied subjects, and will expose perspectives in motor skills training based on VR

Rehabilitative devices for a top-down approach

In recent years, neurorehabilitation has moved from a "bottom-up" to a "top down" approach. This change has also involved the technological devices developed for motor and cognitive rehabilitation. It implies that during a task or during therapeutic exercises, new "top-down" approaches are being used to stimulate the brain in a more direct way to elicit plasticity-mediated motor re-learning. This is opposed to "Bottom up" approaches, which act at the physical level and attempt to bring about changes at the level of the central neural system. Areas covered: In the present unsystematic review, we present the most promising innovative technological devices that can effectively support rehabilitation based on a top-down approach, according to the most recent neuroscientific and neurocognitive findings. In particular, we explore if and how the use of new technological devices comprising serious exergames, virtual reality, robots, brain computer interfaces, rhythmic music and biofeedback devices might provide a top-down based approach. Expert commentary: Motor and cognitive systems are strongly harnessed in humans and thus cannot be separated in neurorehabilitation. Recently developed technologies in motor-cognitive rehabilitation might have a greater positive effect than conventional therapies

The use of Virtual Reality in Enhancing Interdisciplinary Research and Education

Virtual Reality (VR) is increasingly being recognized for its educational potential and as an effective way to convey new knowledge to people, it supports interactive and collaborative activities. Affordable VR powered by mobile technologies is opening a new world of opportunities that can transform the ways in which we learn and engage with others. This paper reports our study regarding the application of VR in stimulating interdisciplinary communication. It investigates the promises of VR in interdisciplinary education and research. The main contributions of this study are (i) literature review of theories of learning underlying the justification of the use of VR systems in education, (ii) taxonomy of the various types and implementations of VR systems and their application in supporting education and research (iii) evaluation of educational applications of VR from a broad range of disciplines, (iv) investigation of how the learning process and learning outcomes are affected by VR systems, and (v) comparative analysis of VR and traditional methods of teaching in terms of quality of learning. This study seeks to inspire and inform interdisciplinary researchers and learners about the ways in which VR might support them and also VR software developers to push the limits of their craft.Comment: 6 Page

Reinforced Feedback in Virtual Environment for Plantar Flexor Poststroke Spasticity Reduction and Gait Function Improvement

Background. Ankle spasticity is a frequent phenomenon that limits functionality in poststroke patients. Objectives. Our aim was to determine if there was decreased spasticity in the ankle plantar flex (PF) muscles in the plegic lower extremity (LE) and improvement of gait function in stroke patients after traditional rehabilitation (TR) in combination with virtual reality with reinforced feedback, which is termed "reinforced feedback virtual environment" (RFVE). Methods. The evaluation, before and after treatment, of 10 hemiparetic patients was performed using the Modified Ashworth Scale (MAS), Functional Ambulatory Category (FAC), and Functional Independence Measure (FIM). The intervention consisted of 1 hour/day of TR plus 1 hour/day of RFVE (5 days/week for 3 weeks; 15 sessions in total). Results. The MAS and FAC reached statistical significance (P<0.05). The changes in the FIM did not reach statistical significance (P=0.066). The analysis between the ischemic and haemorrhagic patients showed significant differences in favour of the haemorrhagic group in the FIM scale. A significant correlation between the FAC and the months after the stroke was established (P=-0.711). Indeed, patients who most increased their score on the FAC at the end of treatment were those who started the treatment earliest after stroke. Conclusions. The combined treatment of TR and RFVE showed encouraging results regarding the reduction of spasticity and improvement of gait function. An early commencement of the treatment seems to be ideal, and future research should increase the sample size and assessment tools

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

Training and assessment paradigms for laparoscopic surgical skills are evolving from traditional mentor–trainee tutorship towards structured, more objective and safer programs. Accreditation of surgeons requires reaching a consensus on metrics and tasks used to assess surgeons’ psychomotor skills. Ongoing development of tracking systems and software solutions has allowed for the expansion of novel training and assessment means in laparoscopy. The current challenge is to adapt and include these systems within training programs, and to exploit their possibilities for evaluation purposes. This paper describes the state of the art in research on measuring and assessing psychomotor laparoscopic skills. It gives an overview on tracking systems as well as on metrics and advanced statistical and machine learning techniques employed for evaluation purposes. The later ones have a potential to be used as an aid in deciding on the surgical competence level, which is an important aspect when accreditation of the surgeons in particular, and patient safety in general, are considered. The prospective of these methods and tools make them complementary means for surgical assessment of motor skills, especially in the early stages of training. Successful examples such as the Fundamentals of Laparoscopic Surgery should help drive a paradigm change to structured curricula based on objective parameters. These may improve the accreditation of new surgeons, as well as optimize their already overloaded training schedules

Virtual reality in the rehabilitation of people with intellectual disabilities

Virtual reality (VR) possesses many qualities that give it rehabilitative potential for people with intellectual disabilities, both as an intervention and an assessment. It can provide a safe setting in which to practice skills that might carry too many risks in the real world. Unlike human tutors, computers are infinitely patient and consistent. Virtual worlds can be manipulated in ways the real world cannot be and can convey concepts without the use of language or other symbol systems. Published applications for this client group have all been as rehabilitative interventions. These are described in three groups: promoting skills for independent living, enhancing cognitive performance, and improving social skills. Five groups of studies are reviewed that utilize virtual technology to promote skills for independent living: grocery shopping, preparing food, orientation, road safety, and manufacturing skills. Fears that skills or habits learnt in a virtual setting would not transfer to the real world setting have not been supported by the available evidence, apart from those studies with people with autistic spectrum disorders. Future directions are in the development of more applications for independent living skills, exploring interventions for promoting motor and cognitive skills, and the developments of ecologically valid forms of assessment

Virtual reality obstacle crossing: adaptation, retention and transfer to the physical world

Virtual reality (VR) paradigms are increasingly being used in movement and exercise sciences with the aim to enhance motor function and stimulate motor adaptation in healthy and pathological conditions. Locomotor training based in VR may be promising for motor skill learning, with transfer of VR skills to the physical world in turn required to benefit functional activities of daily life. This PhD project aims to examine locomotor adaptations to repeated VR obstacle crossing in healthy young adults as well as transfers to the untrained limb and the physical world, and retention potential of the learned skills. For these reasons, the current thesis comprises three studies using controlled VR obstacle crossing interventions during treadmill walking. In the first and second studies we investigated adaptation to crossing unexpectedly appearing virtual obstacles, with and without feedback about crossing performance, and its transfer to the untrained leg. In the third study we investigated transfer of virtual obstacle crossing to physical obstacles of similar size to the virtual ones, that appeared at the same time point within the gait cycle. We also investigated whether the learned skills can be retained in each of the environments over one week. In all studies participants were asked to walk on a treadmill while wearing a VR headset that represented their body as an avatar via real-time synchronised optical motion capture. Participants had to cross virtual and/or physical obstacles with and without feedback about their crossing performance. If applicable, feedback was provided based on motion capture immediately after virtual obstacle crossing. Toe clearance, margin of stability, and lower extremity joint angles in the sagittal plane were calculated for the crossing legs to analyse adaptation, transfer, and retention of obstacle crossing performance. The main outcomes of the first and second studies were that crossing multiple virtual obstacles increased participants’ dynamic stability and led to a nonlinear adaptation of toe clearance that was enhanced by visual feedback about crossing performance. However, independent of the use of feedback, no transfer to the untrained leg was detected. Moreover, despite significant and rapid adaptive changes in locomotor kinematics with repeated VR obstacle crossing, results of the third study revealed limited transfer of learned skills from virtual to physical obstacles. Lastly, despite full retention over one week in the virtual environment we found only partial retention when crossing a physical obstacle while walking on the treadmill. In summary, the findings of this PhD project confirmed that repeated VR obstacle perturbations can effectively stimulate locomotor skill adaptations. However, these are not transferable to the untrained limb irrespective of enhanced awareness and feedback. Moreover, the current data provide evidence that, despite significant adaptive changes in locomotion kinematics with repeated practice of obstacle crossing under VR conditions, transfer to and retention in the physical environment is limited. It may be that perception-action coupling in the virtual environment, and thus sensorimotor coordination, differs from the physical world, potentially inhibiting retained transfer between those two conditions. Accordingly, VR-based locomotor skill training paradigms need to be considered carefully if they are to replace training in the physical world

Augmenting mental models

The complexity of conceptualizing mental models has made Virtual Reality an interesting way to enhance communication and understanding between individuals working together on a project or idea. Here, the authors discuss practical applications of using VR for this purpose

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