DOI: 10.3389/fpubh.2023.1143947
Terbit pada 23 Maret 2023 Pada Frontiers in Public Health

A systematic review: Virtual-reality-based techniques for human exercises and health improvement

D. Feng Yuting Chen Xiangning Wang + 8 penulis

Abstrak

Virtual Reality (VR) has emerged as a new safe and efficient tool for the rehabilitation of many childhood and adulthood illnesses. VR-based therapies have the potential to improve both motor and functional skills in a wide range of age groups through cortical reorganization and the activation of various neuronal connections. Recently, the potential for using serious VR-based games that combine perceptual learning and dichoptic stimulation has been explored for the rehabilitation of ophthalmological and neurological disorders. In ophthalmology, several clinical studies have demonstrated the ability to use VR training to enhance stereopsis, contrast sensitivity, and visual acuity. The use of VR technology provides a significant advantage in training each eye individually without requiring occlusion or penalty. In neurological disorders, the majority of patients undergo recurrent episodes (relapses) of neurological impairment, however, in a few cases (60–80%), the illness progresses over time and becomes chronic, consequential in cumulated motor disability and cognitive deficits. Current research on memory restoration has been spurred by theories about brain plasticity and findings concerning the nervous system's capacity to reconstruct cellular synapses as a result of interaction with enriched environments. Therefore, the use of VR training can play an important role in the improvement of cognitive function and motor disability. Although there are several reviews in the community employing relevant Artificial Intelligence in healthcare, VR has not yet been thoroughly examined in this regard. In this systematic review, we examine the key ideas of VR-based training for prevention and control measurements in ocular diseases such as Myopia, Amblyopia, Presbyopia, and Age-related Macular Degeneration (AMD), and neurological disorders such as Alzheimer, Multiple Sclerosis (MS) Epilepsy and Autism spectrum disorder. This review highlights the fundamentals of VR technologies regarding their clinical research in healthcare. Moreover, these findings will raise community awareness of using VR training and help researchers to learn new techniques to prevent and cure different diseases. We further discuss the current challenges of using VR devices, as well as the future prospects of human training.

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This study explores neuroplasticity through the use of virtual reality (VR) and brain–computer interfaces (BCIs). Neuroplasticity is the brain’s ability to reorganize itself by forming new neural connections in response to learning, experience, and injury. VR offers a controlled environment to manipulate sensory inputs, while BCIs facilitate real-time monitoring and modulation of neural activity. By combining VR and BCI, researchers can stimulate specific brain regions, trigger neurochemical changes, and influence cognitive functions such as memory, perception, and motor skills. Key findings indicate that VR and BCI interventions are promising for rehabilitation therapies, treatment of phobias and anxiety disorders, and cognitive enhancement. Personalized VR experiences, adapted based on BCI feedback, enhance the efficacy of these interventions. This study underscores the potential for integrating VR and BCI technologies to understand and harness neuroplasticity for cognitive and therapeutic applications. The researchers utilized the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method to conduct a comprehensive and systematic review of the existing literature on neuroplasticity, VR, and BCI. This involved identifying relevant studies through database searches, screening for eligibility, and assessing the quality of the included studies. Data extraction focused on the effects of VR and BCI on neuroplasticity and cognitive functions. The PRISMA method ensured a rigorous and transparent approach to synthesizing evidence, allowing the researchers to draw robust conclusions about the potential of VR and BCI technologies in promoting neuroplasticity and cognitive enhancement.

Guidelines for the Development of Immersive Virtual Reality Software for Cognitive Neuroscience and Neuropsychology: The Development of Virtual Reality Everyday Assessment Lab (VR-EAL), a Neuropsychological Test Battery in Immersive Virtual Reality

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Virtual reality (VR) head-mounted displays (HMD) appear to be effective research tools, which may address the problem of ecological validity in neuropsychological testing. However, their widespread implementation is hindered by VR induced symptoms and effects (VRISE) and the lack of skills in VR software development. This study offers guidelines for the development of VR software in cognitive neuroscience and neuropsychology, by describing and discussing the stages of the development of Virtual Reality Everyday Assessment Lab (VR-EAL), the first neuropsychological battery in immersive VR. Techniques for evaluating cognitive functions within a realistic storyline are discussed. The utility of various assets in Unity, software development kits, and other software are described so that cognitive scientists can overcome challenges pertinent to VRISE and the quality of the VR software. In addition, this pilot study attempts to evaluate VR-EAL in accordance with the necessary criteria for VR software for research purposes. The VR neuroscience questionnaire (VRNQ; Kourtesis et al., 2019b) was implemented to appraise the quality of the three versions of VR-EAL in terms of user experience, game mechanics, in-game assistance, and VRISE. Twenty-five participants aged between 20 and 45 years with 12–16 years of full-time education evaluated various versions of VR-EAL. The final version of VR-EAL achieved high scores in every sub-score of the VRNQ and exceeded its parsimonious cut-offs. It also appeared to have better in-game assistance and game mechanics, while its improved graphics substantially increased the quality of the user experience and almost eradicated VRISE. The results substantially support the feasibility of the development of effective VR research and clinical software without the presence of VRISE during a 60-min VR session.

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Virtual reality (VR) represents a key technology of the 21st century, attracting substantial interest from a wide range of scientific disciplines. With regard to clinical neuropsychology, a multitude of new VR applications are being developed to overcome the limitations of classical paradigms. Consequently, researchers increasingly face the challenge of systematically evaluating the characteristics and quality of VR applications to design the optimal paradigm for their specific research question and study population. However, the multifaceted character of contemporary VR is not adequately captured by the traditional quality criteria (ie, objectivity, reliability, validity), highlighting the need for an extended paradigm evaluation framework. To address this gap, we propose a multidimensional evaluation framework for VR applications in clinical neuropsychology, summarized as an easy-to-use checklist (VR-Check). This framework rests on 10 main evaluation dimensions encompassing cognitive domain specificity, ecological relevance, technical feasibility, user feasibility, user motivation, task adaptability, performance quantification, immersive capacities, training feasibility, and predictable pitfalls. We show how VR-Check enables systematic and comparative paradigm optimization by illustrating its application in an exemplary research project on the assessment of spatial cognition and executive functions with immersive VR. This application furthermore demonstrates how the framework allows researchers to identify across-domain trade-offs, makes deliberate design decisions explicit, and optimizes the allocation of study resources. Complementing recent approaches to standardize clinical VR studies, the VR-Check framework enables systematic and project-specific paradigm optimization for behavioral and cognitive research in neuropsychology.

Virtual reality for the assessment and rehabilitation of neglect: where are we now? A 6-year review update

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30 Mei 2022

Unilateral spatial neglect (USN) is a frequent repercussion of a cerebrovascular accident, typically a stroke. USN patients fail to orient their attention to the contralesional side to detect auditory, visual, and somatosensory stimuli, as well as to collect and purposely use this information. Traditional methods for USN assessment and rehabilitation include paper-and-pencil procedures, which address cognitive functions as isolated from other aspects of patients’ functioning within a real-life context. This might compromise the ecological validity of these procedures and limit their generalizability; moreover, USN evaluation and treatment currently lacks a gold standard. The field of technology has provided several promising tools that have been integrated within the clinical practice; over the years, a “first wave” has promoted computerized methods, which cannot provide an ecological and realistic environment and tasks. Thus, a “second wave” has fostered the implementation of virtual reality (VR) devices that, with different degrees of immersiveness, induce a sense of presence and allow patients to actively interact within the life-like setting. The present paper provides an updated, comprehensive picture of VR devices in the assessment and rehabilitation of USN, building on the review of Pedroli et al. (2015). The present paper analyzes the methodological and technological aspects of the studies selected, considering the issue of usability and ecological validity of virtual environments and tasks. Despite the technological advancement, the studies in this field lack methodological rigor as well as a proper evaluation of VR usability and should improve the ecological validity of VR-based assessment and rehabilitation of USN.

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