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Guerrini F, Bertolino L, Safa A, Pittarello M, Parisi A, Beretta LV, Zambelli E, Totis F, Campanaro G, Pavia L, Spena G, Nicolosi F, Servadei F. The Use of Technology-Based Simulation among Medical Students as a Global Innovative Solution for Training. Brain Sci 2024; 14:627. [PMID: 39061368 PMCID: PMC11274913 DOI: 10.3390/brainsci14070627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/12/2024] [Accepted: 06/18/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Technological advancements have been rapidly integrated within the neurosurgical education track since it is a high-risk specialty with little margin for error. Indeed, simulation and virtual reality during training can improve surgical performance and technical skills. Our study aims to investigate the impact of neurosurgical technology-based simulation activities on medical students. METHODS AND MATERIALS The "Suturing Mission-The Symposium" was a three-day event held at Humanitas University. Participants had access to live-streamed conferences held by worldwide experts in several fields of neurosurgery and practical simulations of dura mater sutures, microvascular anastomosis, and augmented reality neurosurgical approaches. An anonymous survey was conducted at the beginning and end of the event. RESULTS 141 medical students with a mean age of 21 participated. After the course, 110 participants (77.5%) showed interest in pursuing a surgical path, with a great prevalence in those who had planned to have a surgical career before the event (88.7% vs. 41.4%, p < 0.001). Participants were also asked about their comfort levels while handling surgical instruments, and a good outcome was reached in 72.7% of participants, with a significant difference between those who had previously attended a suture course (87.8% vs. 66.3%, p = 0.012). CONCLUSION Training sessions on surgical simulators were effective in increasing participants' interest in pursuing a surgical path, improving their understanding of postgraduate orientation, and boosting their confidence with surgical instruments.
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Affiliation(s)
- Francesco Guerrini
- Unit of Neurosurgery, Department of Head & Neck Surgery, Fondazione Policlinico IRCCS San Matteo, 27100 Pavia, Italy; (F.G.)
| | - Luca Bertolino
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy; (L.B.); (E.Z.)
| | - Adrian Safa
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy; (L.B.); (E.Z.)
| | - Matilde Pittarello
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy; (L.B.); (E.Z.)
| | - Anna Parisi
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy; (L.B.); (E.Z.)
| | | | - Elena Zambelli
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy; (L.B.); (E.Z.)
| | - Francesca Totis
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy; (L.B.); (E.Z.)
| | - Giovanni Campanaro
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy; (L.B.); (E.Z.)
| | - Lorenzo Pavia
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy; (L.B.); (E.Z.)
| | - Giannantonio Spena
- Unit of Neurosurgery, Department of Head & Neck Surgery, Fondazione Policlinico IRCCS San Matteo, 27100 Pavia, Italy; (F.G.)
| | - Federico Nicolosi
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Milan, Italy
| | - Franco Servadei
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy; (L.B.); (E.Z.)
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
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Lorenz M, Brade J, Klimant P, Heyde CE, Hammer N. Age and gender effects on presence, user experience and usability in virtual environments-first insights. PLoS One 2023; 18:e0283565. [PMID: 36972245 PMCID: PMC10042342 DOI: 10.1371/journal.pone.0283565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 03/09/2023] [Indexed: 03/29/2023] Open
Abstract
Virtual Reality (VR) is applied in various areas were a high User Experience is essential. The sense of Presence while being in VR and its relation to User Experience therefore form crucial aspects, which are yet to be understood. This study aims at quantifying age and gender effects on this connection, involving 57 participants in VR, and performing a geocaching game using a mobile phone as experimental task to answer questionnaires measuring Presence (ITC-SOPI), User Experience (UEQ) and Usability (SUS). A higher Presence was found for the older participants, but there was no gender difference nor any interaction effects of age and gender. These findings are contractionary to preexisting limited work which has shown higher Presence for males and decreases of Presence with age. Four aspects discriminating this study from literature are discussed as explanations and as a starting point for future investigations into the topic. The results further showed higher ratings in favor of User Experience and lower ratings towards Usability for the older participants.
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Affiliation(s)
- Mario Lorenz
- Professorship for Production Systems and Processes, Chemnitz University of Technology, Chemnitz, Germany
- Department of Orthopedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Jennifer Brade
- Professorship for Production Systems and Processes, Chemnitz University of Technology, Chemnitz, Germany
| | - Philipp Klimant
- Professorship for Production Systems and Processes, Chemnitz University of Technology, Chemnitz, Germany
| | - Christoph-E. Heyde
- Department of Orthopedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Niels Hammer
- Department of Orthopedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
- Division of Biomechatronics, Fraunhofer Institute for Machine Tools and Forming Technology IWU, Dresden, Germany
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Grilo AM, Almeida B, Rodrigues C, Isabel Gomes A, Caetano M. Using virtual reality to prepare patients for radiotherapy: A systematic review of interventional studies with educational sessions. Tech Innov Patient Support Radiat Oncol 2023; 25:100203. [PMID: 36873800 PMCID: PMC9982317 DOI: 10.1016/j.tipsro.2023.100203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/06/2023] [Accepted: 02/20/2023] [Indexed: 03/05/2023] Open
Abstract
Purpose To understand the impact of radiotherapy educational sessions with virtual reality on oncologic adult patients' psychological and cognitive outcomes related to the treatment experience. Methods This review was performed according to the Preferred Reporting Items for Systematic Reviews guidelines. A systematic electronic search in three databases, MEDLINE, Scopus, and Web of Science, was conducted in December 2021 to find interventional studies with adult patients undergoing external radiotherapy who received an educational session with virtual reality before or during the treatment. The studies that provided qualitative or quantitative information about the impact of educational sessions on patients' psychological and cognitive dimensions related to RT experience were retained for analysis. Results Of the 25 records found, eight articles about seven studies were analysed that involved 376 patients with different oncological pathologies. Most studies evaluated knowledge and treatment-related anxiety, mainly through self-reported questionnaires. The analysis showed a significant improvement in patients' knowledge and comprehension of radiotherapy treatment. Anxiety levels also decreased with virtual reality educational sessions and throughout the treatment in almost all the studies, although with less homogeneous results. Conclusion Virtual reality methods in standard educational sessions can enhance cancer patients' preparation for radiation therapy by increasing their understanding of treatment and reducing anxiety.
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Affiliation(s)
- Ana Monteiro Grilo
- H&TRC − Health & Technology Research Center, ESTeSL − Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
- CICPSI − Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal
- Corresponding author.
| | - Bárbara Almeida
- ESTeSL − ESTeSL – Escola Superior de Tecnologia da Saúde de Lisboa, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
| | - Carolina Rodrigues
- ESTeSL − ESTeSL – Escola Superior de Tecnologia da Saúde de Lisboa, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
| | - Ana Isabel Gomes
- CICPSI − Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - Marco Caetano
- ESTeSL − ESTeSL – Escola Superior de Tecnologia da Saúde de Lisboa, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
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Dincelli E, Yayla A. Immersive virtual reality in the age of the Metaverse: A hybrid-narrative review based on the technology affordance perspective. JOURNAL OF STRATEGIC INFORMATION SYSTEMS 2022. [DOI: 10.1016/j.jsis.2022.101717] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mishra R, Narayanan MK, Umana GE, Montemurro N, Chaurasia B, Deora H. Virtual Reality in Neurosurgery: Beyond Neurosurgical Planning. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031719. [PMID: 35162742 PMCID: PMC8835688 DOI: 10.3390/ijerph19031719] [Citation(s) in RCA: 69] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/29/2022] [Accepted: 01/30/2022] [Indexed: 02/04/2023]
Abstract
Background: While several publications have focused on the intuitive role of augmented reality (AR) and virtual reality (VR) in neurosurgical planning, the aim of this review was to explore other avenues, where these technologies have significant utility and applicability. Methods: This review was conducted by searching PubMed, PubMed Central, Google Scholar, the Scopus database, the Web of Science Core Collection database, and the SciELO citation index, from 1989–2021. An example of a search strategy used in PubMed Central is: “Virtual reality” [All Fields] AND (“neurosurgical procedures” [MeSH Terms] OR (“neurosurgical” [All Fields] AND “procedures” [All Fields]) OR “neurosurgical procedures” [All Fields] OR “neurosurgery” [All Fields] OR “neurosurgery” [MeSH Terms]). Using this search strategy, we identified 487 (PubMed), 1097 (PubMed Central), and 275 citations (Web of Science Core Collection database). Results: Articles were found and reviewed showing numerous applications of VR/AR in neurosurgery. These applications included their utility as a supplement and augment for neuronavigation in the fields of diagnosis for complex vascular interventions, spine deformity correction, resident training, procedural practice, pain management, and rehabilitation of neurosurgical patients. These technologies have also shown promise in other area of neurosurgery, such as consent taking, training of ancillary personnel, and improving patient comfort during procedures, as well as a tool for training neurosurgeons in other advancements in the field, such as robotic neurosurgery. Conclusions: We present the first review of the immense possibilities of VR in neurosurgery, beyond merely planning for surgical procedures. The importance of VR and AR, especially in “social distancing” in neurosurgery training, for economically disadvantaged sections, for prevention of medicolegal claims and in pain management and rehabilitation, is promising and warrants further research.
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Affiliation(s)
- Rakesh Mishra
- Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India;
| | | | - Giuseppe E. Umana
- Trauma and Gamma-Knife Center, Department of Neurosurgery, Cannizzaro Hospital, 95100 Catania, Italy;
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), University of Pisa, 56100 Pisa, Italy
- Correspondence:
| | - Bipin Chaurasia
- Department of Neurosurgery, Bhawani Hospital, Birgunj 44300, Nepal;
| | - Harsh Deora
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India;
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Bauer ACM, Andringa G. The Potential of Immersive Virtual Reality for Cognitive Training in Elderly. Gerontology 2020; 66:614-623. [PMID: 32906122 DOI: 10.1159/000509830] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 06/17/2020] [Indexed: 11/19/2022] Open
Abstract
The number of elderly is growing rapidly, including those that struggle with cognitive decline and, consequently, activities of daily living. Developing interventions that slow down cognitive decline would greatly benefit the autonomy of these elderly, as well as their caretakers. Virtual reality (VR) is an immersive and interactive human-computer interface with real-time simulation that is suggested to be a promising tool to improve cognitive functioning. This literature review discusses the features of immersive VR, including its opportunities and limitations, that are of special relevance for improving cognition in elderly. First, the high flexibility of VR allows for personalized and safe training of potentially harmful situations and isolated aspects of tasks. Second, VR's dynamic and real-time feedback on performance provides a labor-extensive tool for caretakers in elderly care. Third, the acquisition of high resolution data enables the exposure of subtle changes over time, relevant for detecting the nature and extent of cognitive changes in elderly, including those with dementia. Fourth, immersive VR has been related to cybersickness. Finally, VR is immersive and enables the perception and expression of emotions, motor behaviors, and multiple senses. Aged subjects are found to have sparing of emotional learning and show increased reliance on multisensory integration for learning. Moreover, they experience high levels of flow, motivation, and presence in VR setups. Despite the clear potential of immersive VR, the studies available are small scale and have not been replicated. The digital illiteracy of elderly and healthcare personnel form an additional barrier for implementation. Hence, while replication of outcomes and standardization of VR interventions is required before it can be used in standard care, VR may provide a particularly effective tool for training cognition in elderly.
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Affiliation(s)
- Anna Cornelia Maria Bauer
- Department of Science, University College Roosevelt, Utrecht University, Middelburg, The Netherlands
| | - Gerda Andringa
- Department of Science, University College Roosevelt, Utrecht University, Middelburg, The Netherlands, .,Academic Workplace for the Elderly in Zeeland, Middelburg, The Netherlands,
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Gopalakrishnan S, Jacob CES, Kumar M, Karunakaran V, Raman R. Comparison of Visual Parameters Between Normal Individuals and People with Low Vision in a Virtual Environment. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2020; 23:171-178. [DOI: 10.1089/cyber.2019.0235] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Sarika Gopalakrishnan
- Shanmugha Arts, Science, Technology & Research Academy (SASTRA) University, Thanjavur, India
- Low Vision Care Clinic, Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | | | - Meenakshi Kumar
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, India
| | | | - Rajiv Raman
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, India
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Yang Z, Shi J, Xiao Y, Yuan X, Wang D, Li H, Xu W. Influences of Experience and Visual Cues of Virtual Arm on Distance Perception. Iperception 2020; 11:2041669519901134. [PMID: 32030118 PMCID: PMC6978829 DOI: 10.1177/2041669519901134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 12/20/2019] [Indexed: 01/28/2023] Open
Abstract
Egocentric distance perception refers to the perception of distance from a target to a perceiver, which is an important component of visual space perception. It is important to activities in virtual environments and influenced by several factors, such as action capacities and visual cues. However, few studies have investigated such aspects. Hence, Experiments 1 and 2 investigated the effect of using experience and visual cues, respectively, of virtual arms on egocentric distance perception in near and far spaces at equal, prolonged, and shortened lengths of a virtual arm. Results revealed that using experience and visual cues of the virtual arm had a significant effect on egocentric distance perception when the length of virtual arm was equal to the real arm and prolonged but not when shortened. The egocentric distance perception on the conditions of having using experience and virtual arm was most precise. The findings provide implications for the design and implementation of virtual body self-representation in virtual environments.
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Affiliation(s)
| | - Jinlei Shi
- Department of Psychology,
Zhejiang
Sci-Tech University, Hangzhou,
China
| | - Yi Xiao
- National Key Laboratory of Human Factors
Engineering, China Astronauts Research and Training Center, Beijing,
China
| | | | | | - Hongting Li
- Department of Psychology,
Zhejiang
Sci-Tech University, Hangzhou,
China
| | - Weidan Xu
- Hangzhou College of Commerce,
Zhejiang
Gongshang University, Hangzhou,
China
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Gerber SM, Muri RM, Mosimann UP, Nef T, Urwyler P. Virtual reality for activities of daily living training in neurorehabilitation: a usability and feasibility study in healthy participants. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:1-4. [PMID: 30440283 DOI: 10.1109/embc.2018.8513003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
After severe injury or neurodegenerative disorders patients often experience long-term functional deficits, resulting in a reduction o performance in activities of daily living (ADL). Given their direct relevance to everyday functioning and quality of life, neurorehabilitative programs using simulated ADL's have seen increased interest recently. One of the core elements in simulated ADL's is the interface between the user and the virtual environment, which has a high impact on the therapeutic outcome. The aim of this study was to nalyze the feasibility of a simple virtual ADL (tea preparation task) using two different input devices. The tea preparation task setup consisted of a computer rendering the virtual environment, a head-mounted display (HMD) to visually present the ADL, and two input devices (mouse and handheld controller) to guide virtual hands in the virtual environment. A total of 24 healthyyoung adults performed the tea preparation task after which workload, usability, immersion and presence was rated. The handheld controller was rated significantly lower workload and higher usability than the mouse input device. Also, the sense of being there (immersion) and spatial presence ratings for the task and setup were close to the maximum score of 5. Thus, the handheld controller outperformed the mouse, suggesting that user interaction in the virtual environment with the handheld controller is similar to the real world and intuitive to use. Overall, the simulated ADL implemented with VR technology is feasible for diagnostic and rehabilitative purposes in patients experiencing long-term functional deficits.
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Panerai S, Catania V, Rundo F, Ferri R. Remote Home-Based Virtual Training of Functional Living Skills for Adolescents and Young Adults With Intellectual Disability: Feasibility and Preliminary Results. Front Psychol 2018; 9:1730. [PMID: 30283382 PMCID: PMC6156546 DOI: 10.3389/fpsyg.2018.01730] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 08/27/2018] [Indexed: 11/24/2022] Open
Abstract
Background: Virtual Reality (VR) is acquiring increasing credibility as a tool for teaching independent living skills to people with Intellectual Disability (ID). Generalization of skills acquired during VR training into real environment seems to be feasible. Objective: To assess feasibility and verify effectiveness of a remote home-based rehabilitation, focused on functional living skills, for adolescents and young adults with ID, by using virtual apps installed on tablets. In particular, to assess if this tool can be managed independently, if it is enjoyable and simple to be used, and if the acquired skills can be generalized to the real environment of everyday life. Subjects and method: A single group, pre- and post-test research design was used. Sixteen participants with ID were included. A digital system was arranged, with a server managing communication between the database and the apps installed on tablets. In vivo tests were performed before and after the eleven sessions of VR training. Satisfaction questionnaires were also administered. Results: Statistically significant improvements were found between the pre- and post-in vivo tests, as well as between the VR training sessions, in almost all the parameters taken into account, for each app. Final questionnaires showed a good satisfaction level for both the participants and their families. Conclusion: The highly technological system was managed independently by participants with ID, who found it simple to be used, useful and even fun; generalization across settings was obtained. Results obtained require to be confirmed by future controlled studies, with larger samples.
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Affiliation(s)
| | | | - Francesco Rundo
- Unit of Neurology, Oasi Research Institute - IRCCS, Troina, Italy
| | - Raffaele Ferri
- Unit of Neurology, Oasi Research Institute - IRCCS, Troina, Italy
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11
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Stütz T, Emsenhuber G, Huber D, Domhardt M, Tiefengrabner M, Oostingh GJ, Fötschl U, Matis N, Ginzinger S. Mobile Phone-Supported Physiotherapy for Frozen Shoulder: Feasibility Assessment Based on a Usability Study. JMIR Rehabil Assist Technol 2017; 4:e6. [PMID: 28729234 PMCID: PMC5544899 DOI: 10.2196/rehab.7085] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 12/09/2016] [Accepted: 04/29/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients with frozen shoulder show limited shoulder mobility often accompanied by pain. Common treatment methods include physiotherapy, pain medication, administration of corticosteroids, and surgical capsulotomy. Frozen shoulder often lasts from months to years and mostly affects persons in the age group of 40 to 70 years. It severely reduces the quality of life and the ability to work. OBJECTIVE The objective of this study was to evaluate the feasibility of a mobile health (mHealth) intervention that supports patients affected by "stage two" frozen shoulder. Patients were supported with app-based exercise instructions and tools to monitor their training compliance and progress. These training compliance and progress data supplement the patients' oral reports to the physiotherapists and physicians and can assist them in therapy adjustment. METHODS In order to assess the feasibility of the mHealth intervention, a pilot study of a newly developed app for frozen shoulder patients was conducted with 5 patients for 3 weeks. The main function of the app was the instruction for exercising at home. Standardized questionnaires on usability such as System Usability Scale (SUS) and USE (Usefulness, Satisfaction, and Ease of use), and Technology Acceptance Model-2 (TAM-2) were completed by the study participants at the end of the study. Additionally, a nonstandardized questionnaire was completed by all patients. The correctness of the exercises as conducted by the patients was assessed by a physiotherapist at the end of the study. The mobility of the shoulder and pain in shoulder movement was assessed by a physiotherapist at the start and the end of the study. RESULTS The pilot study was successfully conducted, and the app was evaluated by the patients after 3 weeks. The results of the standardized questionnaires showed high acceptance (TAM-2) and high usability (SUS) of the developed app. The overall usability of the system as assessed by the SUS questionnaire was very good (an average score of 88 out of 100). The average score of the TAM-2 questionnaire on the intention to further use the app was 4.2 out of 5, which indicated that most patients would use the app if further available. The results of the USE questionnaires highlighted that the patients learned how to use the app easily (an average score of 4.2 out of 5) and were satisfied with the app (an average score of 4.7 out of 5). The frequency of app usage and training was very high based on patient reports and verified by analysis of the usage data. The patients conducted the exercises almost flawlessly. CONCLUSIONS Our results indicate the feasibility of the mHealth intervention, as the app was easy to use and frequently used by the patients. The app supported the patients' physiotherapy by providing clear exercising instructions.
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Affiliation(s)
- Thomas Stütz
- SmartHealthCheck Project, Department of Multimedia Technology, University of Applied Sciences Salzburg, Puch / Salzburg, Austria
| | - Gerlinde Emsenhuber
- SmartHealthCheck Project, Department of Multimedia Technology, University of Applied Sciences Salzburg, Puch / Salzburg, Austria
| | - Daniela Huber
- SmartHealthCheck Project, Department of Physiotherapy, University of Applied Sciences Salzburg, Puch / Salzburg, Austria
| | - Michael Domhardt
- SmartHealthCheck Project, Department of Multimedia Technology, University of Applied Sciences Salzburg, Puch / Salzburg, Austria
| | - Martin Tiefengrabner
- SmartHealthCheck Project, Department of Multimedia Technology, University of Applied Sciences Salzburg, Puch / Salzburg, Austria
| | - Gertie Janneke Oostingh
- SmartHealthCheck Project, Department of Biomedical Sciences, University of Applied Sciences Salzburg, Puch / Salzburg, Austria
| | - Ulrike Fötschl
- SmartHealthCheck Project, Department of Biomedical Sciences, University of Applied Sciences Salzburg, Puch / Salzburg, Austria
| | - Nicholas Matis
- Ambulatory Shoulder Care, Department of Orthopedics and Traumatology, University Hospital Salzburg (SALK), Salzburg, Austria
| | - Simon Ginzinger
- SmartHealthCheck Project, Department of Multimedia Technology, University of Applied Sciences Salzburg, Puch / Salzburg, Austria
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Yellowlees PM, Holloway KM, Parish MB. Therapy in virtual environments--clinical and ethical issues. Telemed J E Health 2012; 18:558-64. [PMID: 22823138 DOI: 10.1089/tmj.2011.0195] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND As virtual reality and computer-assisted therapy strategies are increasingly implemented for the treatment of psychological disorders, ethical standards and guidelines must be considered. This study determined a set of ethical and legal guidelines for treatment of post-traumatic stress disorder (PTSD)/traumatic brain injury (TBI) in a virtual environment incorporating the rights of an individual who is represented by an avatar. MATERIALS AND METHODS A comprehensive literature review was undertaken. An example of a case study of therapy in Second Life (a popular online virtual world developed by Linden Labs) was described. RESULTS Ethical and legal considerations regarding psychiatric treatment of PTSD/TBI in a virtual environment were examined. The following issues were described and discussed: authentication of providers and patients, informed consent, patient confidentiality, patient well-being, clinician competence (licensing and credentialing), training of providers, insurance for providers, the therapeutic environment, and emergencies. Ethical and legal guidelines relevant to these issues in a virtual environment were proposed. CONCLUSIONS Ethical and legal issues in virtual environments are similar to those that occur in the in-person world. Individuals represented by an avatar have the rights equivalent to the individual and should be treated as such.
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Affiliation(s)
- Peter M Yellowlees
- Department of Psychiatry, University of California, Davis, Sacramento, California 95817, USA.
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Foran AC. Learning from experience: shared constructs in virtual reality and occupational therapy. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2011. [DOI: 10.12968/ijtr.2011.18.7.362] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Amanda C Foran
- Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry of USC, University of Southern California, California, USA
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Virtual reality-enhanced partial body weight-supported treadmill training poststroke: feasibility and effectiveness in 6 subjects. Arch Phys Med Rehabil 2010; 91:115-22. [PMID: 20103405 DOI: 10.1016/j.apmr.2009.09.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 09/01/2009] [Indexed: 01/12/2023]
Abstract
UNLABELLED Walker ML, Ringleb SI, Maihafer GC, Walker R, Crouch JR, Van Lunen B, Morrison S. Virtual reality-enhanced partial body weight-supported treadmill training poststroke: feasibility and effectiveness in 6 subjects. OBJECTIVE To determine whether the use of a low-cost virtual reality (VR) system used in conjunction with partial body weight-supported treadmill training (BWSTT) was feasible and effective in improving the walking and balance abilities of patients poststroke. DESIGN A before-after comparison of a single group with BWSTT intervention. SETTING University research laboratory. PARTICIPANTS A convenience sample of 7 adults who were within 1 year poststroke and who had completed traditional rehabilitation but still exhibited gait deficits. Six participants completed the study. INTERVENTION Twelve treatment sessions of BWSTT with VR. The VR system generated a virtual environment that showed on a television screen in front of the treadmill to give participants the sensation of walking down a city street. A head-mounted position sensor provided postural feedback. MAIN OUTCOME MEASURES Functional Gait Assessment (FGA) score, Berg Balance Scale (BBS) score, and overground walking speed. RESULTS One subject dropped out of the study. All other participants made significant improvements in their ability to walk. FGA scores increased from mean of 13.8 to 18. BBS scores increased from mean of 43.8 to 48.8, although a ceiling effect was seen for this test. Overground walking speed increased from mean of .49m/s to .68m/s. CONCLUSIONS A low-cost VR system combined with BWSTT is feasible for improved gait and balance of patients poststroke.
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Hu J, Yu H, Shao J, Li Z, Wang J, Wang Y. Effects of Dental 3D Multimedia System on the performance of junior dental students in preclinical practice: a report from China. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2009; 14:123-133. [PMID: 18214704 DOI: 10.1007/s10459-007-9096-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2007] [Accepted: 12/19/2007] [Indexed: 05/25/2023]
Abstract
BACKGROUND Computer-assisted tools are rarely adopted for dental education in China. In China, 3D digital technology, such as Virtual Reality Systems, are often rejected in the dental field due to prohibitive pricing. There is also a reluctance to move away from traditional patterns of dental education. OBJECTIVE The current study is one of a series of research programs designed to investigate the effects of introducing a software program, named the Dental 3D Multimedia System (D3DM), into the education of a group of junior dental students in their preclinical practice. It was theorized that using 3D technology would improve certain aspects of subjects' performance, thus lending support to the idea that electronic media is a useful & valuable means for dental education in China. METHODS A paired-sample contrast study between two groups of dental students was conducted. One group received their training program in the traditional way, unassisted by 3D technology. The second group received their training program in the traditional manner, but also used the D3DM to supplement their education. Data indicating the study efficiency of the two groups were gathered and analyzed. The results between the two groups were then compared. RESULTS Statistical differences were detected on several points between the two groups. These differences indicated that the D3DM-assisted group worked faster, and no worse than the traditional group during the training in labs. The D3DM-assisted group also spent less time interacting with faculty members and seeking feedback during practice. Finally, the results also show that the D3DM-assisted group achieved higher scores in theory exams. CONCLUSION The results indicate that the usage of 3D multimedia PC software had a positive impact on several aspects of subjects' performance. At present, no significant drawbacks from applying the software have been identified.
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Affiliation(s)
- Jian Hu
- Department of Prosthodontics, School of Stomatology, Wuhan University, Hubei, China
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Fujita K, Kato S. Development of on-bed lower extremity exercise system for use with networked virtual space. CONFERENCE PROCEEDINGS : ... ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL CONFERENCE 2007; 2005:2563-6. [PMID: 17282761 DOI: 10.1109/iembs.2005.1616992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A virtual space locomotion interface device using lower limb motion at supine position has been developed to allow the users to exercise and communicate each other at home. The velocity control performance, muscle activity and the energy consumption while using the developed device were evaluated. It was demonstrated that the developed device reflects the user's subjectivity adequately and the virtual space walking distance is to be set as three times of the actual distance to obtain the same exercise effect.
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Affiliation(s)
- Kinya Fujita
- Tokyo University of Agriculture and Technology Nakacho, Koganei, Tokyo 184-8588 JAPAN
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Pridmore T, Cobb S, Hilton D, Green J, Eastgate R. Mixed reality environments in stroke rehabilitation: Interfaces across the real/virtual divide. ACTA ACUST UNITED AC 2007. [DOI: 10.1515/ijdhd.2007.6.1.87] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Fidopiastis CM, Stapleton CB, Whiteside JD, Hughes CE, Fiore SM, Martin GA, Rolland JP, Smith EM. Human Experience Modeler: context-driven cognitive retraining to facilitate transfer of learning. ACTA ACUST UNITED AC 2006; 9:183-7. [PMID: 16640476 DOI: 10.1089/cpb.2006.9.183] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We describe a cognitive rehabilitation mixed-reality system that allows therapists to explore natural cuing, contextualization, and theoretical aspects of cognitive retraining, including transfer of training. The Human Experience Modeler (HEM) mixed-reality environment allows for a contextualized learning experience with the advantages of controlled stimuli, experience capture and feedback that would not be feasible in a traditional rehabilitation setting. A pilot study for testing the integrated components of the HEM is discussed where the participant presents with working memory impairments due to an aneurysm.
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Affiliation(s)
- C M Fidopiastis
- Institute for Simulation and Training, University of Central Florida, Orlando, Florida 32826-0544, USA.
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Betker AL, Szturm T, Moussavi ZK, Nett C. Video game-based exercises for balance rehabilitation: a single-subject design. Arch Phys Med Rehabil 2006; 87:1141-9. [PMID: 16876562 DOI: 10.1016/j.apmr.2006.04.010] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2005] [Accepted: 04/05/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To investigate whether coupling foot center of pressure (COP)-controlled video games to standing balance exercises will improve dynamic balance control and to determine whether the motivational and challenging aspects of the video games would increase a subject's desire to perform the exercises and complete the rehabilitation process. DESIGN Case study, pre- and postexercise. SETTING University hospital outpatient clinic. PARTICIPANTS A young adult with excised cerebellar tumor, 1 middle-aged adult with single right cerebrovascular accident, and 1 middle-aged adult with traumatic brain injury. INTERVENTION A COP-controlled, video game-based exercise system. MAIN OUTCOME MEASURES The following were calculated during 12 different tasks: the number of falls, range of COP excursion, and COP path length. RESULTS Postexercise, subjects exhibited a lower fall count, decreased COP excursion limits for some tasks, increased practice volume, and increased attention span during training. CONCLUSIONS The COP-controlled video game-based exercise regime motivated subjects to increase their practice volume and attention span during training. This in turn improved subjects' dynamic balance control.
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Affiliation(s)
- Aimee L Betker
- Department of Electrical and Computer Engineering, University of Manitoba, Winnipeg, MB, Canada
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Augmenting the Reality of Phantom Limbs: Three Case Studies Using an Augmented Mirror Box Procedure. ACTA ACUST UNITED AC 2006. [DOI: 10.1097/00008526-200607000-00005] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wang P, Kreutzer IA, Bjärnemo R, Davies RC. A Web-based cost-effective training tool with possible application to brain injury rehabilitation. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2004; 74:235-243. [PMID: 15135574 DOI: 10.1016/j.cmpb.2003.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2003] [Revised: 08/08/2003] [Accepted: 08/08/2003] [Indexed: 05/24/2023]
Abstract
Virtual reality (VR) has provoked enormous interest in the medical community. In particular, VR offers therapists new approaches for improving rehabilitation effects. However, most of these VR assistant tools are not very portable, extensible or economical. Due to the vast amount of 3D data, they are not suitable for Internet transfer. Furthermore, in order to run these VR systems smoothly, special hardware devices are needed. As a result, existing VR assistant tools tend to be available in hospitals but not in patients' homes. To overcome these disadvantages, as a case study, this paper proposes a Web-based Virtual Ticket Machine, called WBVTM, using VRML [VRML Consortium, The Virtual Reality Modeling Language: International Standard ISO/IEC DIS 14772-1, 1997, available at ], Java and EAI (External Authoring Interface) [Silicon Graphics, Inc., The External Authoring Interface (EAI), available at ], to help people with acquired brain injury (ABI) to relearn basic living skills at home at a low cost. As these technologies are open standard and feature usability on the Internet, WBVTM achieves the goals of portability, easy accessibility and cost-effectiveness.
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Affiliation(s)
- Peijun Wang
- Department of Design Sciences, Division of Machine Design, Lund University, Lund, Sweden
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Weiss PLT, Naveh Y, Katz N. Design and testing of a virtual environment to train stroke patients with unilateral spatial neglect to cross a street safely. Occup Ther Int 2004; 10:39-55. [PMID: 12830318 DOI: 10.1002/oti.176] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Virtual reality (VR) entails the use of advanced technologies, including computers and various multimedia peripherals, to produce a simulated (that is, virtual) environment that users perceive as comparable to real world objects and events. In recent years, virtual reality technologies have begun to be used as an assessment and treatment tool in occupational therapy, in part because of the ability to create environments that provide patients with opportunities to engage in meaningful, purposeful tasks that are related to real-life interests and activities. The objective of this study was to determine the suitability and feasibility of using a PC-based, non-immersive, VR system (that is, a system in which the user has a reduced sense of actual presence in and control over the simulated environment) for training individuals with unilateral spatial neglect to cross streets in a safe and vigilant manner. A virtual environment, consisting of a typical city street, was programmed using Superscape's 3D-Webmaster, a 3D web-authoring tool. Twelve subjects, aged 55 to 75 years, participated in the initial feasibility study and, to date, a further eight subjects have participated in the intervention study. Six of the initial subjects and all eight of the intervention subjects had sustained a right hemispheric stroke at least 6 weeks prior to the study. The remaining subjects were healthy age-matched adults who were independently mobile and had no difficulty in crossing streets. The results show that this virtual environment was suitable in both its cognitive and motor demands for the targeted population and indicate that the virtual reality training is likely to prove beneficial to people who have difficulty with crossing streets. The generalizability of these results, and recommendations regarding the use of virtual reality as an occupational therapy intervention, must be substantiated by further studies using a range of VR platforms with people with different cognitive and motor disabilities.
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Affiliation(s)
- Patrice L Tamar Weiss
- Department of Occupational Therapy, Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel.
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Lee JH, Ku J, Cho W, Hahn WY, Kim IY, Lee SM, Kang Y, Kim DY, Yu T, Wiederhold BK, Wiederhold MD, Kim SI. A virtual reality system for the assessment and rehabilitation of the activities of daily living. ACTA ACUST UNITED AC 2004; 6:383-8. [PMID: 14511450 DOI: 10.1089/109493103322278763] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Successful rehabilitation with respect to the activities of daily living (ADL) requires accurate and effective assessment and training. A number of studies have emphasized the requirement for rehabilitation methods that are both relevant to the patient's real world environment, and that can also be transferred to other daily living tasks. Virtual reality (VR) has many advantages over other ADL rehabilitation techniques, and offers the potential to develop a human performance testing and training environment. Therefore, in this study, the virtual supermarket was developed and the possibility of using a VR system to assess and train cognitive ability in ADL investigated. This study demonstrates that VR technology offers great promise in the field of ADL training.
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Affiliation(s)
- Jang Han Lee
- Department of Biomedical Engineering, College of Medicine, Hanyang University, Sungdong PO Box 55, Seoul 133-605, Korea
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Lo Priore C, Castelnuovo G, Liccione D, Liccione D. Experience with V-STORE: considerations on presence in virtual environments for effective neuropsychological rehabilitation of executive functions. CYBERPSYCHOLOGY & BEHAVIOR : THE IMPACT OF THE INTERNET, MULTIMEDIA AND VIRTUAL REALITY ON BEHAVIOR AND SOCIETY 2003; 6:281-7. [PMID: 12855084 DOI: 10.1089/109493103322011579] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The paper discusses the use of immersive virtual reality systems for the cognitive rehabilitation of dysexecutive syndrome, usually caused by prefrontal brain injuries. With respect to classical P&P and flat-screen computer rehabilitative tools, IVR systems might prove capable of evoking a more intense and compelling sense of presence, thanks to the highly naturalistic subject-environment interaction allowed. Within a constructivist framework applied to holistic rehabilitation, we suggest that this difference might enhance the ecological validity of cognitive training, partly overcoming the implicit limits of a lab setting, which seem to affect non-immersive procedures especially when applied to dysexecutive symptoms. We tested presence in a pilot study applied to a new VR-based rehabilitation tool for executive functions, V-Store; it allows patients to explore a virtual environment where they solve six series of tasks, ordered for complexity and designed to stimulate executive functions, programming, categorical abstraction, short-term memory and attention. We compared sense of presence experienced by unskilled normal subjects, randomly assigned to immersive or non-immersive (flat screen) sessions of V-Store, through four different indexes: self-report questionnaire, psychophysiological (GSR, skin conductance), neuropsychological (incidental recall memory test related to auditory information coming from the "real" environment) and count of breaks in presence (BIPs). Preliminary results show in the immersive group a significantly higher GSR response during tasks; neuropsychological data (fewer recalled elements from "reality") and less BIPs only show a congruent but yet non-significant advantage for the immersive condition; no differences were evident from the self-report questionnaire. A larger experimental group is currently under examination to evaluate significance of these data, which also might prove interesting with respect to the question of objective-subjective measures of presence.
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Affiliation(s)
- Corrado Lo Priore
- Servizio di Neuropsicologia, Centro di Riabilitazione Paolo VI, Casalnoceto AL, Italy.
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