Search Results (160)

The formation mechanism of Virtual Reality (VR) Immersive Experience (VRIE) is notably complex; this study aimed to dynamically decode its underlying drivers by innovatively integrating Flow Theory and Privacy Calculus Theory, focusing on Perceptual-Interactive Fidelity (PIF), Consumer Willingness to Immerse in Technology (CWTI), and the applicability of Loss Aversion Theory. To achieve this, we analyzed approximately 30,000 user reviews from Amazon using Latent Semantic Analysis (LSA) and regression analysis. The findings reveal that user attention’s impact on VRIE is non-linear, suggesting an optimal threshold, and confirm PIF as a central influencing mechanism; furthermore, CWTI significantly moderates users’ privacy calculus, thereby affecting VRIE, while Loss Aversion Theory showed limited explanatory power in the VR context. These results provide a deeper understanding of VR user behavior, offering significant theoretical guidance and practical implications for future VR system design, particularly in strategically balancing user cognition, PIF, privacy concerns, and individual willingness. Full article

Background/Objectives: Dental anxiety in children is a common issue that can hinder the delivery of effective dental care. Traditional approaches to managing this are often insufficient or involve pharmacological interventions. This study shows the potential of virtual reality (VR) to aid in reducing anxiety in children undergoing simple dental procedures. By immersing children in relaxing VR environments (such as beaches, forests, mountains, or underwater scenes with calm music), the objective is to assess VR’s effectiveness in calming pediatrics patients during these procedures. Methods: Children scheduled for minor dental treatments wore a wearable device that monitored pulse, perspiration, and stress levels. Each child’s baseline data was collected without the VR headset, followed by data collection during VR exposure before and during dental procedures. VR scenarios ranged from soothing nature scenes to animated cartoons, designed to foster relaxation. Results: The data collected showed a reduction in physiological indicators of stress, such as lower heart rate and reduced perspiration, when the VR headset was used. Children appeared more relaxed, with a calmer response during the procedure itself, compared to baseline levels without VR. Conclusions: This study provides preliminary evidence supporting VR as an effective tool for reducing anxiety and stress in pediatric dental patients. By offering an engaging, immersive experience, VR can serve as an alternative or complementary approach to traditional anxiety management strategies in pediatric dentistry, potentially improving patient comfort and cooperation during dental procedures. Further research could determine if VR may serve as an alternative to local anesthesia for non-intrusive pediatric dental procedures. Full article

Background: Prevention and clinical management of musculoskeletal injuries have historically focused on the assessment and training of modifiable physical factors, but perceptual decision-making has only recently been recognized as a potentially important capability. Immersive virtual reality (VR) systems can measure the speed, accuracy, and consistency of body movements corresponding to stimulus–response instructions for the completion of a forced-choice task. Methods: A cohort of 26 female college soccer players (age 19.5 ± 1.3 years) included 10 players who participated in a baseline assessment, 10 perceptual-response training (PRT) sessions, a post-training assessment that preceded the first soccer practice, and a post-season assessment. The remaining 16 players completed an assessment prior to the team’s first pre-season practice session, and a post-season assessment. The assessments and training sessions involved left- or right-directed neck rotation, arm reach, and step-lunge reactions to 40 presentations of different types of horizontally moving visual stimuli. The PRT program included 4 levels of difficulty created by changes in initial stimulus location, addition of distractor stimuli, and increased movement speed, with ≥90% response accuracy used as the criterion for training progression. Perceptual latency (PL) was defined as the time elapsed from stimulus appearance to initiation of neck rotation toward a peripheral virtual target. The speed–accuracy tradeoff was represented by Rate Correct per Second (RCS) of PL, and inconsistency across trials derived from their standard deviation for PL was represented by intra-individual variability (IIV). Perceptual Decision Efficiency (PDE) represented the ratio of RCS to IIV, which provided a single value representing speed, accuracy, and consistency. Statistical procedures included the bivariate correlation between RCS and IIV, dependent t-test comparisons of pre- and post-training metrics, repeated measures analysis of variance for group X session pre- to post-season comparisons, receiver operating characteristic analysis, and Kaplan–Meier time to injury event analysis. Results: Statistically significant (p < 0.05) results were found for pre- to post-training change, and pre-season to post-season group differences, for RCS, IIV, and PDE. An inverse logarithmic relationship was found between RCS and IIV (Spearman’s Rho = −0.795). The best discriminator between injured and non-injured statuses was PDE ≤ 21.6 (93% Sensitivity; 42% Specificity; OR = 9.29). Conclusions: The 10-session PRT program produced significant improvement in perceptual decision-making that appears to provide a transfer benefit, as the PDE metric provided good prospective prediction of musculoskeletal injury. Full article

Background: Serious videogames have already demonstrated their positive impact on rehabilitation and of particular interest is the virtual reality (VR) technology. This immersive technology has been used in this study to create a neuroaesthetic experience based on the Michelangelo effect for the rehabilitation of patients with spinal cord injury. The aim of this study was to test the usability of a system for virtual art therapy and its capacity to assess patients’ deficits performances. Methods: A VR headset was worn by the participants who experienced a painting simulation of famous artworks (artistic stimuli) against a coloring canvas (non-artistic stimuli). The trajectories of the hand were studied to obtain different kinematic and spectral parameters to evaluate the user performances. A total of 13 healthy subjects and 13 patients with spinal cord injury participated in this study. Results: Significative differences were obtained for most of the parameters between the two groups, except for the normalized jerk and energy of the spectrum. Analysis in the frequency domain showed that both groups preferred horizontal movements for painting the canvas. The NASA and USEQ scores reported a comfortable and user-friendly system according to the patients’ point of view. Conclusions: The system can be a usable tool, the rehabilitative efficacy of which should be tested in patients with spinal cord injury. The kinematic and spectral parameters would allow for the evaluation of the performances alongside the clinical scales, distinguish pathological and physiological performances. Full article

Virtual reality (VR) technologies have gained increasing attention in the field of physical rehabilitation due to their potential to enhance patient engagement and provide adaptive, feedback-rich environments. In this study, we report on the development and preliminary evaluation of a VR-based rehabilitation application aimed at improving upper extremity function, including muscle strength, endurance, and joint mobility. The application delivers a structured set of interactive exercises designed to support recovery through engaging, gamified tasks with real-time performance feedback and scalable difficulty levels. A pilot usability study was conducted with a cohort of target users to assess the system’s practicality, therapeutic relevance, and user satisfaction. Qualitative data were collected to evaluate usability, effectiveness, and areas for further improvement. Preliminary results suggest that the VR application is usable, accessible, and well-received by users, with high levels of engagement reported throughout the intervention. Participants also provided constructive feedback, emphasizing the potential benefits of incorporating enhanced sensory feedback mechanisms to improve immersion and therapeutic impact. These initial findings support the viability of VR-based rehabilitation tools and provide a foundation for future clinical studies aimed at validating their efficacy in diverse patient populations. Full article

Background and Objectives: Osteoarthritis (OA) of the knee and hip is a major cause of pain and functional impairment. This study evaluated the effects of non-immersive virtual reality (NIVR) combined with conventional physical therapy (CPT) on pain intensity, mechanical hyperalgesia, and perceived recovery in older adults with OA. Materials and Methods: Sixty older adults with mild-to-moderate knee or hip OA were randomly assigned to a NIVR group (NIVR-G; n = 30) or a CPT group (CPT-G; n = 30). Both groups completed 30 sessions over 10 weeks (3 sessions/week). The NIVR-G performed 20 minutes of exergames integrated into CPT. Pain intensity was assessed using the Visual Analog Scale (VAS), and mechanical hyperalgesia was evaluated through pressure pain thresholds (PPTs). Secondary outcomes included the Global Rating of Change (GRoC) and the minimal clinically important difference (MCID) for the VAS. This study is a secondary analysis of a randomized controlled trial registered at ClinicalTrials.gov (ID: NCT05839262). Results: The NIVR-G demonstrated significant reductions in pain intensity after 30 sessions (p < 0.05, d = 1.50), with greater improvements compared to the CPT-G (p < 0.05, d = 1.17). The MCID for the VAS was established at 9.2 mm, with a higher proportion of responders in the NIVR-G (p < 0.05). The NIVR-G also reported superior recovery perception on the GRoC scale (p < 0.05). No significant changes in PPTs were observed in either group. However, the improvements in the NIVR-G diminished four weeks post-intervention. Conclusions: NIVR exergames combined with CPT significantly reduced pain intensity, improved perceived recovery, and resulted in a higher proportion of responders compared to CPT alone. These findings support the use of NIVR as an effective adjunct to CPT in older adults with OA; however, further research is needed to optimize its long-term benefits. Full article

In recent years, Virtual Reality (VR) has emerged as a powerful tool for disseminating Cultural Heritage (CH), often incorporating Virtual Humans (VHs) to guide users through historical recreations. The advent of Large Language Models (LLMs) now enables natural, unscripted communication with these VHs, even on limited devices. This paper details a natural interaction system for VHs within a VR application of San Cristóbal de La Laguna, a UNESCO World Heritage Site. Our system integrates Speech-to-Text, LLM-based dialogue generation, and Text-to-Speech synthesis. Adhering to user-centered design (UCD) principles, we conducted two studies: a preliminary study revealing user interest in historically adapted language, and a qualitative test that identified key user experience improvements, such as incorporating feedback mechanisms and gender selection for VHs. The project successfully developed a prioritized user experience, focusing on usability evaluation, immersion, and dialogue quality. We propose a generalist methodology and recommendations for integrating unscripted VH dialogue in VR. However, limitations include dialogue generation latency and reduced quality in non-English languages. While a formative usability test evaluated the process, the small sample size restricts broad generalizations about user behavior. Full article

Aims: Cue exposure therapy (CET) is a promising treatment approach for cocaine substance use disorder (SUD). CET specifically targets the psychological and physiological responses elicited by drug-related cues, aiming to reduce their motivational impact. To advance understanding of CET for cocaine treatment, this systematic review aims to categorise the range of cocaine cues used in research. Methods: A systematic review of the existing literature with searches conducted on PubMed and Web of Science bibliographic databases with no time constraints in August 2024 (PROSPERO: CRD42024554361). Three reviewers were independently involved in the screening, review and data extraction process, in line with PRISMA guidelines. Data extracted included participant demographics, study design, data on the cocaine cue task, and examples (if provided). Each study was appraised and received a quality score. The secondary outcome was to summarise examples for each category type identified. The data are presented as a narrative synthesis. Results: 3600 articles were identified and screened. 235 articles were included in the analysis. Cues identified included images, paraphernalia, drug-related words, cocaine smell, auditory stimuli presented via audiotapes, video recordings, scripts, and virtual reality environments, often combining multiple modalities. Included studies recruited cocaine-dependent individuals, recreational users, polydrug users, and non-cocaine-using controls. The sample sizes of the studies ranged from a single case study to a study including 1974 participants. Conclusions: This review found that studies employed a wide range of cue categories, but detailed examples were often lacking, limiting replication. The number and combination of cues varied: some studies used only cocaine-related images, while others included images, videos, physical items, and audiotapes. The level of immersion and personalisation also differed considerably. All studies used cocaine-specific cues, most commonly images or representations of cocaine substance, cocaine use or drug paraphernalia, drug preparation items, or conversations of cocaine use and its effects. The overall quality of the included studies was deemed good, with all adhering to standard research norms. While this review highlights the breath of cue types used in the literature, further research should focus on enhancing cue exposure techniques by incorporating more immersive and personalised stimuli, and by providing clearer documentation of cue characteristics to support replication and clinical translation. Full article

This paper explores the evolving relationship between Digital Twins (DT) and the Metaverse, two foundational yet often conflated digital paradigms in digital architecture. While DTs function as mirrored models of real-world systems—integrating IoT, BIM, and real-time analytics to support decision-making—Metaverses are typically fictional, immersive, multi-user environments shaped by social, cultural, and speculative narratives. Through several research projects, the team investigate the divergence between DTs and Metaverses through the lens of their purpose, data structure, immersion, and interactivity, while highlighting areas of convergence driven by emerging technologies in Artificial Intelligence (AI) and Extended Reality (XR).This study aims to investigate the convergence of DTs and the Metaverse in digital architecture, examining how emerging technologies—such as AI, XR, and Large Language Models (LLMs)—are blurring their traditional boundaries. By analyzing their divergent purposes, data structures, and interactivity modes, as well as hybrid applications (e.g., data-integrated virtual environments and AI-driven collaboration), this study seeks to define the opportunities and challenges of this integration for architectural design, decision-making, and immersive user experiences. Our research spans multiple projects utilizing XR and AI to develop DT and the Metaverse. The team assess the capabilities of AI in DT environments, such as reality capture and smart building management. Concurrently, the team evaluates metaverse platforms for online collaboration and architectural education, focusing on features facilitating multi-user engagement. The paper presents evaluations of various virtual environment development pipelines, comparing traditional BIM+IoT workflows with novel approaches such as Gaussian Splatting and generative AI for content creation. The team further explores the integration of Large Language Models (LLMs) in both domains, such as virtual agents or LLM-powered Non-Player-Controlled Characters (NPC), enabling autonomous interaction and enhancing user engagement within spatial environments. Finally, the paper argues that DTs and Metaverse’s once-distinct boundaries are becoming increasingly porous. Hybrid digital spaces—such as virtual buildings with data-integrated twins and immersive, social metaverses—demonstrate this convergence. As digital environments mature, architects are uniquely positioned to shape these dual-purpose ecosystems, leveraging AI, XR, and spatial computing to fuse data-driven models with immersive and user-centered experiences. Full article

This pilot study explores the use of Virtual Reality (VR) to enhance perceived thermal comfort (TC) within educational settings, where physical modifications to classrooms are often limited. As sustainability becomes a priority in building design, VR and Immersive Virtual Environments (IVE) offer an innovative approach to optimizing user comfort without altering physical conditions. This study investigates how VR influences comfort perception through qualitative data collected from semi-structured interviews with four architecture students who attended academic presentations in a VR setting. Thematic analysis identified key factors affecting user experience, including visual satisfaction, physical discomfort, engagement, and perceived shifts in comfort parameters. Results indicate that VR environments featuring natural and calming visual elements can enhance perceived TC by reducing stress and increasing focus. However, challenges such as device discomfort, visual limitations, and distractions from non-task-related virtual elements were also noted. Findings highlight the importance of aligning visual elements with task requirements, optimizing brightness for engagement, and ensuring better connectivity between VR settings and real-world surroundings. As a pilot study, these findings provide preliminary insights into VR’s potential to support user comfort and engagement in student-centered learning environments, particularly in automated climate-controlled spaces with limited user control, laying the groundwork for future research. Full article

Background: Chronic pain affects millions worldwide, influenced by biological, psychological, and social factors. Catastrophizing predicts chronic pain outcomes, increased pain intensity, and worsening recovery. Virtual reality (VR) interventions offer innovative pain management strategies, but their effects on catastrophizing remain unclear. Methods: This systematic review and meta-analysis followed the PRISMA guidelines. Studies involving adults with chronic musculoskeletal pain, VR-based interventions, and randomized controlled trials were included. The primary outcome was pain catastrophizing. Searches were conducted in PubMed, CINAHL, Scopus, WoS, and PEDro until May 2025. The risk of bias was assessed using Cochrane RoB-2. Meta-analysis calculated effect sizes using mean differences (MD) and standardized mean differences (SMD) with fixed and randomized-effects models. Results: Of 306 records, 244 were screened, 19 underwent full-text review, and two additional studies were identified via Google Scholar. Nine studies were included, eight of which were meta-analyzed. The interventions included eight immersive and one non-immersive VR studies, lasting 3 to 12 weeks. A small but statistically significant effect was found when comparing VR-based interventions with controls (SMD = −0.26 [−0.48; −0.04]). Psycho-cognitive VR-based interventions had a significant effect (SMD = −0.32 [−0.56; −0.09]), while exercise-based VR did not (MD = −0.11 [−4.36; 4.14]). Immersive VR showed a small but significant effect when compared to non-intervention or sham controls (SMD = −0.37 [−0.75; −0.00]). However, when compared to all types of comparators, the effect was not statistically significant (SMD = −0.25 [−0.51 to −0.00]). Heterogeneity was moderate and not significant (p > 0.05). Conclusions: VR-based interventions, particularly immersive with psycho-cognitive approaches, show potential in reducing pain catastrophizing. Future randomized trials are needed to elucidate VR’s efficacy in managing pain catastrophizing. Full article

Background/Objectives: Individuals with chronic stroke often experience various impairments, including poor balance, reduced mobility, limited physical activity, and difficulty performing daily tasks. In the context of the COVID-19 pandemic, telerehabilitation (TR) can overcome the barriers of geographical and physical distancing, time, costs, and travel, as well as the anxiety about contracting COVID-19. In this retrospective case-control study, we aim to evaluate the motor and cognitive effects of balance TR training carried out with a sensor-based non-immersive virtual reality system compared to conventional rehabilitation in chronic stroke patients. Methods: Twenty chronic post-stroke patients underwent evaluation for inclusion in the analysis through an electronic recovery data system. The patients included in the study were divided into two groups with similar medical characteristics and duration of rehabilitation training. However, the groups differed in the type of rehabilitation approach used. The experimental group (EG) received TR with a sensor-based VR device, called VRRS—HomeKit (n. 10). In contrast, the control group (CG) underwent conventional home-based rehabilitation (n. 10). Results: At the end of the training, we observed significant improvements in the EG in the 10-m walking test (10MWT) (p = 0.01), Timed-Up-Go Left (TUG L) (p = 0.01), and Montreal Cognitive Assessment (MoCA) (p = 0.005). Conclusions: In our study, we highlighted the potential role of sensor-based virtual reality TR in chronic stroke patients for improving lower limb function, suggesting that this approach is feasible and not inferior to conventional home-based rehabilitation. Full article

Background and Objectives: Percutaneous cardiovascular interventions (PCIs) have become a cornerstone in the management of cardiovascular diseases. However, patients often experience significant anxiety and pain during these procedures, which can negatively impact their overall experience and clinical outcomes. Virtual reality (VR) is an emerging non-pharmacological intervention designed to alleviate procedural anxiety and pain through immersive distraction techniques. Materials and Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) identified from PubMed, CENTRAL, Scopus, Google Scholar, and Web of Science up to November 2024. Primary outcomes were peri-procedural anxiety and pain; secondary outcomes included vital signs, procedure duration, and safety (e.g., delirium). Continuous data were pooled using a random-effect model and reported as standardized mean differences (SMDs) with 95% confidence intervals (CIs) in Stata MP v.17. Certainty of evidence was assessed using the GRADE approach. Results: Ten RCTs involving 890 patients were included. VR distraction significantly reduced peri-procedural anxiety (SMD: –0.70; 95% CI: –1.15 to –0.26; p < 0.001). However, no significant differences were observed between groups for peri-procedural pain (SMD: –0.64; 95% CI: –1.45 to 0.16; p = 0.12), systolic blood pressure (SMD: –0.31; 95% CI: –1.23 to 0.61; p = 0.50), diastolic blood pressure (SMD: –0.25; 95% CI: –1.07 to 0.56; p = 0.54), heart rate (SMD: –0.44; 95% CI: –0.93 to 0.05; p = 0.08), respiratory rate (SMD: –0.93; 95% CI: –2.18 to 0.31; p = 0.14), or procedure duration (SMD: 0.07; 95% CI: –1.14 to 0.28; p = 0.49). Conclusions: VR significantly ameliorated peri-procedure anxiety in patients undergoing PCIs; however, it had no effect on peri-procedure pain or vital signs. This is based on uncertain evidence from heterogeneous studies, warranting further confirmation through large-scale RCTs. Full article

Introduction: Virtual Reality (VR) training has potential evidence for reducing the risks of falls of older adults with mild cognitive impairment (MCI). There are indications of a positive training effect of a cognitive-motor intervention method to improve the postural balance and cognition for safer walking. This study aimed to evaluate the training effects of VR training for reducing the risks of falls among older adults with mild cognitive impairment (MCI). Methods: An experimental design was employed to evaluate how the participants attended a full-immersive VR Cave Automatic Virtual Environment (CAVE) training program. Fifty-five participants were randomly assigned to the VR group or the control group. The VR group received 16 training sessions over 8–10 weeks, while the control group received a non-VR falls prevention program. The primary outcome assessed any falls after the study, and the secondary outcomes assessed changes in cognition and executive function, walk speed and balance performances, and the psychological factor such as fear of falling relating to the risk factors of fall. Results: The VR group showed significantly greater improvement than the control group in terms of measures of cognitive-motor performance across group and time interaction. However, there were inconsistent results in functional mobility and fall efficacy between the two groups. Conclusion: This study provides promising evidence on the VR CAVE training for reducing the risks of falls among older adults with MCI from Hong Kong. VR technology-based applications are an emerging area in current aged care and rehabilitation services. Full article

Background/Objectives: Virtual reality (VR) is increasingly being explored as a non-pharmacological therapy to enhance the well-being of people with cognitive impairment (PwCI). Studies suggest that VR-based interventions improve mood, reduce apathy, and enhance emotional engagement, making VR a valuable tool for cognitive and emotional support. This scoping review synthesizes evidence on VR-based reminiscence therapy (VRRT) for PwCI. It aims to map existing knowledge, highlight implementation challenges, and offer practical, technical design, and evidence-informed recommendations for clinical integration—building on prior reviews that have touched on these aspects, but placing a stronger and more structured emphasis on real-world applicability and translational insights. This review draws extensively on qualitative findings across the included studies to better capture contextual factors, user experiences, facilitator roles, and barriers to usability. Moreover, unlike previous research, we included only studies involving individuals—either directly or via proxies—with an age-related cognitive impairment, formally diagnosed by a qualified authority. Methods: A systematic search based on the PRISMA-ScR guideline identified 310 studies, of which 11 met the inclusion criteria. These studies assessed the effectiveness and feasibility of immersive VRRT. Research methodologies included longitudinal (n = 2), cross-sectional (n = 2), mixed-methods (n = 4), and randomized controlled trials (n = 3)—with most studies focusing on feasibility—with a cumulative sample size of approximately 287 participants. The quality of the included studies was generally moderate; common limitations included small sample sizes, short intervention periods, and limited control conditions. Results: The findings highlight VRRT’s potential to enhance engagement, emotional well-being, and cognitive function. However, usability challenges and technical limitations persist. While VR offers promising benefits, further research is needed to refine interventions, address personalization barriers, and assess long-term effects. Conclusions: This review underscores the importance of integrating VRRT into care programs and improving accessibility. Future research should enhance methodological rigor to ensure reliable outcomes and maximize VR’s impact on PwCI well-being. The scoping review protocol is registered a priori with the Center for Open Science (OSF) (registration type: OSF Preregistration, data registered: 15 November 2024, associated project: osf.io/r7jha, identifier: DOI 10.17605/OSF.IO/R7JHA). Full article