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Frontal view of the human brain based on H0351.2002 dataset in Allen Brain Atlas. Frontal lobe (yellow), parietal lobe (red), temporal lobe (pink). L, left; R, right.
Source publication
Our access to computer-generated worlds changes the way we feel, how we think, and how we solve problems. In this review, we explore the utility of different types of virtual reality, immersive or non-immersive, for providing controllable, safe environments that enable individual training, neurorehabilitation, or even replacement of lost functions....
Contexts in source publication
Context 1
... frontal lobe is located at the front of the head [56] (Figure 1). In VR applications, it is actively involved in working memory and motor control [69,70]. ...
Citations
... For the older population, VR offers a unique set of benefits that can significantly improve their quality of life. One of the primary advantages is its ability to enhance cognitive function through interactive games and virtual experiences that stimulate the brain (Borghetti et al. 2023;Georgiev et al. 2021;Piech and Czernicki 2021;Sokołowska 2024). These immersive exercises can also improve mobility and strength, helping to maintain physical health and independence Wang 2024). ...
This paper responds to the scholarly call for investigating the role of technology consumption in promoting healthy aging—it aims to identify the public’s beliefs about the potential of virtual reality technology (VR) for the well-being of older adults. The study utilized a big-data methodology and employed machine learning to scrape comments made by social media users on the most popular YouTube videos that discuss older people's use of VR technology. After the data cleaning process, the study was left with 1,917 comments out of 3,952 that were then subject to analysis through thematic, emotion, and sentiment analyses. The findings revealed three themes of the public beliefs: 1) empowerment through technology, generational adaptability, and learning; 2) social and ethical implications of VR for healthy aging; and 3) cognitive and physical engagement. The emotion and sentiment analyses indicated that the general public has a predominantly positive perception of the application of virtual reality technology for older people. In summary, the synthesis of the results from the three analyses suggested that VR has the potential to empower seniors and promote mental and physical activity while also highlighting the importance of maintaining genuine connections and ethical standards.
Keywords. Healthy aging, virtual reality, beliefs and attitudes, technology, macromarketing, big data.
... Mixed reality (MR) is a form of hybrid reality in which the real and virtual elements can interact with one another, thereby granting the user the ability to interact with both real and virtual objects [9]. Extended reality (XR) is a broad term encompassing all immersive technologies, including AR, VR, and MR, as well as future technologies yet to be developed [10]. ...
... VR's immersive and interactive nature provides unique opportunities for enhancing cognitive functions. Research has demonstrated that VR can enhance cognitive performance and promote neuronal plasticity, increasing cortical grey matter volumes and a higher concentration of electroencephalographic beta waves [10]. In the context of neurorehabilitation, VR has been utilized to assist patients with stroke [11] or traumatic brain injury [12] in their recovery process and may even be an essential ingredient for the replacement of lost functions through an appropriate brain-computer interface (BCI) that controls robotic devices [13]. ...
Background/Aims
Older age and cognitive inactivity have been associated with cognitive impairment, which in turn is linked to economic and societal burdens due to the high costs of care, especially for care homes and informal care. Emerging non-pharmacological interventions using new technologies, such as virtual reality (VR) delivered on a head-mounted display (HMD), might offer an alternative to maintain or improve cognition. The study aimed to evaluate the efficacy and safety of a VR-based Digital Therapeutics application for improving cognitive functions among healthy older adults.
Methods
Seventy-two healthy seniors (experimental group N = 35, control group N = 37), aged 65–85 years, were recruited by the Medical University of Lodz (Poland). Participants were randomly allocated to the experimental group (a VR-based cognitive training which consists of a warm-up module and three tasks, including one-back and dual-N-back) or to the control group (a regular VR headset app only showing nature videos). The exercises are performed in different 360-degree natural environments while listening to a preferred music genre and delivered on a head-mounted display (HMD). The 12-week intervention of 12 min was delivered at least three times per week (36 sessions). Compliance and performance were followed through a web-based application. Primary outcomes included attention and working memory (CNS-Vital Signs computerized cognitive battery). Secondary outcomes comprised other cognitive domains. Mixed linear models were constructed to elucidate the difference in pre- and post-intervention measures between the experimental and control groups.
Results
The users performed, on average, 39.8 sessions (range 1–100), and 60% performed more than 36 sessions. The experimental group achieved higher scores in the visual memory module (B = 7.767, p = 0.011) and in the one-back continuous performance test (in terms of correct responses: B = 2.057, p = 0.003 and omission errors: B = -1.950, p = 0.007) than the control group in the post-test assessment. The results were independent of participants’ sex, age, and years of education. The differences in CNS Vital Signs’ global score, working memory, executive function, reaction time, processing speed, simple and complex attention, verbal memory, cognitive flexibility, motor speed, and psychomotor speed were not statistically significant.
Conclusions
VR-based cognitive training may prove to be a valuable, efficacious, and well-received tool in terms of improving visual memory and some aspect of sustainability of attention among healthy older adults. This is a preliminary analysis based on part of the obtained results to that point. Final conclusions will be drawn after the analysis of the target sample size.
Trial registration
Clinicaltrials.gov ID NCT05369897.
... The VR system is categorized under two reflections: immersive and non-immersive. Non-immersive VR comprises a computer screen, where the user is joined to the virtual world with simultaneous communication with the external world ( Georgiev et al., 2021 ;Tejera et al., 2020 ). The utilization of VR in the rehabilitation of cancer patients has received significant attention, particularly in addressing post-surgical symptoms such as pain. ...
... VR engages a patient's visual and auditory processing, and even physical actions, demanding more attention ( Voinescu et al., 2023 ). Besides distraction, VR is also expected to bring about long-term changes in the sensory and motor brain regions, known as neuroplasticity, when used over extended periods ( Georgiev et al., 2021 ). According to clinic staff and clinic nurses' observations when patients utilize VR, they tolerate treatments better ( Atef et al., 2020 ). ...
... This study aimed to investigate the effectiveness of VR training in improving concentration performance and alternating attention. The application of such a training as a strategy for enhancing CF, is consistent with prior research that has investigated the advantages of VR technology in various cognitive areas such as memory, decision-making, and visuospatial abilities, as demonstrated in research by Georgiev et al. 39 , Maggio et al. 40 , and Serweta-Pawlik et al. 38 . The findings from this study offer additional confirmation of the advantages associated with VR cognitive training. ...
... Our study findings align with previous research that has showcased the promising advantages of VR technology in augmenting CF [38][39][40] . Specifically, the experimental group displayed discernible enhancements in both concentration performance and alternating attention metrics. ...
In the dynamic landscape of e-sports, where intense competitive gaming demands high cognitive abilities, concentration performance and alternating attention play a pivotal role. E-sports encompass diverse genres, each requiring specific cognitive functions. Maintaining unwavering focus is crucial, as split-second decisions can determine victory. The study explores the potential of Virtual Reality (VR) training to enhance concentration performance and alternating attention, shedding light on the importance and possibilities of optimizing cognitive abilities for e-athletes. VR training emerges as a promising intervention, offering immersive environments for cognitive exercises. The study investigates the impact of VR training on concentration performance and alternating attention in amateur e-athletes, utilizing standardized tests. A randomized controlled trial with 66 participants reveals significant improvements in the VR training group, highlighting the adaptability and plasticity of cognitive processes. The findings suggest that VR training can enhance concentration abilities, providing valuable insights for e-sports and potentially extending to other fields requiring sustained attention and rapid task-switching. The study underscores the convergence of cognitive psychology, neuroscience, and VR technology, paving the way for innovative training methodologies and advancements in e-sports performance.
... This innovative approach has emerged as an effective and powerful therapeutic tool, facilitating motor learning and offering the potential to significantly improve balance and gait in neurologic patients. Furthermore, when combined with conventional rehabilitation, VR-based rehabilitation can provide additional benefits and enhance the overall treatment experience and outcomes [20]. However, the evidence has not yet resulted in standardized guidelines, probably motivated by insufficient methodological quality and the lack of randomized clinical trials with robust methodological designs [21]. ...
Background and Objectives: This study aimed to examine the responsiveness and concurrent validity of a serious game and its correlation between the use of serious games and upper limbs (UL) performance in Parkinson’s Disease (PD) patients. Materials and Methods: Twenty-four consecutive upper limbs (14 males, 8 females, age: 55–83 years) of PD patients were assessed. The clinical assessment included: the Box and Block test (BBT), Nine-Hole Peg test (9HPT), and sub-scores of the Unified Parkinson’s Disease Rating-Scale Motor section (UPDRS-M) to assess UL disability. Performance scores obtained in two different tests (Ex. A and Ex. B, respectively, the Trolley test and Mushrooms test) based on leap motion (LM) sensors were used to study the correlations with clinical scores. Results: The subjective fatigue experienced during LM tests was measured by the Borg Rating of Perceived Exertion (RPE, 0–10); the BBT and 9HPT showed the highest correlation coefficients with UPDRS-M scores (ICCs: −0.652 and 0.712, p < 0.05). Exercise A (Trolley test) correlated with UPDRS-M (ICC: 0.31, p < 0.05), but not with the 9HPT and BBT tests (ICCs: −0.447 and 0.390, p < 0.05), while Exercise B (Mushroom test) correlated with UPDRS-M (ICC: −0.40, p < 0.05), as did these last two tests (ICCs: −0.225 and 0.272, p < 0.05). The mean RPE during LM tests was 3.4 ± 3.2. The evaluation of upper limb performance is feasible and does not induce relevant fatigue. Conclusions: The analysis of the ICC supports the use of Test B to evaluate UL disability and performance in PD patients, while Test A is mostly correlated with disability. Specifically designed serious games on LM can serve as a method of impairment in the PD population.
... Virtual reality (VR) is emerging as a swiftly advancing technology, garnering recent popularity as a promising support tool for neurorehabilitation among individuals with ABI [10][11][12][13]. Using VR in rehabilitation represents a versatile, captivating, and multifaceted approach capable of addressing patients' sensorimotor and cognitive capacities, thereby eliciting positive responses. ...
... Consequently, users can engage in a realistic virtual environment, interacting with intuitive gestures that mimic their real-world movements. This immersive experience often leads to a profound sense of presence and may even induce a phenomenon referred to as "virtual embodiment" [11,20]. ...
Background
Acquired brain injury (ABI) is a prominent cause of disability globally, with virtual reality (VR) emerging as a promising aid in neurorehabilitation. Nonetheless, the diversity among VR interventions can result in inconsistent outcomes and pose challenges in determining efficacy. Recent reviews offer best practice recommendations for designing and implementing therapeutic VR interventions to evaluate the acceptance of fully immersive VR interventions.
Objective
This study aims to evaluate the usability and feasibility of a co-designed VR-based neurorehabilitation support tool by conducting multiple proof-of-concept trials in a sample of patients with ABI within a hospital setting.
Methods
A single session deploying custom immersive serious games to train cognitive functions using a new-generation head-mounted display was conducted among a sample of inpatients with ABI. Structured questionnaires were administered at the end of the session to evaluate the usability of the system and the intervention, participants’ familiarity with the technology, and any adverse effects related to cybersickness. Additionally, the training duration while wearing the headset and the demographic characteristics of the participants were considered.
Results
A total of 20 patients with ABI participated in a 1-hour proof-of-concept trial. The mean usability score was 37 (SD 2.6) out of 40, the technology familiarity level was 9.2 (SD 2.9) out of 12, and the Simulator Sickness Questionnaire total score was 1.3 (SD 2). On average, participants wore the headset for approximately 25.6 (SD 4.7) minutes during the intervention. There were no substantial differences in usability and technology familiarity levels based on patients’ etiology or age, with no notable symptoms of cybersickness reported. Significantly strong correlations were noted between cybersickness symptoms and various usability categories, including exposure, motivation, interactivity, task specificity, and immersion aspects. Further, there was a significant association between the intervention time and the number of tasks performed (P<.001). Furthermore, patients who derived enjoyment from VR sessions expressed a heightened interest in incorporating VR into their daily neurorehabilitation practice (P<.001). Moreover, oculomotor issues were found to be highly sensitive to the onset of disorientation sickness symptoms (P<.001).
Conclusions
Through a collaborative approach, this study showcases the usability and feasibility of a VR-based support tool for cognitive rehabilitation among inpatients with ABI. Key components of such interventions encompass a multidisciplinary array of immersive experiences integrating neurorehabilitation principles and serious games techniques.
... Numerous rehabilitation AI-powered technologies have been proposed in pediatric neurorehabilitation, including virtual reality and intelligent games [8,9]. AI has even been used to power-optimize the mechanical designs of neurorehabilitation robotics [10]. ...
... The literature review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, which is described in length in [11]. Eligibility criteria included published manuscripts that were written in English, published between 2016 and 2022 (older references were used only to highlight specific topics such as deep learning and the importance of neurorehabilitation), and that reported the use of (1) artificial emotional intelligence, (2) interactive reinforcement learning, (3) probabilistic models, (4) policy learning, (5) natural language processing, (6) facial expression analysis, (7) real-time learning for adaptive behavior, (8) classifiers, (9) learning by demonstration, (10) unbiased AI, (11) explainable AI, and (12) interpretable AI for (1) social interaction, (2) rehabilitation outcome prediction and Figure 1. The ecosystem of AI-driven robotic neurorehabilitation. ...
... The literature review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, which is described in length in [11]. Eligibility criteria included published manuscripts that were written in English, published between 2016 and 2022 (older references were used only to highlight specific topics such as deep learning and the importance of neurorehabilitation), and that reported the use of (1) artificial emotional intelligence, (2) interactive reinforcement learning, (3) probabilistic models, (4) policy learning, (5) natural language processing, (6) facial expression analysis, (7) real-time learning for adaptive behavior, (8) classifiers, (9) learning by demonstration, (10) unbiased AI, (11) explainable AI, and (12) interpretable AI for (1) social interaction, (2) rehabilitation outcome prediction and condition assessment, (3) physical therapy, (4) assistive robotics, (5) smart interfaces, (6) cognitive training, and (7) identification of intended behavior. All papers were searched in the fields of (1) engineering, (2) computer science, or (3) medicine. ...
The landscape of neurorehabilitation is undergoing a profound transformation with the integration of artificial intelligence (AI)-driven robotics. This review addresses the pressing need for advancements in pediatric neurorehabilitation and underscores the pivotal role of AI-driven robotics in addressing existing gaps. By leveraging AI technologies, robotic systems can transcend the limitations of preprogrammed guidelines and adapt to individual patient needs, thereby fostering patient-centric care. This review explores recent strides in social and diagnostic robotics, physical therapy, assistive robotics, smart interfaces, and cognitive training within the context of pediatric neurorehabilitation. Furthermore, it examines the impact of emerging AI techniques, including artificial emotional intelligence, interactive reinforcement learning, and natural language processing, on enhancing cooperative neurorehabilitation outcomes. Importantly, the review underscores the imperative of responsible AI deployment and emphasizes the significance of unbiased, explainable, and interpretable models in fostering adaptability and effectiveness in pediatric neurorehabilitation settings. In conclusion, this review provides a comprehensive overview of the evolving landscape of AI-driven robotics in pediatric neurorehabilitation and offers valuable insights for clinicians, researchers, and policymakers.
... In applications in psychotherapy, adaptive VR can already be used to modulate the degree of stress imposed by a virtual scene (e.g. the height or narrowness of a virtual walkway above a pit in exposure therapy for fear of heights) [105]. Similarly, in applications in which modulating the degree of immersion might be important for the rehabilitation outcome, e.g., see Georgiev et al. [106], the proposed model could support close-loop systems to keep the immersion at the intended level, e.g., by sending an appropriate stimuli when a drift of attention away from the induced reality is detected (significant reduction of the angle ϕ a (t)), but perhaps also reducing properties conducive to immersion if the level of anxiety is identified as being too high. ...
Currently, we face an exponentially increasing interest in immersion, especially sensory–driven immersion, mainly due to the rapid development of ideas and business models centered around a digital virtual universe as well as the increasing availability of affordable immersive technologies for education, communication, and entertainment. However, a clear definition of ‘immersion’, in terms of established neurocognitive concepts and measurable properties, remains elusive, slowing research on the human side of immersive interfaces.
To address this problem, we propose a conceptual, taxonomic model of attention in immersion. We argue (a) modeling immersion theoretically as well as studying immersion experimentally requires a detailed characterization of the role of attention in immersion, even though (b) attention, while necessary, cannot be a sufficient condition for defining immersion. Our broader goal is to characterize immersion in terms that will be compatible with established psychophysiological measures that could then in principle be used for the assessment and eventually the optimization of an immersive experience. We start from the perspective that immersion requires the projection of attention to an induced reality, and build on accepted taxonomies of different modes of attention for the development of our two–competitor model. The two–competitor model allows for a quantitative implementation and has an easy graphical interpretation. It helps to highlight the important link between different modes of attention and affect in studying immersion.
... VR applications have been used in the treatment/rehabilitation of orthopedic conditions (such as ankle sprains and shoulder pain and impingement) [19], neurological rehabilitation [20], the general rehabilitation of the upper body, particularly the upper extremities [21,22], Parkinson's disease, Alzheimer's disease, and eating disorders [23]. Many studies show the effectiveness of VR in neurological rehabilitation [24][25][26][27], including post-stroke rehabilitation [15,26,28]. The use of virtual reality in general rehabilitation has many advantages [29]. ...
Stroke is a leading cause of disability among adults in Europe. Complications following stroke include limb paresis and unilateral spatial neglect (USN) syndrome. These complications significantly reduce the patient’s ability to function normally both in the short and long term. The chance to regain function is rehabilitation. One of the techniques in USN’s rehabilitation is repetitive visual scanning training, and the effects of rehabilitation can be enhanced by limb activation, such as moving objects from one side to the other. However, rehabilitation carried out in this way is monotonous, and the assistance of a physiotherapist is necessary. This paper proposes an alternative method of rehabilitation, using virtual reality. The created application contains the most important element that occurs during rehabilitation, which is a movement pattern. At the same time, it diversifies the rehabilitation process and allows rehabilitation without constant contact with a physiotherapist. This paper presents the most important strategies to minimize the occurrence of cybersickness, which were applied in the developed application. The created application was approved by a physician and tested with the participation of five post-stroke patients. The first results were positive. Increased motivation was observed among patients using VR in therapy. Patients noticed an improvement in motor function, as well as a reduction in reaction times. In addition, physiotherapists observed an improvement in the range of motion during virtual reality therapy compared to traditional therapy. This gives hope that the app can be used in clinical practice. However, in order for the app to be incorporated into clinical practice, it is necessary to conduct studies with a larger group of patients.
... VR can induce changes in the morphology and number of neurons, dendrites, synapses, and glial cells by stimulating neurogenesis, synaptogenesis, dendritic arborization, and gliogenesis (Cheung et al., 2014), (Mindy et al., 2015) and (Schiza et al., 2019). Virtual reality has demonstrated neurobiological effects on neuronal plasticity, leading to increased cortical gray matter volumes, elevated concentration of electroencephalographic beta-waves and improved cognitive performance (Georgiev et al., 2021). ...
Brain health is a critical part of well-being because it is a foundation for the ability to communicate, make decisions and solve real-life problems. Virtual reality games involve motor and sensory activities that can help to improve brain connectivity by providing an immersive and interactive experience that engages multiple brain regions simultaneously. Reinforcing sensorimotor activities influences cognitive skills and improves brain health. Sensorimotor play in virtual reality is a relatively new concept that is gaining attention as a tool for promoting brain health and cognitive abilities. It is believed that this type of play can have positive impact on brain health and cognitive function, such as improving memory, enhancing focus, and reducing stress and anxiety. The aims of the current paper are (1) – to present evidence, based on neuro correlates, of the importance of the sensorimotor play to the brain health and (2) – to propose a conceptual model for a personalized VR game design using neurocognitive feedback obtained through Brain-Computer Interface that assesses brain areas during sensorimotor stimulation.
