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Correspondence:
Geneviève Forest
Université du Québec en Outaouais
Gatineau, Canada
E-mail: genevieve.forest@uqo.ca
Evidence for a relationship between rapid eye
movement (REM) sleep and memory has been
found in a large number of studies over the past 30
years. These studies have used learning tasks
such as declarative (paired associated, learning
stories, word recognition) and non declarative
(words priming, procedural learning) memory tests.
Results have shown that REM sleep deprivation
impairs learning on some of these tasks. These
studies also showed increased period of REM
sleep following intensive learning sessions, more
particularly when the material is complex and emo-
tionally charged (stories, films, etc.). Learning also
occurs during the cognitive-behavior therapy (CBT)
of phobias. Indeed, CBT involves the processing of
emotionally charged information in order to learn
new associations between the threatening stimuli
and their consequences. In addition, the person
learns how to control the anxiety elicited by the
feared object. The present case study aims at veri-
fying if exposure to the threatening stimuli, which is
task oriented towards a more emotional learning
than cognitive restructuring, also solicit REM sleep
mechanisms. The sleep of a man suffering from
aviophobia was recorded for four consecutive
nights. EEG (C3, C4, O1, O2), EMG (sub-mental),
and EOG were recorded and scored according to
the standard method using 20 second epochs.
The first night was an adaptation night used to rule
out sleep disorders such as sleep apnea, periodic
limb movement during sleep, or bruxism. The sec-
ond night was the baseline night. On the third day,
the subject underwent an intensive CBT using vir-
tual reality exposure (total duration of three hours
of cybertherapy). Consequently, the third night of
recording was the experimental night. The fourth
night was a follow-up night. The subject had an ad-
ditional three hours of cybertherapy on the fifth day.
Clinical observations as well as questionnaires ad-
ministrated before and after CBT confirm the suc-
cess of the therapy. Sleep recordings showed that
REM sleep significantly increases after CBT, but
not the night immediately following the therapy ses-
sion. Indeed, REM sleep percentages were 21.49%
for the baseline night, 21.27% for the experimental
night, and 31.49% for the follow-up night. These re-
sults suggest first that REM sleep seems to be in-
volved in the consolidation of psychological and
emotionally charged information. Moreover, these
results suggest that there may be a delay in this
particular consolidation process. This is in accor-
dance with the concept of “REM sleep windows,”
which suggests that REM sleep window is “a time
after acquisition when there are increases in REM
sleep over normal levels,” and that these windows
vary “with the strain and type of learning task and
the number of trials per session”. More subjects are
needed to validate these results.
Mental Training with Virtual Reality in Post-
Stroke Rehabilitation: A Progress Report
Andrea Gaggioli, Francesca Morganti,
Andrea Meneghini, Mariano Alcaniz, and
Giuseppe Riva
Correspondence:
Andrea Gaggioli
Applied Technology for Neuro-Psychology Lab
Istituto Auxologico Italiano
Department of Psychology
Catholic University
Milan, Italy
E-mail: andrea.gaggioli@auxologico.it
Mental practice (MP) with motor imagery (MI) is a
training method consisting in mentally simulating a
movement, with the goal of improving performance.
In recent years, several authors have proposed MP
with MI as a potentially valuable technique for pro-
moting functional regain in people suffering from
post-stroke hemiplegia. The benefit of mental prac-
tice would be to repetitively activate cerebral and
cerebellar sensorimotor structures damaged by a
stroke, thereby engaging compensatory networks
to promote motor rehabilitation. However, mentally
simulating a movement can be a demanding task,
especially for brain-injured individuals. This article
reports progress of a research project that is evalu-
ating the use of computerized technology to guide
mental practice in the rehabilitation of upper-limb
hemiparesis after stroke. The experimental protocol
includes two phases, each during 4 weeks. During
the first month of intervention, the patient under-
goes three computer-enhanced mental practice
sessions per week at the rehabilitation center,
using a custom-made virtual reality (VR) system
called “VR mirror.” The system allows to record mo-
tions of the non-affected arm, and present these vi-
sually as if performed by the affected arm. In
particular, training procedure with VR mirror con-
sists of the following steps. First, the therapist
shows the patient how to perform the exercise with
the healthy arm. When the patient then performs
the task, the movement is registered by tracking
sensors positioned on the patient’s forearm and
wrist. Then, a 3D reconstruction of the movement
acquired by sensors is superimposed over the (un-
seen) paretic limb. After watching the virtual limb on
ABSTRACTS FROM CYBERTHERAPY 2006 673
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the screen, the patient is asked to mentally re-
hearse the movement he has just observed, taking
a first-person perspective (imagery response times
are collected). Last, the patient has to perform the
movement with the affected arm. During physical
execution, the system tracks the movement again,
and measures its deviation from the movement per-
formed with the nonparetic arm. Using this mea-
surement, which is done in real time, the system
provides the patient with audiovisual feedback de-
scribing performance on the task. The procedure
described above is repeated five times within each
practice session, for each targeted exercise (flex-
ion-extension of the wrist; intra-extra rotation of the
forearm; flexion-extension of the elbow). At the end
of the laboratory training phase, the patient used a
portable display device to practice at home. The
portable display stores a sequence of movies de-
picting these motor exercises. After viewing these
movies, the patient is asked to take a first person
perspective, and to imagine executing the move-
ments with the impaired arm. This sequence is per-
formed three times a week, for four consecutive
weeks. Pretreatment and post-treatment measures
include the Fugl-Meyer Assessment of Sensorimo-
tor Impairment, and the Action Research Arm Test
(ARA). Performance on the specific tasks is also
evaluated through response times and sensors
data.
Flow in Real and Virtual Environments
Andrea Gaggioli
Correspondence:
Andrea Gaggioli
Applied Technology for Neuro-Psychology Lab
Istituto Auxologico Italiano
Department of Psychology
Catholic University
Milan, Italy
E-mail: andrea.gaggioli@auxologico.it
So far, virtual reality (VR) experience has been
mainly investigated from the perspective of pres-
ence, broadly defined as the feeling of “being there”
in a mediated environment. Typically, this research
has been conducted in laboratory settings to as-
sess how the manipulation of specific system vari-
ables (such as the perceptual fidelity of the
displays, the ease of interaction, the length of expo-
sure to the virtual environment, and several others)
affects the “feeling of reality” perceived by partici-
pants, as measured through self-report question-
naires and psycho-physiological responses. In this
article, we introduce an alternative theoretical and
methodological approach, which aims to compare
the experience profile associated with “virtual” and
“real-life” activities, focusing on its cognitive, affec-
tive, and motivational components. In particular, our
goal was to assess whether the use of VR is asso-
ciated with flow, an optimal experience character-
ized by the perception of high environmental
challenges matched with adequate personal skills,
high concentration, enjoyment, engagement, loss
of self-consciousness, focused attention, and intrin-
sic motivation. Forty-two students (27 females and
15 males), aged 19–24 years (M = 21.0, SD = 1.4)
volunteered to participate in the study. Quality of
experience associated with real and virtual activi-
ties was assessed by means of the experience
sampling method, a procedure based on repeated
on-line assessments of the external situation and
personal states of consciousness, as real daily
events and situations occur. ESM taps how people
daily invest their attention and resources, what they
do, what they think of, and how patterns in subjec-
tive experience relate to life conditions. Each partic-
ipant received a booklet of self-report forms and an
electronic pager that emitted a beeping sound at
random intervals. The participants carried the
questionnaires and pager during all the hours of the
week they were tested, receiving five to eight sig-
nals a day during waking hours. When the pager
beeped, the participants were to fill out a report.
The week of observation included two VR sessions
in non-consecutive days at the Psychology Labora-
tory. For data analysis, experiential variables were
aggregated into four dimensions: mood, engagement,
confidence, and intrinsic motivation. Flow was iden-
tified on the basis of (a) perceived balance between
opportunities for action (challenges) and personal
skills, and (b) significantly positive values of all the
experiential dimensions. Results showed that VE
use was a high challenging activity that participants
often associated with optimal experience (22% of
self-reports). Reading, television, and the use of
other media, used both in the context of both learn-
ing and leisure activities were associated to optimal
experience in lower percentages (respectively, 15%,
8%, and 19% of self-reports). Implications of these
findings for VR research and practice are discussed.
Pilot Study of Enforced Collaboration During
Computerized Storytelling to Enhance Social
Communication of Children with High-
Functioning Autism
E. Gal, D. Goren-Bar, N. Bauminger, O. Stock, and
P. L. T. Weiss
Correspondence:
E. Gal
LIRT
674 ABSTRACTS FROM CYBERTHERAPY 2006
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