Search

Study Design: Pilot randomized controlled trial. Purpose: To compare the efficacy between virtual reality intervention (using Nintendo Wii) along with conventional occupational therapy and conventional occupational therapy alone in improving upper limb function in patients with spinal cord injury (SCI). Overview of Literature: The use of virtual reality has gained importance in the rehabilitation sector over the last few years. Nintendo Wii has the potential to encourage upper limb function while engaging in an interesting activity, which is important in long-term interventions, such as the treatment of SCI. Methods: Overall, 22 patients with SCI participated in the study. They were randomly assigned to two groups. Group I received 30 minutes of virtual reality intervention (using Nintendo Wii) and 30 minutes of conventional therapy, whereas group II received conventional therapy only for 30 minutes. Both groups received therapy 3 days a week for 4 weeks. One hand of each patient was identified as the target hand based on the inclusion criteria. All patients were assessed at baseline, 2 weeks and 4 weeks (post-intervention), and 6 weeks (follow-up). The functional ability of the target hand was assessed using the Capabilities of Upper Extremity (CUE) questionnaire. Gross motor dexterity was assessed using the Box and Block Test (BBT). The level of independence in activities of daily living was assessed by the Spinal Cord Independence Measure-Self Report and quality of life by the World Health Organization Quality of Life-BREF. Results: After 4 weeks of intervention, there was no significant difference in improved hand function between the groups. Mean scores were higher for group I than for group II, with a higher percent change (31.5% in CUE questionnaire and 51.7% in BBT) in group I. Conclusions: Virtual reality along with conventional therapy produces similar results in upper limb function as does conventional therapy alone. [ABSTRACT FROM AUTHOR]

Peer support promotes the overall wellness of people with mental illness by establishing mutual partnerships throughout their different stages of recovery. In health research, investments in patient-oriented research have become prioritized. However, peer-contributed research remains relatively rare, especially in the study of psychosis. Our research team chose to include a peer research assistant in the elaboration and refinement of a novel personalized and patient-oriented psychotherapy for voice hearers, using virtual reality (Avatar Therapy (AT)). This paper details the case of a partnership between a mental health service user and clinical researchers by showcasing Mr X, the first to follow the therapy for his input and our peer support worker for future patients, in his journey toward recovery. Before AT, Mr X was unable to advance due to his voices. His participation was to initially gain from his personal expertise and invite his critique to improve AT. However, what he gained from AT was much more; his voices diminished by 80-90% and he was able to reduce his medication on four occasions. Also, he followed a university-level peer helper program and became employed. Mr X is an inspirational case of how AT may have a positive impact on one’s life. [ABSTRACT FROM AUTHOR]

Present evidence suggests that the use of virtual reality has great advantages in evaluating visuospatial navigation and memory for the diagnosis of psychiatric or other neurological disorders. There are a few virtual reality studies on allocentric and egocentric memories in schizophrenia, but studies on both memories in bipolar disorder are lacking. The objective of this study was to compare the performance of allocentric and egocentric memories in patients with schizophrenia and bipolar disorder. For this resolve, an advanced virtual reality navigation task (VRNT) was presented to distinguish the navigational performances of these patients. Twenty subjects with schizophrenia and 20 bipolar disorder patients were compared with 20 healthy-matched controls on the newly developed VRNT consisting of a virtual neighbourhood (allocentric memory) and a virtual maze (egocentric memory). The results demonstrated that schizophrenia patients were significantly impaired on all allocentric, egocentric, visual, and verbal memory tasks compared with patients with bipolar disorder and normal subjects. Dissimilarly, the performance of patients with bipolar disorder was slightly lower than that of control subjects in all these abilities, but no significant differences were observed. It was concluded that allocentric and egocentric navigation deficits are detectable in patients with schizophrenia and bipolar disorder using VRNT, and this task along with RAVLT and ROCFT can be used as a valid clinical tool for distinguishing these patients from normal subjects. [ABSTRACT FROM PUBLISHER]

popularity as an effective treatment for anxiety disorders. The purpose of this article is to determine the applicability of VRET in the treatment of dental phobia of two patients. Two case examples of female dental patients, aged 56 and 24 years, who met the criteria for dental phobia according to the Phobia Checklist, illustrate the use of VRET in the dental setting. VRET that is used as a psychological treatment for dental fear and dental phobia can potentially be given by a non-specialist (for example dental assistant), thereby making it a cost-effective therapy for the treatment of dental phobia. Clinical relevance: This article is the first of its kind to demonstrate Virtual Reality Exposure Therapy (VRET) in the treatment of dental anxiety. [ABSTRACT FROM AUTHOR]

Purpose: To assess the reliability and validity of a hand motion sensor, Leap Motion Controller (LMC), in the 15-s hand grip-and-release test, as compared against human inspection of an external digital camera recording.Methods: Fifty healthy participants were asked to fully grip-and-release their dominant hand as rapidly as possible for two trials with a 10-min rest in-between, while wearing a non-metal wrist splint. Each test lasted for 15 s, and a digital camera was used to film the anterolateral side of the hand on the first test. Three assessors counted the frequency of grip-and-release (G-R) cycles independently and in a blinded fashion. The average mean of the three was compared with that measured by LMC using the Bland-Altman method. Test-retest reliability was examined by comparing the two 15-s tests.Results: The mean number of G-R cycles recorded was: 47.8 ± 6.4 (test 1, video observer); 47.7 ± 6.5 (test 1, LMC); and 50.2 ± 6.5 (test 2, LMC). Bland-Altman indicated good agreement, with a low bias (0.15 cycles) and narrow limits of agreement. The ICC showed high inter-rater agreement and the coefficient of repeatability for the number of cycles was ±5.393, with a mean bias of 3.63.Conclusions: LMC appears to be valid and reliable in the 15-s grip-and-release test. This serves as a first step towards the development of an objective myelopathy assessment device and platform for the assessment of neuromotor hand function in general. Further assessment in a clinical setting and to gauge healthy benchmark values is warranted. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of a virtual reality commercial gaming device, Nintendo wii (NW) with conventional therapy and customary care in facilitating upper limb recovery after stroke. Design: Randomized, controlled, single-blinded study. Setting: Tertiary rehabilitation center. Participants: 105 subjects admitted to in inpatient rehabilitation program within 6 weeks of stroke onset. Interventions: Subjects were randomly assigned to one of three groups of upper limb exercises: (1) NW gaming; (2) conventional therapy; (3) control. NW gaming and conventional therapy were provided fourtimes a week for 3 weeks. Main outcome measure(s): The main outcome measure was Fugl-Meyer assessment (FMA) of upper limb function. Secondary outcome measures included Action Research Arm Test, Functional Independence Measure, and Stroke Impact Scale. These measures were assessed at baseline, completion of intervention (week 3) and at 4 weeks and 8 weeks after completion of intervention. The primary outcome measure was the change in FMA scores at completion of intervention. Results: The mean age was 57.5±9.8 years, and subjects were enrolled at a mean of 13.7±8.9 days after stroke. The mean baseline FMA score was 16.4±14.2. There was no difference in FMA scores between all 3 groups at the end of intervention, and at 4 and 8 weeks after completion of intervention. Similar findings were also noted for the secondary outcome measures. Conclusion(s): Twelve sessions of augmented upper limb exercises via NW gaming or conventional therapy over a 3-week period was not effective in enhancing upper limb motor recovery compared to control. [ABSTRACT FROM AUTHOR]

Virtual reality therapy is already used for anxiety disorders as an alternative to in vivo and in imagino exposure. To our knowledge, however, no one has yet proposed using remote virtual reality (e-virtual reality). The aim of the present study was to assess e-virtual reality in an acrophobic population. Six individuals with acrophobia each underwent six sessions (two sessions per week) of virtual reality exposure therapy. The first three were remote sessions, while the last three were traditional sessions in the physical presence of the therapist. Anxiety (STAI form Y-A, visual analog scale, heart rate), presence, technical difficulties and therapeutic alliance (Working Alliance Inventory) were measured. In order to control the conditions in which these measures were made, all the sessions were conducted in hospital. None of the participants dropped out. The remote sessions were well accepted. None of the participants verbalized reluctance. No major technical problems were reported. None of the sessions were cancelled or interrupted because of software incidents. Measures (anxiety, presence, therapeutic alliance) were comparable across the two conditions. e-Virtual reality can therefore be used to treat acrophobic disorders. However, control studies are needed to assess online feasibility, therapeutic effects and the mechanisms behind online presence. [ABSTRACT FROM AUTHOR]

Postural control is a complex dynamic mechanism, which integrates information from visual, vestibular and somatosensory systems. Idiopathic Parkinson’s disease (IPD) patients are unable to produce appropriate reflexive responses to changing environmental conditions. Still, it is controversial what is due to voluntary or involuntary postural control, even less what is the effect of levodopa. We aimed to evaluate compensatory postural adjustments (CPA), with kinematic and time-frequency analyzes, and further understand the role of dopaminergic medication on these processes. 19 healthy subjects (Controls) and 15 idiopathic Parkinson’s disease (IPD) patients in the OFF and ON medication states, wearing IMUs, were submitted to a virtual reality scenario with visual downward displacements on a staircase. We also hypothesized if CPA would involve mechanisms occurring in distinct time scales. We subsequently analyzed postural adjustments on two frequency bands: low components between 0.3 and 1.5 Hz (LB), and high components between 1.5 and 3.5 Hz (HB). Vertical acceleration demonstrated a greater power for discriminating IPD patients from healthy subjects. Visual perturbation significantly increased the power of the HB in all groups, being particularly more evident in the OFF state. Levodopa significantly increased their basal power taking place on the LB. However, controls and IPD patients in the ON state revealed a similar trend of the control mechanism. Results indicate an improvement in muscular stiffness provided by levodopa. They also suggest the role of different compensatory postural adjustment patterns, with LB being related to inertial properties of the oscillating mass and HB representing reactions to the ongoing visual input-changing scenario. [ABSTRACT FROM AUTHOR]

Background: Brain Injury (BI) has become one of the most common causes of neurological disability in developed countries. Cognitive disorders result in a loss of independence and patients' quality of life. Cognitive rehabilitation aims to promote patients' skills to achieve their highest degree of personal autonomy. New technologies such as virtual reality or interactive video allow developing rehabilitation therapies based on reproducible Activities of Daily Living (ADLs), increasing the ecological validity of the therapy. However, the lack of frameworks to formalize and represent the definition of this kind of therapies can be a barrier for widespread use of interactive virtual environments in clinical routine.Objectives: To provide neuropsychologists with a methodology and an instrument to design and evaluate cognitive rehabilitation therapeutic interventions strategies based on ADLs performed in interactive virtual environments.Methods: The proposed methodology is used to model therapeutic interventions during virtual ADLs considering cognitive deficit, expected abnormal interactions and therapeutic hypotheses. It allows identifying abnormal behavioural patterns and designing interventions strategies in order to achieve errorless-based rehabilitation.Results: An ADL case study ('buying bread') is defined according to the guidelines established by the ADL intervention model. This case study is developed, as a proof of principle, using interactive video technology and is used to assess the feasibility of the proposed methodology in the definition of therapeutic intervention procedures.Conclusions: The proposed methodology provides neuropsychologists with an instrument to design and evaluate ADL-based therapeutic intervention strategies, attending to solve actual limitation of virtual scenarios, to be use for ecological rehabilitation of cognitive deficit in daily clinical practice. The developed case study proves the potential of the methodology to design therapeutic interventions strategies; however our current work is devoted to designing more experiments in order to present more evidence about its values. [ABSTRACT FROM AUTHOR]

This study analyses participants' preferences regarding three computeraided exposure treatments for fear of flying (FF): virtual reality exposure treatment assisted by a therapist (VRET), computer-aided exposure with a therapist present throughout exposure sessions (CAE-T), and self-administered computer-aided exposure (CAE-SA). Sixty participants with FF were randomly assigned to one of these treatments. At the end of a treatment, a demonstration of the other two treatment options was given and patients were asked to rate their preferences. At post-treatment, assessment data on treatment preferences were obtained from 48 participants (CAE-T n= 14; CAE-SA n= 16, and VRET n= 18). Participants favoured VRET as the most effective, the most recommended, but also they valued it as the most aversive. Attending to the specific treatment condition received by the participants, results showed that in VRET and CAE-T, participants assessed their own treatment as more preferred, more efficacious and more recommendable. Results suggest relevant features regarding the efficiency of computer-based treatments, and offer insights into improving computer-aided psychological interventions. [ABSTRACT FROM AUTHOR]

This study aimed to apply virtual body swapping through mental rehearsal for patients with complex regional pain syndrome (CRPS) and to investigate whether it is applicable to them. Ten patients who met the diagnostic criterion for CRPS type 1 were randomly assigned to either the treatment or control group. All participants were asked to watch the virtual body swapping training video clip with a head mounted display. The treatment group was additionally asked to assume a posture similar to the body on the screen and rehearse the movements mentally, as if the body presented on the screen was their body. No difference between the groups was found for pain intensity, however, the treatment group showed significantly more improvement in body perception disturbance (BPD) after the treatment than the control group. Even if the presented study is a preliminary one, the above results suggest that virtual body swapping through mental rehearsal is applicable for patients with CRPS and may be useful for improving BPD. The limitations of the study and the future investigations needed to provide clearer clinical suggestions are presented and discussed. [ABSTRACT FROM AUTHOR]

There is evidence that virtual reality (VR) pain distraction is effective at improving pain-related outcomes. However, more research is needed to investigate VR environments with other pain-related goals. The main aim of this study was to compare the differential effects of two VR environments on a set of pain-related and cognitive variables during a cold pressor experiment. One of these environments aimed to distract attention away from pain (VRD), whereas the other was designed to enhance pain control (VRC). Participants were 77 psychology students, who were randomly assigned to one of the following three conditions during the cold pressor experiment: (a) VRD, (b) VRC, or (c) Non-VR (control condition). Data were collected regarding both pain-related variables (intensity, tolerance, threshold, time perception, and pain sensitivity range) and cognitive variables (self-efficacy and catastrophizing). Results showed that in comparison with the control condition, the VRC intervention significantly increased pain tolerance, the pain sensitivity range, and the degree of time underestimation. It also increased self-efficacy in tolerating pain and led to a reduction in reported helplessness. The VRD intervention significantly increased the pain threshold and pain tolerance in comparison with the control condition, but it did not affect any of the cognitive variables. Overall, the intervention designed to enhance control seems to have a greater effect on the cognitive variables assessed. Although these results need to be replicated in further studies, the findings suggest that the VRC intervention has considerable potential in terms of increasing self-efficacy and modifying the negative thoughts that commonly accompany pain problems. [ABSTRACT FROM AUTHOR]

For daily burn wound care and therapeutic physical therapy skin stretching procedures, powerful pain medications alone are often inadequate. This feasibility study provides the first evidence that entering an immersive virtual environment using very inexpensive (∼$400) wide field of view Oculus Rift Virtual Reality (VR) goggles can elicit a strong illusion of presence and reduce pain during VR. The patient was an 11-year-old male with severe electrical and flash burns on his head, shoulders, arms, and feet (36 percent total body surface area (TBSA), 27 percent TBSA were third-degree burns). He spent one 20-minute occupational therapy session with no VR, one with VR on day 2, and a final session with no VR on day 3. His rating of pain intensity during therapy dropped from severely painful during no VR to moderately painful during VR. Pain unpleasantness dropped from moderately unpleasant during no VR to mildly unpleasant during VR. He reported going 'completely inside the computer generated world', and had more fun during VR. Results are consistent with a growing literature showing reductions in pain during VR. Although case studies are scientifically inconclusive by nature, these preliminary results suggest that the Oculus Rift VR goggles merit more attention as a potential treatment for acute procedural pain of burn patients. Availability of inexpensive but highly immersive VR goggles would significantly improve cost effectiveness and increase dissemination of VR pain distraction, making VR available to many more patients, potentially even at home, for pain control as well as a wide range of other VR therapy applications. This is the first clinical data on PubMed to show the use of Oculus Rift for any medical application. [ABSTRACT FROM AUTHOR]

BACKGROUND: Video-games are becoming a common tool to guide patients through rehabilitation because of their power of motivating and engaging their users. Video-games may also be integrated into an infrastructure that allows patients, discharged from the hospital, to continue intensive rehabilitation at home under remote monitoring by the hospital itself, as suggested by the recently funded Rewire project. OBJECTIVE: Goal of this work is to describe a novel low cost platform, based on video-games, targeted to neglect rehabilitation. METHODS: The patient is guided to explore his neglected hemispace by a set of specifically designed games that ask him to reach targets, with an increasing level of difficulties. Visual and auditory cues helped the patient in the task and are progressively removed. A controlled randomization of scenarios, targets and distractors, a balanced reward system and music played in the background, all contribute to make rehabilitation more attractive, thus enabling intensive prolonged treatment. RESULTS: Results from our first patient, who underwent rehabilitation for half an hour, for five days a week for one month, showed on one side a very positive attitude of the patient towards the platform for the whole period, on the other side a significant improvement was obtained. Importantly, this amelioration was confirmed at a follow up evaluation five months after the last rehabilitation session and generalized to everyday life activities. CONCLUSIONS: Such a system could well be integrated into a home based rehabilitation system. [ABSTRACT FROM AUTHOR]

Abstract: Background: Ability to drive was an important factor of quality of life for subjects with spinal cord injuries (SCI). However, the effect of virtual reality (VR) environment on driving ability and simulation-based driving training of people with SCI has not yet been investigated in any systematic, objective study. The purpose of this study was to examine the effect of the virtual reality created by a driving simulator, and determine the number of simulator sessions necessary for patients with spinal cord injuries to reach maximum driving competence. Methods: This was a longitudinal, prospective before–after trial. It was comprised of 12 spinal cord injury patients who attended driving rehabilitation between July and December 2005. At their initial and subsequent evaluations, the participants’ driving skills were measured as they drove along a simulated 6 km two- and three-lane urban road with traffic signals, overpass, underpass, obstacles, and a number of straight and curved stretches of road. The primary outcome measures consisted of total driving time, average speed, center-line violation, stop-line violation, collisions, and steering/braking stability, with a sampling rate of 16 Hz. Each training session lasted for 30 minutes and was carried out twice a week for about 1.5 months. Results: After 5 sessions of simulator driving training, there was a significant increase in the average speed and/or total driving time. The participants could stop their cars more precisely at the stop-line in traffic signal testing, and there was significantly less speed variation and center line violation in overpass testing. Conclusion: This study shows the significant effect of a virtual environment on the progress of driving rehabilitation, and suggests that incorporating virtual reality into rehabilitation programs will accelerate the maximal recovery of the patient’s driving competence. [Copyright &y& Elsevier]

The linear elastic models of soft tissue are widely used in virtual-reality-based surgery simulation due to their computational efficiency; however, it is well known that these models are only a coarse approximation of the real biological soft tissue. To achieve realistic simulation, the deformable model should incorporate many other tissue properties such as nonlinearity, anisotropy, and viscoelasticity. Among these properties, viscoelasticity is a very important one, and it directly determines the behaviors of the tissue when it is cut, deformed, or torn. In this paper, we proposed to incorporate the property of viscoelasticity into the visual model of soft tissue. One significant advantage of the developed model is its fast computation. Experiments show that the incorporation of nonlinear viscoelasticity makes the simulated tissue look much more realistic than other models, whereas the computation time is increased by only approximately 5% compared with models without the consideration of viscoelasticity. [ABSTRACT FROM AUTHOR]

Abstract: Cyclothialidines are a class of bacterial DNA gyrase B (GyrB) subunit inhibitors, targeting its ATP-binding site. Starting from the available structural information on cyclothialidine GR122222X (2), an in silico virtual screening campaign was designed combining molecular docking calculations with three-dimensional structure-based pharmacophore information. A novel class of 2-amino-4-(2,4-dihydroxyphenyl)thiazole based inhibitors (5–9) with low micromolar antigyrase activity was discovered. [Copyright &y& Elsevier]

Abstract: A structure-based virtual screening survey was used to identify potential inhibitors of the human M14 family of metallocarboxypeptidases. A good correlation between docking energy scores and measured K i values was observed, indicating an efficient performance of the screening procedure. Among various compounds displaying K i values in the low micromolar range, N-(3-chlorophenyl)-4-((5-(3-methoxybenzylthio)-1,3,4-oxadiazol-2-yl)methyl)thiazol-2-amine emerged as the most powerful inhibitor for human carboxypeptidase B (CPB). According to molecular docking, this compound fits into CPB active site cleft through coordination of the catalytic zinc ion with the 1,3,4-oxadiazole moiety. This represents a novel five-membered heterocyclic type of inhibitor for disease-linked metallocarboxypeptidases and an interesting lead for further development. [Copyright &y& Elsevier]

Abstract: Background: Use of virtual reality planning and rehearsal for planning and training of cerebral aneurysm clipping was recently reported. We aimed to illustrate its applications in preoperative planning and training for cerebral AVM excision. Case Description: We illustrated the application of preoperative rehearsal for excision of cerebral AVM for 2 patients in a stereoscopic virtual reality environment. One patient was a 44-year-old lady with a right posterior temporal AVM, and 1 patient was a 23-year-old lady with a left frontal AVM. Through Dextroscope, an anatomical understanding of arterial feeders, nidus, and draining veins in relationship to surrounding cerebral cortex was obtained. It allowed one to see the exposure with the different angles of visualization, similar to what happened under the operative microscope. Conclusion: Dextroscopic virtual reality stimulation provided an illustrated preoperative planning and training for excision of cerebral AVM. [Copyright &y& Elsevier]

Abstract: Pharmacophore modelling, docking and virtual screening have become important tool in drug discovery process. Serotonin 2C (5-HT2C) receptor ligands have got major attention for their therapeutic uses as antidepressant and anorectic agents. Two step pharmacophore and docking based virtual screening was done using 5-HT2C agonists. Two common feature pharmacophore directed virtual hits had submicromolar activity. Refined pharmacophore with excluded volumes was constructed and combined with homology model based docking. Best hit from this virtual screening showed IC50 of 20.1nM. Similarity search of this hit compound resulted more active ligand with 7.8nM activity. [Copyright &y& Elsevier]

Abstract: The peptidoglycan biosynthetic pathway provides an array of potential targets for antibacterial drug design, attractive especially with respect to selective toxicity. Within this pathway, the members of the Mur ligase family are considered as promising emerging targets for novel antibacterial drug design. Based on the available MurD crystal structures co-crystallised with N-sulfonyl glutamic acid inhibitors, a virtual screening campaign was performed, combining three-dimensional structure-based pharmacophores and molecular docking calculations. A novel class of glutamic acid surrogates—benzene 1,3-dicarboxylic acid derivatives—were identified and compounds 14 and 16 found to possess dual MurD and MurE inhibitory activity. [Copyright &y& Elsevier]

Exposure to virtual reality phobic environments was used with patients with chronic agoraphobia. The exposure to virtual stimuli has been verified as a useful procedure in treating phobic disorders. However, there are some specific problems with agoraphobia (determining phobic stimuli, avatars, etc.). The aim of this experimental study is to test a combined treatment, virtual reality exposure and cognitive-behavioral treatment (VRET), compared with a traditional cognitive-behavioral approach (CBT), in reducing agoraphobia symptoms. Two experimental groups were used. 15 patients with chronic agoraphobia received a VRET procedure (3D), and 13 received CBT. Both groups had 11 treatment sessions. The post-treatment measurements included a brief behavioral avoidance test (BAT). Results showed a significant improvement in agoraphobia symptoms (cognition, body sensation, level of anxiety, depression) in both groups. In general, this improvement remained three months later. Also, the BAT procedure indicated the ability of most patients to deal with a phobic environment. Additionally, the VRET group showed a slight amelioration of symptoms compared with the CBT group. These data are discussed in terms of the specific difficulties of VRET with agoraphobia, and the viability of our seven virtual environments to generate an acceptable exposure to phobic stimuli. [ABSTRACT FROM AUTHOR]

This controlled clinical trial tested virtual reality exposure (VRE) therapy for the fear of flying (FOF), a relatively new and innovative way to do exposure therapy, and compared it to standard (in vivo) exposure therapy (SE) and a wait list (WL) control with a 6- and 12-month follow-up. Eighty-three participants with FOF were randomly assigned to VRE, SE, or WL. Seventy-five participants, 25 per group, completed the study. Twenty-three WL participants completed randomly assigned treatment following the waiting period. Treatment consisted of 4 sessions of anxiety management training followed either by exposure to a virtual airplane (VRE) or an actual airplane at the airport (SE) conducted over 6 weeks. Results indicate that VRE was superior to WL on all measures, including willingness to fly on the posttreatment flight (76% for VRE and SE; 20% for WL), VRE and SE were essentially equivalent on standardized questionnaires, willingness to fly, anxiety ratings during the flight, self-ratings of improvement, and patient satisfaction with treatment. Follow-up assessments at 6 and 12 months indicated that treatment gains were maintained, with more than 70% of respondents from both groups reporting continued flying at follow-up. Based on these findings, the use of VRE in the treatment of FOF was supported in this controlled study, suggesting that experiences in the virtual world can change experiences in the real world. [ABSTRACT FROM AUTHOR]

This study examined the effects of a virtual reality distraction intervention on chemotherapy-related symptom distress levels in 16 women aged 50 and older. A cross-over design was used to answer the following research questions: (1) Is virtual reality an effective distraction intervention for reducing chemotherapy-related symptom distress levels in older women with breast cancer? (2) Does virtual reality have a lasting effect? Chemotherapy treatments are intensive and difficult to endure. One way to cope with chemotherapy-related symptom distress is through the use of distraction. For this study, a head-mounted display (Sony PC Glasstron PLM - S700) was used to display encompassing images and block competing stimuli during chemotherapy infusions. The Symptom Distress Scale (SDS), Revised Piper Fatigue Scale (PFS), and the State Anxiety Inventory (SAI) were used to measure symptom distress. For two matched chemotherapy treatments, one pre-test and two post-test measures were employed. Participants were randomly assigned to receive the VR distraction intervention during one chemotherapy treatment and received no distraction intervention (control condition) during an alternate chemotherapy treatment. Analysis using paired t-tests demonstrated a significant decrease in the SAI (p = 0.10) scores immediately following chemotherapy treatments when participants used VR. No significant changes were found in SDS or PFS values. There was a consistent trend toward improved symptoms on all measures 48 h following completion of chemotherapy. Evaluation of the intervention indicated that women thought the head mounted device was easy to use, they experienced no cybersickness, and 100% would use VR again. [ABSTRACT FROM AUTHOR]

This paper reports on the results of a research project, on comparing one virtual collaborative environment with a first-person visual immersion (first-perspective interaction) and a second one where the user interacts through a sound-kinetic virtual representation of himself (avatar), as a stress-coping environment in real-life situations. Recent developments in coping research are proposing a shift from a trait-oriented approach of coping to a more situation-specific treatment. We defined as real-life situation a target-oriented situation that demands a complex coping skills inventory of high self-efficacy and internal or external "locus of control" strategies. The participants were 90 normal adults with healthy or impaired coping skills, 25-40 years of age, randomly spread across two groups. There was the same number of participants across groups and gender balance within groups. All two groups went through two phases. In Phase I, Solo, one participant was assessed using a three-stage assessment inspired by the transactional stress theory of Lazarus and the stress inoculation theory of Meichenbaum. In Phase I, each participant was given a coping skills measurement within the time course of various hypothetical stressful encounters performed in two different conditions and a control group. In Condition A, the participant was given a virtual stress assessment scenario relative to a first-person perspective (VRFP). In Condition B, the participant was given a virtual stress assessment scenario relative to a behaviorally realistic motion controlled avatar with sonic feedback (VRSA). In Condition C, the No Treatment Condition (NTC), the participant received just an interview. In Phase II, all three groups were mixed and exercised the same tasks but with two participants in pairs. The results showed that the VRSA group performed notably better in terms of cognitive appraisals, emotions and attributions than the other two groups in Phase I (VRSA, 92%; VRFP, 85%; NTC, 34%). In Phase II, the difference again favored the VRSA group against the other two. These results indicate that a virtual collaborative environment seems to be a consistent coping environment, tapping two classes of stress: (a) aversive or ambiguous situations, and (b) loss or failure situations in relation to the stress inoculation theory. In terms of coping behaviors, a distinction is made between self-directed and environment-directed strategies. A great advantage of the virtual collaborative environment with the behaviorally enhanced sound-kinetic avatar is the consideration of team coping intentions in different stages. Even if the aim is to tap transactional processes in real-life situations, it might be better to conduct research using a sound-kinetic avatar based collaborative environment than a virtual first-person perspective scenario alone. The VE consisted of two dual-processor PC systems, a video splitter, a digital camera and two stereoscopic CRT displays. The system was programmed in C[sup ++] and VRScape Immersive Cluster from VRCO, which created an artificial environment that encodes the user's motion from a video camera, targeted at the face of the users and physiological sensors attached to the body. [ABSTRACT FROM AUTHOR]

This paper presents preliminary data from two clinical trials currently underway using flat screen virtual reality (VR) technology for physical rehabilitation. In the first study, we are comparing a VR-delivered exercise program to a conventional exercise program for the rehabilitation of shoulder joint range-of-motion in patients with chronic frozen shoulder. In the second study, we are comparing two exercise programs, VR and conventional, for balance retraining in subjects post-traumatic brain injury. Effective VR-based rehabilitation that is easily adapted for individuals to use both in inpatient, outpatient and home-based care could be used as a supplement or alternative to conventional therapy. If this new treatment approach is found to be effective, it could provide a way to encourage exercise and treatment compliance, provide safe and motivating therapy and could lead to the ability to provide exercises to clients in distant locations through telehealth applications of VR treatment. VR is a new technology and the possibilities for rehabilitation are only just beginning to be assessed. [ABSTRACT FROM AUTHOR]

Reports the 12-month follow-up of virtual reality and standard exposure therapies of patients with the fear of flying. Superiority of virtual reality exposure (VRE) therapy and standard exposure (SE) to wait-list control; Maintenance of patient of their treatment gains; Percentage of VRE and SE participants flown on real airplane.

In vivo, systematic desensitization has been effective in the treatment of agoraphobia. Currently, computer and display technology allow the creation of virtual reality environments. Virtual reality therapy (VRT), based on this sophisticated technology, has been used in the treatment of subjects who have been diagnosed with agoraphobia, a disorder that is defined as an extreme, irrational fear of being in places or situations from which escape might be difficult or embarrassing. These studies, however, are limited in scope, having been conducted by using subjective tools to measure the effectiveness of therapy. The goal of this study was to evaluate the effectiveness of VRT by using not only the subjective tools but also several objective ones, such as blood pressure, respiration, and heart rate. A virtual environment tunnel scene with traffic jam was created for this study; this scene was rated as one of the most fearful situations for our patients. The study included seven subjects who were diagnosed with panic disorder with agoraphobia using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. The data failed to support the efficacy of the objective measures. Improving the immersion process and the objective measures for evaluating the effectiveness of VRT for agoraphobics appears to be a reasonable research strategy. [ABSTRACT FROM AUTHOR]

Fear of flying is a common condition. Virtual reality exposure has recently been shown to be an effective treatment, but fear of flying is heterogeneous, affecting people with distinctly different diagnoses. Thirty-one patients were treated. Over half had a fear of crash, the rest suffered with claustrophobia, fear of heights, or panic disorder with agoraphobia. Twentyone patients flew following treatment. There were no differences between diagnostic groups. Follow-up showed that patients continued to fly, but with anxiety. Research and treatment implications are discussed. [ABSTRACT FROM AUTHOR]

Natural viewing conditions place equal demands on the vergence and accommodation systems. The two responses are co-ordinated via the interactive components which couple the two systems: accommodative vergence and vergence accommodation. The crosslink components are usually quantified by the AC/A and CA/C ratios. Whether these ratios are stable entities, genetically determined, or modifiable by experience has been the subject of some debate. A 'Virtual Reality' stimulus was used to place unequal demands on the vergence and accommodation systems. Pre-task and post-task measures of AC/A and CA/C were objectively determined. The changes in the post-task measures are discussed with reference to a dual interactive model of vergence and accommodation. Model simulations suggest that adaptation of the vergence and accommodative controllers (tonic adaptation) may also play a part by altering the open loop bias. The results therefore support the idea that vergence accommodation and accommodative vergence are capable of adaptation. [ABSTRACT FROM AUTHOR]

Presents a case study to demonstrate the effectiveness of virtual environment desensitization (VED) in treating sufferers of fear of flying. Virtual environment components; Symptoms experienced during VED therapy.

Considers using virtual reality psychotherapy approach in panic disorder with agoraphobia. Features of panic disorder; Treatment of both panic disorder and panic disorder with agoraphobia; Advantages of virtual reality graded exposure therapy compared to in vivo exposure.

The article highlights the introduction of Virtual reality technology to Southcoast Health Wound Center at St. Luke’s Hospital patients by the non-profit organization, Charitable Foundation. Topics discussed include the technology helps to mitigate patient pain and anxiety during medical procedures; views of Chris O’Neil on the technology's benefits; and virtual reality system technology helps to overcome from painful injuries, particularly burn victims and pediatric patients.

The article offers information regarding the use of virtual reality for the treatment of pain in the U.S. It highlights the move of the National Institutes of Health to provide research funding on non-pharmacological and virtual reality therapies for pain treatment in diverse populations including ethnic minority groups and persons with disabilities in the country. The National Institute on Drug Abuse is mentioned.