Upper limb rehabilitation system based on virtual reality for breast cancer patients: Development and usability study

Background Functional exercise is crucial for breast cancer patients after surgery, and the use of virtual reality technology to assist patients with postoperative upper limb functional rehabilitation has gradually attracted the attention of researchers. However, the usability of the developed rehabilitation system is still unknown to a large extent. The purpose of this study was to develop a virtual reality upper limb rehabilitation system for patients after breast cancer surgery and to explore its usability. Methods We built a multidisciplinary team based on virtual reality and human-computer interaction technology and designed and developed an upper limb function rehabilitation system for breast cancer patients after surgery. Breast cancer patients were recruited from a grade III-a general hospital in Changchun city for the experiment. We used the System Usability Scale to evaluate the system availability, the Presence Questionnaire scale to measure the immersive virtual reality scene, and the Simulator Sickness Questionnaire subjective measurement scale for simulator sickness symptoms. Results This upper limb rehabilitation system hardware consisted of Head-mounted Display, a control handle and notebook computers. The software consisted of rehabilitation exercises and game modules. A total of 15 patients were tested on this system, all of whom were female. The mean age was 54.73±7.78 years, and no patients were excluded from the experiment because of adverse reactions such as dizziness and vomiting. The System Usability Scale score was 90.50±5.69, the Presence Questionnaire score was 113.40±9.58, the Simulator Sickness Questionnaire-nausea score was 0.93±1.16, the Simulator Sickness Questionnaire-oculomotor score was 0.80±1.27, the Simulator Sickness Questionnaire-disorientation score was 0.80±1.27, and the Simulator Sickness Questionnaire total score was 2.53±3.40. Conclusions This study fills in the blanks regarding the upper limb rehabilitation of breast cancer patients based on virtual reality technology system usability research. As the starting point of research in the future, we will improve the system’s function and design strictly randomized controlled trials, using larger samples in the promotion, to evaluate its application in breast cancer patients with upper limbs and other physiological functions and the feasibility and effects of rehabilitation.

Hyper-reoriented walking in minimal space

We present a new reorientation technique, “hyper-reoriented walking,” which greatly reduces the amount of physical space required in virtual reality (VR) applications asking participants to walk along a grid-like path (such as the most common layout in department stores). In hyper-reoriented walking, users walk along the gridlines with a virtual speed of twice the speed of real walking and perform turns at cross-points on the grid with half the speed of the rotation speed in the physical space. The impact of the technique on participants’ sense of orientation and increase in simulator sickness was investigated experimentally involving 19 participants walking in a labyrinth of infinite size that included straight corridors and 90° T-junctions at the end of the corridors. Walking accuracy was assessed by tracking the position of the head mounted display, and cyber-sickness was recorded with the simulator sickness questionnaire and with open questions. Walking straight forward was found to closely match the ideal path, which is the grid line, but slight errors occasionally occurred when participants turned at the T-junctions. A correction algorithm was therefore necessary to bring users back to the gridline. For VR experiments in a grid-like labyrinth with paths of 5 m in length, the technique reduces required size of the tracked physical walking area to 3 m × 2 m.

Arguing in Favor of Revising the Simulator Sickness Questionnaire Factor Structure When Assessing Side Effects Induced by Immersions in Virtual Reality

Two issues are increasingly of interest in the scientific literature regarding unwanted virtual reality (VR) induced side effects: (1) whether the latent structure of the Simulator Sickness Questionnaire (SSQ) is comprised of two or three factors, and (2) if the SSQ measures symptoms of anxiety that can be misattributed to unwanted negative side effects induced by immersions in VR. Study 1 was conducted with a sample of 876 participants. A confirmatory factor analysis clearly supported a two-factor model composed of nausea and oculomotor symptoms instead of the 3-factor structure observed in simulators. To tease-out symptoms of anxiety from unwanted negative side effects induced by immersions in VR, Study 2 was conducted with 88 participants who were administered the Trier Stress Social Test in groups without being immersed in VR. A Spearman correlation showed that 11 out of 16 side effects correlated significantly with anxiety. A factor analysis revealed that items measuring general discomfort, difficulty concentrating, sweating, nausea, and vertigo loaded significantly on the anxiety factor comprised of items from the State-Trait Anxiety Inventory. Finally, a multiple regression indicated that the items measuring general discomfort and difficulty concentrating significantly predicted increases in anxiety. The overall results support the notion that side effects associated with immersions in VR consist mostly of a nausea and an oculomotor latent structure and that a few items are confounding anxiety and cybersickness. The data support the suggestion to revise the scoring procedures of the Simulator Sickness Questionnaire when using this instrument with immersions in VR.

DOES IMMERSIVE VIRTUAL REALITY INDUCE CYBERSICKNESS AND IMPACT EQUILIBRIUM COORDINATION?

Cybersickness continues to become a negative consequence that degrades the interface for users of virtual worlds created for Virtual Reality (VR) users. There are various abnormalities that might cause quantifiable changes in body awareness when donning an Head Mounted Display (HMD) in a Virtual Environment (VE). VR headsets do provide VE that matches the actual world and allows users to have a range of experiences. Motion sickness and simulation sickness performance gives self-report assessments of cybersickness with VEs. In this study a simulator sickness questionnaire is being used to measure the aftereffects of the virtual environment. This research aims to answer if Immersive VR induce cybersickness and impact equilibrium coordination. The present research is formed as a cross-sectional observational analysis. According to the selection criteria, a total of 40 subjects would be recruited from AVBRH, Sawangi Meghe for the research. With intervention being used the experiment lasted 6 months. Simulator sickness questionnaire is used to evaluate the after-effects of a virtual environment. It holds a single period for measuring motion sickness and evaluation of equilibrium tests were done twice at exit and after 10 mins. Virtual reality being used in video games is still in its development. Integrating gameplay action into the VR experience will necessitate a significant amount of study and development. The study has evaluated if Immersive VR induce cybersickness and impact equilibrium coordination. To measure cybersickness, numerous scales have been developed. The essence of cybersickness has been revealed owing to work on motion sickness in a simulated system.

Motion Sickness Lessons from the Southern Ocean

BACKGROUND: The objectives were to assess the prevalence, severity, and medication taken, and to look for predictive factors in order to better identify characteristics of passengers at risk of motion sickness during transport from Hobart in Tasmania to the French polar stations in Antarctica. METHODS: There were 239 passengers who were surveyed over 4 yr with 4 round trips per year using the Motion Sickness Susceptibility Questionnaire (MSSQ), Simulator Sickness Questionnaire (SSQ), state-trait anxiety test (STAI-Trait and STAI-State), and general parameters (age, gender, number of trips, jet-lag, direction of the trip), medication, calculation of the distance of each passengers cabin to the center of gravity (CoG). RESULTS: While the passengers had a low intrinsic sensitivity to motion sickness (MSSQ), 94 reported at least one SSQ symptom of motion sickness, and 38 vomited. Five associated factors were discovered: greater initial sensitivity (MSSQ), anticipation of being ill, younger age, higher level of anxiety at midtrip, and greater distance from the CoG. Of the passengers, there were 54 who took anti-motion sickness medication at different times of the trip, however, these passengers experienced more nausea. This could be due to self-selection since they were more sensitive to motion sickness. CONCLUSION: We identified three predictive factors of motion sickness (greater intrinsic susceptibility, younger age, and greater cabin distance from the CoG). For preventive purposes, two associated factors of MS (anticipation of being ill, MSSQ score) were determined to classify three groups of risk of MS to improve passenger care during the trip. Besnard S, Bois J, Hitier M, Vogt J, Laforet P, Golding JF. Motion sickness lessons from the Southern Ocean. Aerosp Med Hum Perform. 2021; 92(9):720727.

Traducción y adaptación transcultural al español del Simulator Sickness Questionnaire (Translation and cross-cultural adaptation to Spanish of the Simulator Sickness Questionnaire)

La Realidad Virtual (RV) es una herramienta cada vez más presente en la valoración y tratamiento del paciente neurológico. Sin embargo, en ocasiones, la exposición a entornos inmersivos puede desencadenar efectos adversos. Detectar las posibles complicaciones de su uso se antoja fundamental para dotar de seguridad a sus aplicaciones terapéuticas. El objetivo de este trabajo ha sido realizar una traducción y adaptación transcultural del cuestionario Simulator Sickness Questionnaire (SSQ), empleado para valorar el cybersickness o sintomatología adversa asociada al uso de la RV, de cara a minimizar riesgos vinculados a su uso en población española. Se llevó a cabo una traducción, retrotraducción y adaptación del instrumento original y una validación de contenido y equivalencia semántica del cuestionario a través de la opinión de expertos, llegando a una versión preliminar evaluada en un ensayo piloto con 54 participantes. Tras la obtención de la versión preliminar en español, el análisis de validez de contenido mostró valores elevados (índice de validez de contenido ³ 0.89; valores de kappa ³ 0.89). 42 de los 54 participantes en el estudio (78%) entendieron el total de la equivalencia semántica planteada y el 100% de la muestra comprendió 13 de los 16 ítems adaptados (81%). El proceso de traducción y adaptación transcultural al castellano del SSQ llevado a cabo, ha dado como resultado una versión equivalente al cuestionario original, presentando una elevada concordancia semántica que facilitará el desarrollo de futuros estudios en población española sobre la sintomatología adversa que pudiera generar la RV. Abstract. Virtual Reality (VR) uses is growing in the assessment and treatment of neurological patients. However, immersive environments exposure can trigger adverse effects. Checking the possible complications of its use is essential to provide security to therapeutic approaches. The aim of this work has been to carry out a translation and cross-cultural adaptation of the Simulator Sickness Questionnaire (SSQ), used to assess cybersickness or adverse symptoms associated with VR, with the aim to decrease risks in the Spanish population. Forward-translation, back-translation and cross-cultural adaptation of the original questionnaire was carried out. Content validation and semantic equivalence was assessed by an expert panel, leading to a preliminary version evaluated in a pilot trial with 54 participants. After obtaining the preliminary version in Spanish, the content validity analysis showed high values (content validity index ³ 0.89 and kappa values ³ 0.89). 42 of the 54 participants (78%) understood the total semantic equivalence raised and 100% of the sample understood 13 of the 16 adapted items (81%). The translation and cross-cultural adaptation into Spanish of the SSQ was carried out in this study, showed an equivalent version to the original questionnaire, presenting a high semantic concordance and facilitating the development of future studies in the Spanish population on the adverse symptoms that VR could generate.

Cybersickness Testing Of Gender And Experience Factors Using Virtual Reality

One of the technologies that people are starting to get interested in is virtual reality (VR). VR is widely used as a means of entertainment, even more so at this time, the e-sports industry is developing rapidly. However, the use of VR can cause cybersickness, a disease arising from sensory and perceptual mismatches between the visual and vestibular systems. The emergence of cybersickness can be related to gender and experience using VR. There have been studies on cybersickness, but the results obtained had not come to the same conclusion. This research aims to identify the effect of gender and experience using VR, predict the timing of cybersickness by using physiological measurements, and provide recommendations that can minimize cybersickness in activities using VR. The measuring instruments used are the galvanic skin response (GSR) and a simulator sickness questionnaire (SSQ). In this study, the influence test is conducted by using ANOVA and Kruskal-Wallis to determine whether gender and experience using VR affect the potential for cybersickness. Based on the GSR measurement results, it found that gender and experiences of using VR do not affect a person's potential for cybersickness. From the result of SSQ measurement, gender does not affect the cybersickness, but the experience of using VR affected a person's potential for cybersickness. Qualitatively, cybersickness symptoms appear in the 15-20 minutes after the VR game has set in. Therefore, it is recommended to limit the usage of VR to less than 15 to 20 minutes per session. Keywords: cybersickness, galvanic skin response (GSR), simulator sickness questionnaire (SSQ), virtual reality

Time Course of Simulator Sickness in Asian Military Pilots

INTRODUCTION: This study sought to determine the incidence, severity, and time-course of simulator sickness (SS) among Asian military pilots following flight simulator training.METHODS: A survey was conducted on Republic of Singapore Air Force pilots undergoing simulator training. Each subject completed a questionnaire immediately after (0H), and at the 3-h (3H) and 6-h (6H) marks. The questionnaire included the simulator sickness questionnaire (SSQ) and a subjective scale to rate their confidence to fly.RESULTS: In this study, 258 pilots with a median age of 31.50 yr (range, 2155 yr) and mean age of 32.61 6.56 yr participated. The prevalence of SS was 48.1% at 0H, 30.8% at 3H, and 16.4% at 6H. Based on a threshold of an SSQ score >10, the prevalence of operationally significant SS was 33.3% at 0H, 13.2% at 3H, and 8.1% at 6H. The most frequent symptoms were fatigue (38.1%), eye strain (29.0%), and fullness of head (19.9%). There was no significant difference in mean scores between rotary and fixed wing pilots. Older, more experienced pilots had greater scores at 0H, but this association did not persist. A correlation was found between SSQ score and self-reported confidence.DISCUSSION: To our knowledge, this study is the first to report the prevalence of operationally significant SS in Asian military pilots over serial time points. Most pilots with SS are able to subjectively judge their fitness to fly. Sensitivity analysis suggests the true prevalence of SS symptoms at 3H and 6H to be closer to 23.8% and 12.0%, respectively.Loi JEQ, Lee MLL, Tan BBC, See B. Time course of simulator sickness in Asian military pilots. Aerosp Med Hum Perform. 2020; 91(11):892896.

Exploring the Participant-Related Determinants of Simulator Sickness in a Physical Motion Car Rollover Simulation as Measured by the Simulator Sickness Questionnaire

Physical motion driving simulators serve as a valuable research and training tool. Since many simulator participants suffer from simulator sickness (SS), we aimed to gain a better understanding of participant-related variables that may influence its incidence and severity. The study involved a 2-min mobile-platform car rollover simulation conducted in a group of 100 healthy adult participants. SS was measured with the Simulator Sickness Questionnaire immediately before and after the simulation. We investigated how the symptomatology of SS varies with gender, as well as with participants’ previous experiences such as extra driving training or car accidents. Although many SS symptoms occurred already before the simulation, all the symptoms except burping had a significantly greater incidence and severity after the simulation. Before the simulation, men reported disorientation symptoms more often than women, while participants with prior experiences of extra driving training or car accidents scored significantly higher in three out of four Questionnaire components: nausea symptoms, oculomotor symptoms, and the total score. The study offers interesting insights into associations between SS and prior experiences observed by means of high-fidelity real-motion simulations. More research is needed to determine the nature of these associations and their potential usefulness, for example, in helping accident survivors to cope with the distressing or even potentially disabling psychological consequences of accidents.