This research was supported by grant no. 06-2013-105 from the SK Telecom Research Fund. This work was supported by the Soonchunhyang University Research Fund.

The study was approved by the Seoul National University Bundang Hospital Institutional Review Board, and all participants gave written informed consent before screening.
1. Game Contents Development
NOTE: The mobile game-based upper extremity virtual reality program for patients with stroke (MoU-Rehab) consists of mobile game applications.
<ol>
	<li>Install the studio and environment for development using a programing language.</li>
	<li>Collect data on x, y and z-axis locations of patients&#39; movements through the built-in sensors of the smartphone.</li>
	<li>Allocate storage for data on the motion, location, and velocity with the following source code: 
	float[ ] gravity_data = new float[3]; 
	float[ ] accel_data = new float[3]; 
	float[ ] m_acc_data = new float[3]; 
	final float alpha = (float)0.8; 
	Gather data measured by the built-in sensor with the following source code. 
	SensorManager sm = (SensorManager) getSystemService(SENSOR_SERVICE); 
	Sensor mSensor = sm.getDefaultSensor(Sensor.TYPE_ACCELEROMETER);</li>
	<li>Send the data to the tablet PC after image processing through the short-distance wireless connection to display x, y, and z-coordinates as images on the screen.</li>
	<li>Design all game applications to improve the strength, endurance, range of motion, control, speed, and accuracy of movement in the upper extremity. 
	NOTE: Board-certified physiatrists (rehabilitation medicine doctors) and occupational therapists gathered and discussed what therapeutic maneuvers would be appropriate to transform into game programs. Movements in each joint was targeted based on the conventional occupational therapy methods that promote the recovery of upper limb function and improve the strength, endurance, range of motion, control, speed, and accuracy of movement in the upper extremity</li>
	<li>Recommend game applications to each patient according to their upper extremity function measured by the Brunnstr&#246;m stage. 
	NOTE: The Brunnstr&#246;m stage (B-stage) for the arm and hand evaluates the upper extremity recovery stages (1=flaccid, no voluntary movements; 7= normal function)16. For example, patients categorized as Brunnstr&#246;m stage 1 used applications that induce shoulder flexion/extension movements with the assistance of the unaffected arm. Patients categorized as Brunnstr&#246;m stage 5 used applications that require precise control of movements.</li>
	<li>Adjust the level of difficulty of the game applications individually, by changing the speed, maintenance time for the specific posture, and range of motion according to the severity of the upper extremity dysfunction. Refer to the examples with detailed information as below (Figure 2).</li>
</ol>
2. Study Design
NOTE: A quasi-randomized, double-blind, controlled trial was conducted to evaluate the program&#39;s feasibility and effectiveness. Participants who (1) were diagnosed with ischemic stroke; (2) had the ability to follow a one-step command; (3) had the medical stability to participate in active rehabilitation, and (4) had upper extremity impairment, were included. Patients were excluded if they (1) had delirium, confusion, or other severe consciousness problems, (2) suffered from uncontrolled medical conditions, (3) were unable to follow commands because of severe cognitive impairment, (4) had a visual disturbance, and (5) had poor sitting balance. Participants were recruited at the university hospital.
<ol>
	<li>To make the participants completely blinded to the group assignment, assign them to either control or experimental group by admission period because participants needed to share the OT room.</li>
	<li>Ensure that the patients in the intervention group received 30 min of conventional OT and 30 min of the mobile game-based VR upper extremity rehabilitation program using a smartphone and a tablet PC.</li>
	<li>Ensure that the patients in the control group received conventional OT alone for 1 h per day. 
	NOTE: The rehabilitation program for both groups consisted of 10 sessions of therapy, 5 days per week, for 2 weeks.</li>
	<li>Educate the patients in the intervention group on how to use the program in the first treatment session, although each game application provided brief instructions at the beginning. Ensure that the patients used the program for 30 min on their own during the study.</li>
	<li>Assess the outcome measurements at the beginning, at the end of the treatment and at a one-month follow-up.</li>
	<li>Let a single blinded evaluator who is an experienced occupational therapist perform all the clinical assessments during all the testing sessions. 
	NOTE: The primary outcome measure was the Fugl-Meyer Assessment of the upper extremity (FMA-UE), which measures the motor function of the patients&#39; hemiparetic arm (0 = lowest score; 66 = highest score).17 The secondary outcome was evaluated by the Brunnstr&#246;m stage (B-stage) for the arm and hand and manual muscle testing (0&#8211;5).</li>
</ol>
3. Usage of Mobile Game-based VR Upper Extremity Rehabilitation Program
<ol>
	<li>Have the participant sit on the desk.</li>
	<li>Place the tablet PC on the desk and turn the tablet PC on.</li>
	<li>Turn the smartphone on and turn on the short-distance wireless connection on the smartphone.</li>
	<li>Select the game application on the tablet PC by touching the screen of the tablet PC.</li>
	<li>Enable short-distance wireless connection on the tablet PC and connect to the smartphone.</li>
	<li>Put the smartphone in the armband and attach the armband to the upper arm or forearm using a commercially available smartphone armband according to the desired movement.</li>
	<li>Choose either the basic version or the customized version.</li>
	<li>Select the game speed, time, a number of target movements, and the expected achievement of the game on the touchscreen of the tablet PC on the customized version according to the participants&#8217; ability.</li>
	<li>Let the participant touch the start button. Ask the participant to take a posture following the commands of the game. Move the maximal range of motion for calibration.</li>
	<li>Start playing the game and move to the next game when the game ends (generally 5&#8211;10 min long).
	<ol>
		<li>&#34;Honey Pot Guard&#34; Game 
		NOTE: This game targets the elbow flexion and extension motion.
		<ol>
			<li>Ask the patients to beat a bear from the honey pot by throwing apples using the movement of the elbow joint.</li>
			<li>Let the patient throw apples when the flexed elbow is extended.</li>
			<li>Adjust the level of difficulty by the location where the bear appears and the speed at which a new bear appears based on the available range of motion and speed of the motion in the patient&#39;s elbow joint.</li>
		</ol>
		</li>
		<li>&#34;Protect the Bunny&#34; Game 
		NOTE: This game targets the shoulder abduction and adduction motion.
		<ol>
			<li>Ask the patients to protect the bunny by catching stones with a net using the movement of the shoulder joint.</li>
			<li>Ensure that the net moves when the adducted shoulder is abducted.</li>
			<li>Adjust the level of difficulty by the location where the stone appears and the speed with which a new stone appears based on the available range of motion and speed of motion in the patient&#39;s shoulder joint.</li>
		</ol>
		</li>
		<li>&#34;Put out Fire&#34; game 
		NOTE: This game targets the shoulder abduction and adduction or shoulder flexion and extension.
		<ol>
			<li>Ask the patients to put the fire out with the water hose through the window; the water hose is moved according to the motion of the shoulder.</li>
			<li>Ensure that the water hose moves right and left and up and down according to the motion of the shoulder joint; the time needed to put out the fire depends on the size of the fire.</li>
			<li>Adjust the level of difficulty by the location where the fire appears, the speed with which a new fire appears, and the size of the fire based on the available range of motion and the speed and endurance of motion of the patient&#8217;s shoulder joint.</li>
		</ol>
		</li>
		<li>&#34;Flower Splash&#34; game 
		NOTE: This game targets the shoulder abduction and adduction, elbow flexion and extension, or wrist pronation and supination motion.
		<ol>
			<li>Ask the patients to water the moving seed with a watering can by the motion of the joint and make the flowers blossom.</li>
			<li>Ensure that when the seed moves, the watering follows according to the motion of the joint.</li>
			<li>Adjust the level of difficulty by the moving speed of the seed with respect to the accuracy and speed of motion.</li>
		</ol>
		</li>
	</ol>
	</li>
	<li>Track the patients&#39; upper extremity movements by the built-in sensors (accelerometer, gyroscope) of the smartphone, and transfer information about the movement to the tablet PC through the short-distance wireless connection.</li>
	<li>Provide visual and auditory feedback for patients on their movement with the display on the tablet PC.</li>
	<li>Demonstrate the real achievement of the game as compared with the expected achievement at the end of the game.</li>
</ol>

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All authors declare no conflict of interest.

Patients with stroke usually have disabilities related to motor impairments due to incomplete motor recovery. Such disabilities, lengthy travel time to a clinic, or socioeconomic difficulties can hinder patients&#39; access to adequate rehabilitation therapy. A ubiquitous healthcare (u-Health) program can be a good option for removing those barriers. As a part of such a u-Health program, a mobile game-based VR rehabilitation program was developed for upper limb recovery after ischemic stroke in the present study. Our fin...

Stroke is one of the most common causes of neurological impairment in adults. Recovery from impairment after a stroke is usually incomplete, and approximately 50% of patients are left with disabilities, making them dependent on others1. In particular, upper limb dysfunction makes stroke survivors dependent on others for assistance with activities of daily living (ADL)2. Regaining the lost function in the upper extremities may be more difficult to achieve than returning the normal function of ambulation to the lower extremities. Although bilateral lower extremity movement is indispensable for locomotion, patients can perform ADL with unilateral upper extremity movement. This leads to a learned non-use phenomenon of the affected limb3. This phenomenon is an obstacle to the rehabilitation of the upper extremity in stroke survivors. Therefore, a tremendous amount of research is focused on the upper limb function recovery. Studies have highlighted the importance of extensive practice and repetitive task-specific training4,5,6.
Virtual reality (VR) technology has recently been introduced into the field of rehabilitation7. VR allows users to interact with a simulated environment and receive continuous, immediate feedback related to performance. VR has the potential to apply basic concepts of neurorehabilitation in stroke patients, such as intensive, repetitive, and task-oriented training8. Specifically, non-immersive VR does not require high-level graphics performance or special hardware. Therefore, non-immersive VR is a good candidate for providing a low-cost, ubiquitous, and interesting treatment program. Previous studies used computers, monitors, and special devices, such as consoles, sensor gloves, joy-sticks, and commercial gaming systems for non-immersive VR9. Higher start-up costs and sufficient space were mandatory for using such systems. Recently, low-cost tools, such as commercial gaming devices, have been utilized to develop new rehabilitation systems10,11. However, the consoles with sensors in those devicesare not sufficiently small and lightweight for carrying. Nevertheless, to improve the popularity of non-immersive VR as a post-stroke upper extremity treatment method and to create a ubiquitous rehabilitation environment for stroke survivors, portable and inexpensive tools are needed.
Furthermore, game-based therapy can be a good option for stroke rehabilitation. Many patients complain that conventional occupational therapy (OT) for upper limb function recovery is boring and monotonous12,13. A more interesting and motivating tool for the therapy is, therefore, necessary to promote patients&#39; engagement in rehabilitation training. Many studies that involve the use of commercial games have been conducted14,15,16. However, the games used do not target the desired movement of the upper extremity in patients with stroke, and they lack special consideration for the spasticity that may be present after a stroke.
This paper describes the development of a mobile game-based VR program and its use for patients who have experienced a stroke and suffer from upper limb dysfunction (Figure 1).

<table>
	<tbody>
		<tr>
			<td>Galaxy Note 10.0</td>
			<td>Samsung</td>
			<td>Galaxy Note 10.0</td>
			<td>Tablet PC</td>
		</tr>
		<tr>
			<td>Galaxy S2</td>
			<td>Samsung</td>
			<td>Galaxy S2</td>
			<td>Smartphone</td>
		</tr>
		<tr>
			<td>Bluetooth</td>
			<td>Bluetooth SIG</td>
			<td>Bluetooth</td>
			<td>short-distance wireless connection&#160;</td>
		</tr>
		<tr>
			<td>Java</td>
			<td>Oracle</td>
			<td>Java</td>
			<td>programming language</td>
		</tr>
	</tbody>
</table>

mobile game-based virtual reality program for upper extremity stroke rehabilitation

Stroke rehabilitation requires repetitive, intensive, goal-oriented therapy. Virtual reality (VR) has the potential to satisfy these requirements. Game-based therapy can promote patients&#39; engagement in rehabilitation therapy as a more interesting and a motivating tool. Mobile devices such as smartphones and tablet PCs can provide personalized home-based therapy with interactive communication between patients and clinicians. In this study, a mobile VR upper extremity rehabilitation program using game applications was developed. The findings from the study show that the mobile game-based VR program effectively promotes upper extremity recovery in patients with stroke. In addition, patients completed two weeks of treatment using the program without adverse effects and were generally satisfied with the program. This mobile game-based VR upper extremity rehabilitation program can substitute for some parts of the conventional therapy that are delivered one-on-one by an occupational therapist. This time-efficient, easy to implement, and clinically effective program would be a good candidate tool for tele-rehabilitation for upper extremity recovery in patients with stroke. Patients and therapists can collaborate remotely through these e-health rehabilitation programs while reducing economic and social costs.

A total of 24 patients were enrolled and assigned to either the control or the experimental group (Table 1). A greater improvement in the FMA-UE, B-stage, and manual muscle testing was found after treatment with the mobile game-based VR upper extremity rehabilitation program than with conventional therapy (Figure 3). The effect was maintained until the one-month follow-up. This means MoU-Rehab was not inferior to the conventional therapy that...

Watch this Scientific Journal Video about Mobile Game-based Virtual Reality Program for Upper Extremity Stroke Rehabilitation at JoVE.com

Mobile Game-based Virtual Reality Program for Upper Extremity Stroke Rehabilitation

Here, we present a protocol to develop and apply a mobile game-based virtual reality program for the recovery of upper limb dysfunction in patients with stroke. The present study shows that the mobile program is feasible and effectively promotes upper limb recovery in stroke patients.

Stroke rehabilitation requires repetitive, intensive, goal-oriented therapy. Virtual reality (VR) has the potential to satisfy these requirements. ...

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18.7K Views.  Seoul National University College of Medicine, Seoul National University Bundang Hospital. Here, we present a protocol to develop and apply a mobile game-based virtual reality program for the recovery of upper limb dysfunction in patients with stroke. The present study shows that the mobile program is feasible and effectively promotes upper limb recovery in stroke patients.

Video: Mobile Game-based Virtual Reality Program for Upper Extremity Stroke Rehabilitation

Two-photon Calcium Imaging in Mice Navigating a Virtual Reality Environment

In recent years, two-photon imaging has become an invaluable tool in neuroscience, as it allows for chronic measurement of the activity of genetically identified cells during behavior1-6. Here we describe methods to perform two-photon imaging in mouse cortex while the animal navigates a virtual reality environment. We focus on the aspects of the experimental procedures that are key to imaging in a behaving animal in a brightly lit virtual environment. The key problems that arise in this experimental setup that we here address are: minimizing brain motion related artifacts, minimizing light leak from the virtual reality projection system, and minimizing laser induced tissue damage. We also provide sample software to control the virtual reality environment and to do pupil tracking. With these procedures and resources it should be possible to convert a conventional two-photon microscope for use in behaving mice.

Here we describe the experimental procedures involved in two-photon imaging of mouse cortex during behavior in a virtual reality environment.

In recent years, two-photon imaging has become an invaluable tool in neuroscience, as it allows for chronic measurement of the activity of genetically ...

Development of a Virtual Reality Assessment of Everyday Living Skills

Cognitive impairments affect the majority of patients with schizophrenia and these impairments predict poor long term psychosocial outcomes.&#160; Treatment studies aimed at cognitive impairment in patients with schizophrenia not only require demonstration of improvements on cognitive tests, but also evidence that any cognitive changes lead to clinically meaningful improvements.&#160; Measures of &#8220;functional capacity&#8221; index the extent to which individuals have the potential to perform skills required for real world functioning. &#160;Current data do not support the recommendation of any single instrument for measurement of functional capacity.&#160; The Virtual Reality Functional Capacity Assessment Tool (VRFCAT) is a novel, interactive gaming based measure of functional capacity that uses a realistic simulated environment to recreate routine activities of daily living. Studies are currently underway to evaluate and establish the VRFCAT&#8217;s sensitivity, reliability, validity, and practicality.&#160;This new measure of functional capacity is practical, relevant, easy to use, and has several features that improve validity and sensitivity of measurement of function in clinical trials of patients with CNS disorders.

A challenge for proving treatment efficacy for cognitive impairments in schizophrenia is finding the optimizing measurement of skills related to everyday functioning.&#160; The Virtual Reality Functional Capacity Assessment Tool (VRFCAT) is an interactive gaming based computerized measure aimed at skills associated with everyday functioning, including baseline impairments and treatment related changes.

Cognitive impairments affect the majority of patients with schizophrenia and these impairments predict poor long term psychosocial outcomes.&#160; ...

Multifunctional Setup for Studying Human Motor Control Using Transcranial Magnetic Stimulation, Electromyography, Motion Capture, and Virtual Reality

The study of neuromuscular control of movement in humans is accomplished with numerous technologies. Non-invasive methods for investigating neuromuscular function include transcranial magnetic stimulation, electromyography, and three-dimensional motion capture. The advent of readily available and cost-effective virtual reality solutions has expanded the capabilities of researchers in recreating &#8220;real-world&#8221; environments and movements in a laboratory setting. Naturalistic movement analysis will not only garner a greater understanding of motor control in healthy individuals, but also permit the design of experiments and rehabilitation strategies that target specific motor impairments (e.g. stroke). The combined use of these tools will lead to increasingly deeper understanding of neural mechanisms of motor control. A key requirement when combining these data acquisition systems is fine temporal correspondence between the various data streams. This protocol describes a multifunctional system&#8217;s overall connectivity, intersystem signaling, and the temporal synchronization of recorded data. Synchronization of the component systems is primarily accomplished through the use of a customizable circuit, readily made with off the shelf components and minimal electronics assembly skills.

Transcranial magnetic stimulation, electromyography, and 3D motion capture are commonly used non-invasive techniques for investigating neuromuscular function in humans. In this paper, we describe a protocol that synchronously samples data generated by all three of these tools along with the unique addition of virtual reality stimulus presentation and feedback.

The study of neuromuscular control of movement in humans is accomplished with numerous technologies. Non-invasive methods for investigating neuromuscular ...

A Structured Rehabilitation Protocol for Improved Multifunctional Prosthetic Control: A Case Study

Advances in robotic systems have resulted in prostheses for the upper limb that can produce multifunctional movements. However, these sophisticated systems require upper limb amputees to learn complex control schemes. Humans have the ability to learn new movements through imitation and other learning strategies. This protocol describes a structured rehabilitation method, which includes imitation, repetition, and reinforcement learning, and aims to assess if this method can improve multifunctional prosthetic control. A left below elbow amputee, with 4 years of experience in prosthetic use, took part in this case study. The prosthesis used was a Michelangelo hand with wrist rotation, and the added features of wrist flexion and extension, which allowed more combinations of hand movements. The participant&#8217;s Southampton Hand Assessment Procedure score improved from 58 to 71 following structured training. This suggests that a structured training protocol of imitation, repetition and reinforcement may have a role in learning to control a new prosthetic hand. A larger clinical study is however required to support these findings.

As prosthetic development moves towards the goal of natural control, harnessing amputees&#8217; inherent ability to learn new motor skills may enable proficiency. This manuscript describes a structured rehabilitation protocol, which includes imitation, repetition, and reinforcement learning strategies, for improved multifunctional prosthetic control.

Advances in robotic systems have resulted in prostheses for the upper limb that can produce multifunctional movements. However, these sophisticated ...

Using Virtual Reality to Transfer Motor Skill Knowledge from One Hand to Another

As far as acquiring motor skills is concerned, training by voluntary physical movement is superior to all other forms of training (e.g. training by observation or passive movement of trainee&#39;s hands by a robotic device). This obviously presents a major challenge in the rehabilitation of a paretic limb since voluntary control of physical movement is limited. Here, we describe a novel training scheme we have developed that has the potential to circumvent this major challenge. We exploited the voluntary control of one hand and provided real-time movement-based manipulated sensory feedback as if the other hand is moving. Visual manipulation through virtual reality (VR) was combined with a device that yokes left-hand fingers to passively follow right-hand voluntary finger movements. In healthy subjects, we demonstrate enhanced within-session performance gains of a limb in the absence of voluntary physical training. Results in healthy subjects suggest that training with the unique VR setup might also be beneficial for patients with upper limb hemiparesis by exploiting the voluntary control of their healthy hand to improve rehabilitation of their affected hand.

We describe a novel virtual-reality based setup which exploits voluntary control of one hand to improve motor-skill performance in the other (non-trained) hand. This is achieved by providing real-time movement-based sensory feedback as if the non-trained hand is moving. This new approach may be used to enhance rehabilitation of patients with unilateral hemiparesis.

As far as acquiring motor skills is concerned, training by voluntary physical movement is superior to all other forms of training (e.g. training by ...

Paradigms of Lower Extremity Electrical Stimulation Training After Spinal Cord Injury

Skeletal muscle atrophy, increased adiposity and reduced physical activity are key changes observed after spinal cord injury (SCI) and are associated with numerous cardiometabolic health consequences. These changes are likely to increase the risk of developing chronic secondary conditions and impact the quality of life in persons with SCI. Surface neuromuscular electrical stimulation evoked resistance training (NMES-RT) was developed as a strategy to attenuate the process of skeletal muscle atrophy, decrease ectopic adiposity, improve insulin sensitivity and enhance mitochondrial capacity. However, NMES-RT is limited to only a single muscle group. Involving multiple muscle groups of the lower extremities may maximize the health benefits of training. Functional electrical stimulation-lower extremity cycling (FES-LEC) allows for the activation of 6 muscle groups, which is likely to evoke greater metabolic and cardiovascular adaptation. Appropriate knowledge of the stimulation parameters is key to maximizing the outcomes of electrical stimulation training in persons with SCI. Adopting strategies for long-term use of NMES-RT and FES-LEC during rehabilitation may maintain the integrity of the musculoskeletal system, a pre-requisite for clinical trials aiming to restore walking after injury. The current manuscript presents a combined protocol using NMES-RT prior to FES-LEC. We hypothesize that muscles conditioned for 12 weeks prior to cycling will be capable of generating greater power, cycle against higher resistance and result in greater adaptation in persons with SCI.

Spinal cord injury is a traumatic medical condition that may result in elevated risks of chronic secondary metabolic disorders. Here, we presented a protocol using surface neuromuscular electrical stimulation-resistance training in conjunction with functional electrical stimulation-lower extremities cycling as a strategy to ameliorate several of these medical problems.

Skeletal muscle atrophy, increased adiposity and reduced physical activity are key changes observed after spinal cord injury (SCI) and are associated with ...

A Networked Desktop Virtual Reality Setup for Decision Science and Navigation Experiments with Multiple Participants

Investigating the interactions among multiple participants is a challenge for researchers from various disciplines, including the decision sciences and spatial cognition. With a local area network and dedicated software platform, experimenters can efficiently monitor the behavior of the participants that are simultaneously immersed in a desktop virtual environment and digitalize the collected data. These capabilities allow for experimental designs in spatial cognition and navigation research that would be difficult (if not impossible) to conduct in the real world. Possible experimental variations include stress during an evacuation, cooperative and competitive search tasks, and other contextual factors that may influence emergent crowd behavior. However, such a laboratory requires maintenance and strict protocols for data collection in a controlled setting. While the external validity of laboratory studies with human participants is sometimes questioned, a number of recent papers suggest that the correspondence between real and virtual environments may be sufficient for studying social behavior in terms of trajectories, hesitations, and spatial decisions. In this article, we describe a method for conducting experiments on decision-making and navigation with up to 36 participants in a networked desktop virtual reality setup (i.e., the Decision Science Laboratory or DeSciL). This experiment protocol can be adapted and applied by other researchers in order to set up a networked desktop virtual reality laboratory.

This paper describes a method for conducting multi-user experiments on decision-making and navigation using a networked computer laboratory.

Investigating the interactions among multiple participants is a challenge for researchers from various disciplines, including the decision sciences and ...

Virtual Reality Experiments with Physiological Measures

Virtual reality (VR) experiments are increasingly employed because of their internal and external validity compared to real-world observation and laboratory experiments, respectively. VR is especially useful for geographic visualizations and investigations of spatial behavior. In spatial behavior research, VR provides a platform for studying the relationship between navigation and physiological measures (e.g., skin conductance, heart rate, blood pressure). Specifically, physiological measures allow researchers to address novel questions and constrain previous theories of spatial abilities, strategies, and performance. For example, individual differences in navigation performance may be explained by the extent to which changes in arousal mediate the effects of task difficulty. However, the complexities in the design and implementation of VR experiments can distract experimenters from their primary research goals and introduce irregularities in data collection and analysis. To address these challenges, the Experiments in Virtual Environments (EVE) framework includes standardized modules such as participant training with the control interface, data collection using questionnaires, the synchronization of physiological measurements, and data storage. EVE also provides the necessary infrastructure for data management, visualization, and evaluation. The present paper describes a protocol that employs the EVE framework to conduct navigation experiments in VR with physiological sensors. The protocol lists the steps necessary for recruiting participants, attaching the physiological sensors, administering the experiment using EVE, and assessing the collected data with EVE evaluation tools. Overall, this protocol will facilitate future research by streamlining the design and implementation of VR experiments with physiological sensors.

Virtual reality (VR) experiments can be difficult to implement and require meticulous planning. This protocol describes a method for the design and implementation of VR experiments that collect physiological data from human participants. The Experiments in Virtual Environments (EVE) framework is employed to accelerate this process.

Virtual reality (VR) experiments are increasingly employed because of their internal and external validity compared to real-world observation and ...

A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program

Despite the evidence that cardiac rehabilitation (CR) reduces the risk of recurrent cardiac events, only a minority of eligible patients are willing to join existing programs at cardiac rehabilitation centers. The unique remote patient monitoring system presented here enables healthcare providers to monitor CR patients at home in real-time and at low cost. The system combines mobile technology, artificial intelligence, and supportive services, expanding the delivery of medical care to the patient&#39;s home. The primary aim of the study is to increase the long-term adherence to physical activity in patients who participate in CR via the addition of a home-based digitally monitored CR component to the standard CR program in patients with ischemic heart disease (IHD), with the idea of forming new habitual health behaviors and increasing the long-term motivation for physical exercise (PE) habits at home. Secondary aims are to assess the program&#39;s impact on the physical activity level measured by average steps per day, minutes of exercise per week, blood pressure, metabolic parameters, body mass index, and waist-to-hip ratio, as well as a quality-of-life (QoL) questionnaire.The study has two arms: (1) home-based monitored exercise using a smart digital garment and wristband, in addition to motivation and reinforcement via text messages; (2) standard CR facility-based exercise. The study design is a randomized, controlled trial comparing standard CR to a home-based monitoring and reinforcement program. The study program is designed for 12 weeks.Clinical tests and anthropometric measurements are performed before and after the study, measuring height, weight, waist circumference, visceral fat and body mass index (BMI), blood pressure, and HbA1c and lipid profile. Patients have to complete a baseline survey including socio-demographic characteristics and QoL questionnaire SF-36. At the end of the study, patients complete a survey regarding the use of the smart digital garment&#39;s benefits and usability. The study is currently underway.

The aim is to promote a new approach to cardiac rehabilitation (CR), using a unique remote patient monitoring system that will enable healthcare providers to monitor CR patients at home at low cost, with the intention of making CR services more accessible and improving compliance. The study is currently underway.

Despite the evidence that cardiac rehabilitation (CR) reduces the risk of recurrent cardiac events, only a minority of eligible patients are willing to ...

Online Explorative Study on the Learning Uses of Virtual Reality Among Early Adopters

Virtual reality (VR) has shown great educational potential because it makes it possible to simulate any desired situation or event, thus playing an important role in addressing current educational challenges. Despite the unlimited learning possibilities that VR may offer, unless users are willing to apply virtual devices to education, the investment of time, money, and effort will be fruitless. It is therefore crucial to assess the educational interest of the first generation of VR users and to identify their current needs. To this end, in this study we designed an online questionnaire and applied it through the SaaS (Software as a service) of a private server. The sample consisted of 117 early VR adopters recruited via a main portal of communication and information technologies in Spain. In order to engage participants, we posted a thread in the main forum, which is dedicated to the advances and potential uses of VR. Once the responses were gathered, we analyzed the relationship between 12 variables (mean contrasts with Snedecor&#39;s F, and contingency analysis with chi-square and Sommer&#39;s d). The results showed that the current profile of a VR user is a male over 35 years old, with university studies, and who has purchased his viewer recently (&#60;1 year). As for the learning and teaching applications that these users were interested in, only 13.7% of the participants in this study use VR for educational purposes, although 28.2% were interested, indicating that perhaps the lack of applications or learning experiences may be hampering the use of VR within education. Almost half of the early adopters surveyed would like to learn using VR technology and are somehow optimistic about the relationship between VR and education, particularly those who are younger.

This article describes the profile of Spanish early adopters of virtual reality and their interests and preferences regarding learning and educational applications for this technology. To this aim, we designed an online questionnaire and interviewed 117 users of the main virtual reality forum on the Internet.

Virtual reality (VR) has shown great educational potential because it makes it possible to simulate any desired situation or event, thus playing an ...