Webinars

Persuasive virtual agents for peer pressure toward alcohol use in Immersive Virtual Reality: Current state and future directions

Mr. Simon Lengener and Ms. Samantha Murray, Univeristy of Twente, Netherlands

“ALCO-VR” project: Virtual Reality Cue-Exposure Therapy for the treatment of alcohol use disorder”

Dr. Alexandra Ghita, Department of Health, Medical and Neuropsychology, Leiden University, Netherlands

Do we learn better in VR? The use of motor learning principles in immersive and non-immersive virtual reality

Dr. Martin Lemay, Université du Québec à Montréal, Montreal, Canada

Promotion of healthy habits in adolescents and young adults with physical disabilities: co-design and implementation of a virtual platform in a non-profit organization

Dr. Maxime Robert, Université Laval, Quebec, Canada

Assessing Sensorimotor Control during Walking in VR. Dr. James Finley

Dr. James Finley, Associate Professor of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles

USA Use of Virtual Reality Systems for Care of the Injured Warfighter

Dr. Pinata H Sessoms, Director of the Physical and Cognitive Operational Research Environment, Naval Health Research Center, San Diego, USA

From physical patient-robot interaction to kinaesthetic

Prof. Ludovic Saint-Bauzel, Université de la Sorbonne and Institut des Systèmes Intelligents et de Robotique, France

The talk will focus on research on smart walkers to demonstrate that prediction is a key factor for improvement of interaction and how it has led to new issues that opened questions of kinaesthetic communication and the development of a robotic device.

Human-Avatar Interactions

On October 28, 2020, the International Society of Virtual Rehabilitation presented its first online symposium. The symposium consisted of three 30 minute presentations on topics of current interest to the virtual rehabilitation community. In one of the presentations, Mindy Levin from McGill University and Judy Deutsch from Rutgers University made a presentation entitled “From video games to interactive software applications – cutting through the virtual reality terminology”. The presentation described the evolution and definitions of virtual reality, videogames and exergames for rehabilitation with the ultimate goal of embarking on the road of consensus on the use of this terminology in the field and provided definitions summarized in the boxes below. Building consensus in terms of definitions and terminology is important to facilitate communication within the interdisciplinary field of virtual rehabilitation. After a brief historical perspective of the development of virtual rehabilitation and exergames was illustrated, Dr. Levin discussed the concepts of immersion and presence and how they are applied in VR while Dr. Deutsch shared a brief history of video games and exergames and how their terminology is intertwined with virtual reality. The terms defined in Dr. Deutsch’s section included video games, commercial off-the-shelf video game (COTS), interactive video game, serious games, serious digital health games and active games and exergames. In the discussion that ensured, it was agreed that further efforts are needed to reach consensus in the terminology used in virtual rehabilitation and exergame applications.

Virtual rehabilitation for coping with pandemic: success stories and clinical implications

Marika Demers, University of Southern California, USA
Roberto Llorens, Universitat Politecnica de Valencia, Spain
In their talk, Marika Demers and Roberto Llorens described their experiences with telerehabilitation during the past months as a response to the global pandemic. The past months taught us that people around the world could develop creative solutions to adapt to the COVID-19 pandemic. Their presentation focused on how virtual rehabilitation could be one creative and evidence-based solution to deliver rehabilitation interventions and drive a positive impact for people with disabilities. Specifically, they described the unique benefits of virtual rehabilitation offered synchronously or asynchronously with telerehabilitation to implement home-delivered rehabilitative interventions. We also presented two success stories for coping with the pandemic: 1) Virtual-reality based telerehabilitation initiative to improve balance recovery after stroke and 2) Remote assessment of posture and gait characteristics. The results suggest that a virtual rehabilitation with telerehabilitation is well-accepted by stroke survivors and was not inferior to in-person treatment to address balance impairments. Open-source assessment tools using commercial gaming accessories also show promise for remote assessment of posture and gait in stroke survivors. The presentation concluded with resources to support clinicians, as they play a crucial role in the selection of appropriate platform and games to meet individual rehabilitation needs.

Human-avatar interactions in virtual environments: opportunities and challenges for locomotor assessment and training

Anouk Lamontagne and Sean D. Lynch McGill University, Montreal, Canad and Jewish Rehabilitation Hospital Research Site – CISSS de Laval, Laval, Canada
Virtual reality is an increasingly validated approach for the study of human interactions in controlled but ecological environments, and for the clinical assessment and training of locomotor disorders for those that would otherwise be at risk in a real-world setting. The presentation focussed on two types of interaction, namely the interactions with avatars and those with virtual pedestrians. Avatars are a representation of one’s self, which can be presented to a participant in real-time that in turn allows for feedback of one’s own performance. Potential challenges of self-representation training can include the different viewing perspectives of an avatar and the contribution of different sensory modalities. Initial findings collected in stoke survivors with post-stroke gait asymmetry suggest that certain participant profiles benefit from a visual avatar presented in the side view to enhance their symmetry of gait. In addition, most participants appear to experience further benefit in gait symmetry when exposed to multimodal sensory feedback (avatars presented in the combined visual and auditory modality) compared to avatars presented in the auditory or visual modality in isolation. With this knowledge pertaining to the quality of feedback and its benefits, future directions can consider the potential benefits of repeated exposure. The second type of interaction concerns virtual humans that represent other pedestrians from a typical community setting. Current work has shown how behaviours of navigation are preserved within virtual reality and lead to similar adaptations to those observed in the physical world. Such validation has presented new horizons to investigate more complex community settings that include the avoidance of collisions with pedestrians, the effects of additional cognitive tasks, and the role of agent-specific gait characteristics during collision avoidance tasks. We reflect on the potential opportunities and challenges from the addition of integrated eye-tracking technology with virtual reality headsets to how virtual pedestrian can aid locomotor assessment and training for populations with gait disorders.

VR in the realm of cognitive-motor interactions

Dr. Joyce Fung is Associate Professor at the School of Physical and Occupational Therapy, McGill University, in Montreal Canada. She is a founding member of ISVR. Dr. Fung has a PT degree from the Hong Kong Polytechnic University and she became the first graduate from the School of Physical and Occupational Therapy (SPOT) at McGill to obtain a PhD in Rehabilitation Science in 1992. She has established a state-of-the-art Posture and Gait research laboratory at the Jewish Rehabilitation Hospital (JRH), a McGill-affiliated teaching hospital and research site of the Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR). Her research program ranges from the study of basic sensorimotor integration mechanisms in the control of posture and balance, to the clinical application of new tools (and technologies), including VR, for the assessment and intervention of balance and mobility disorders.

VR in the realm of vestibular rehabilitation

Dr. Emily A. Keshner is an Emeritus Professor in the Department of Health and Rehabilitation Sciences at Temple University. Dr. Keshner is also a founding member and past president of ISVR. While at Northwestern University, she developed the first virtual reality laboratory in the USA to study posture and balance with Dr. Robert Kenyon from the Electronic Visualization Laboratories at UIC. She served as Chair of the Department of Physical Therapy and Director of the Virtual Environment and Postural Orientation (VEPO) Laboratory at Temple University for many years. Her research has been funded by NIH and focuses on application of human-virtual environment interactions as a window into disordered sensory processing with neurological disorders. She has an interdisciplinary approach to research and built a team of collaborators that included physiologists, biomechanists, computer scientists, and bioengineers.

Virtual Reality Analgesia

Dr. Hunter Hoffman, University of Washington, Seattle USA
Pain during medical procedures is a common problem. Opioid analgesics help reduce pain, and become more effective at higher doses, but opioid side effects limit dose levels, and while overdose is very rare in hospitals, on the streets, opioid overdose deaths at epidemic levels, pressuring doctors to be very conservative about prescribing opioids. In addition to under medication, psychological factors such as fear, anxiety and apprehension can amplify how much pain the person experiences and repeated excessive acute pain can lead to chronic pain. Fortunately, because pain often has a strong psychological component, adjunctive psychological treatments can help reduce pain, with few or no additional side effects. For example, immersive virtual reality analgesia, first reported by Hoffman and colleagues in the 1990s, is currently emerging as an unusually powerful adjunctive non-pharmacologic analgesic. VR has been shown to reduce the intensive pain during burn wound cleaning, and pain during dental procedures, venipuncture, physical therapy, outpatient orthopedic and urological surgery procedures and a wide range of other painful events. fMRI brain scans show that in addition to reducing participants’ subjective experience of pain, VR also reduces pain-related brain activity. A follow-up fMRI study showed that VR reduces pain as much as a moderate dose of hydromorphone. However, although distraction is often credited by researchers, the mechanism of how VR reduces pain.

Applying Virtual Reality to Reduce Neuropathic Pain and Support Rehabilitation after SCI 

Dr. Zina Trost, Virginia Commonwealth University, Richmond, USA
Applying Virtual Reality to Reduce Neuropathic Pain and Support Rehabilitation after SCI
Today, a wide spectrum of established and emerging rehabilitation technologies allows clinicians and their patients to address different objectives and to circumvent physical activity deterioration. There is supporting evidence supporting the use of virtual reality (VR) applications to reduce SCI neuropathic pain and promote functional restoration. The current presentation will summarize and highlight primary research findings related to applications of VR in neuropathic pain treatment for persons with SCI.

Brain-Computer Interface for Virtual Rehabilitation

Prof. Sook Lei, University of Southern California, Los Angeles, USA
Rehabilitation options for stroke survivors with severe arm motor impairments are very limited. One promising opportunity is the use of brain and muscle computer interface combined with virtual reality to offer personalization of neural/muscular targets. This presentation will focus
on how virtual rehabilitation can be used to personalize and improve stroke rehabilitation. The benefits of customized environments to help address individual needs and greater doses of movement will also be discussed. Finally, an example of an ongoing trial that combine muscle
computer interface with home training will be provided to highlight how this technology can be offered via telerehabilitation.

Combining Virtual Reality and Brain-Computer Interfaces for Upper Limb Rehabilitation after Stroke: Opportunities, Challenges and Lessons Learned

Prof. Sergi Bermúdez i Badia, Universidade da Madeira, Funchal, Madeira
In this talk, I intend to discuss the approach we have been systematically following in the last 10 years to combine Virtual Reality (VR) and EEG-based Brain-Computer Interfaces for post-stroke rehabilitation. I will present the advances, challenges and lessons learned we had in the last decade. I will address different facets of the problem and will try to bring some light to the challenges we face: from embedding neuroscientific principles in the design of Virtual Environments, the selection of the most appropriate setup, interaction and gamification strategies in a BCI-driven motor rehabilitation task, as well as some EEG data processing considerations and clinical outcomes. Finally, I will present our current efforts in overcoming some of the current limitations we face in the field by combining simultaneous fMRI-EEG acquisition in VR-driven Motor Imagery neurofeedback.

Discussion – Brain-Computer Interface for Virtual Rehabilitation

Prof. Sergi Bermúdez i Badia, Universidade da Madeira, Funchal, Madeira
PhD candidate, Octavio Marin Pardo, University of Southern California, Los Angeles, USA
moderated by Tamar Weiss, University of Haifa, Israel

Illusions of presence: Implications for neurorehabilitation Virtual Reality in Clinical Psychology

Prof. Mel Slater, University of Barcelona
In virtual reality you can look around wherever you like, and still of course see virtual reality. This typically leads to illusions of presence and body ownership. Almost 30 years ago it was realised that VR can provide an interesting tool for clinical psychology, and over these last three decades there has been considerable research in this area. In this talk I will review some of this previous work which has mainly focused on anxiety disorders. I will move on from this to consider illusions of body representation. In VR if it has been so programmed you will see a life-sized virtual body replacing your own when you look down towards yourself or into a virtual mirror. You are likely then to have the perceptual illusion that the virtual body is yours, even though you know for sure that it is not. This is referred to as a body ownership illusion. Here I will describe this illusion, and give examples of how this has been used in the context of clinical psychology.

Virtual Embodiment in Virtual Environments for Pain Management

Prof. Maria V. Sanchez-Vives, Institute of Biomedical Investigations August Pi i Sunyer, Barcelona, Spain
A significant body of experimental evidence has demonstrated that it is possible to induce the illusion of ownership of a fake limb or even an entire fake body using multisensory correlations. Recently, immersive virtual reality has allowed users to experience the same sensations of ownership over a virtual body inside an immersive virtual environment, which in turn allows virtual reality users to have the feeling of being “embodied” in a virtual body. Using such virtual embodiment to manipulate body perception is starting to be extensively investigated and may have clinical implications for conditions that involve altered body image such as chronic pain. I will review experimental and clinical studies that have explored the manipulation of an embodied virtual body in immersive virtual reality for both experimental and clinical pain relief. We discuss the current state of the art, as well as the challenges faced by, and ideas for, future research. Finally, I will discuss the potentialities of using an embodied virtual body in immersive virtual reality in the field of neurorehabilitation, specifically in the field of pain.

Discussion – Illusions of presence: Implications for neurorehabilitation

Prof. Maria V. Sanchez-Vives, Institute of Biomedical Investigations August Pi i Sunyer, Barcelona, Spain
Prof. Mel Slater, University of Barcelona
moderated by Tamar Weiss, University of Haifa, Israel