Effectiveness and feasibility of virtual reality and gaming system use at home by older adults for enabling physical activity to improve health-related domains: a systematic review

Background
use of virtual reality and commercial gaming systems (VR/gaming) at home by older adults is receiving attention as a means of enabling physical activity.

Objective
to summarise evidence for the effectiveness and feasibility of VR/gaming system utilisation by older adults at home for enabling physical activity to improve impairments, activity limitations or participation.

Methods
a systematic review searching 12 electronic databases from 1 January 2000–10 July 2012 using key search terms. Two independent reviewers screened yield articles using pre-determined selection criteria, extracted data using customised forms and applied the Cochrane Collaboration Risk of Bias Tool and the Downs and Black Checklist to rate study quality.

Results
fourteen studies investigating the effects of VR/gaming system use by healthy older adults and people with neurological conditions on activity limitations, body functions and physical impairments and cognitive and emotional well-being met the selection criteria. Study quality ratings were low and, therefore, evidence was not strong enough to conclude that interventions were effective. Feasibility was inconsistently reported in studies. Where feasibility was discussed, strong retention (≥70%) and adherence (≥64%) was reported. Initial assistance to use the technologies, and the need for monitoring exertion, aggravation of musculoskeletal symptoms and falls risk were reported.

Conclusions
existing evidence to support the feasibility and effectiveness VR/gaming systems use by older adults at home to enable physical activity to address impairments, activity limitations and participation is weak with a high risk of bias. The findings of this review may inform future, more rigorous research.

Haptic virtual reality training environment for micro-robotic cell injection

Micro-robotic cell injection is typically performed manually by a trainedbio-operator, and success rates are often low. To enhance bio-operator performance during real-time cell injection, our earlier work introduced a haptically-enabled micro-robotic cell injection system. The system employed haptic virtual fixtures to provide haptic guidance according to articular performance metrics. This paper extends the work by replicating the system within a virtual reality (VR) environment for bio-operator training. Using the virtual environment, the bio-operator is able to control the virtual injection process in the same way they would with the physical haptic micro-robotic cell injection system, while benefiting from the enhanced visualisation capabilities offered by the 3D VR environment. The system is achieved using cost-effective components offering training at much lower cost than using the physical system.

Keyboard control method for virtual reality micro-robotic cell injection training

The rapid development of virtual reality offers significant potential for skills training applications. Our ongoing work proposes virtual reality operator training for the micro-robotic cell injection procedure. The interface between the operator and the system can be achieved in many different ways. The computer keyboard is ubiquitous in its use for everyday computing applications and also commonly utilized in virtual reality systems. Based on the premise that most people have experience in using a computer keyboard, as opposed to more sophisticated input devices, this paper considers the feasibility of using a keyboard to control the micro-robot for cell injection. In this study, thirteen participants underwent the experimental evaluation. The participants were asked to perform three simulated trial sessions in a virtual micro-robotic cell injection environment. Each session consisted of ten cell injection trials and relevant data for each trial were recorded and analyzed. Results showed participants' performance improvement after the three sessions. It was also observed that participants intuitively controlled multiple axes of the micro-robot simultaneously despite the absence of instruction on how to do so. This continued throughout the experiments and suggests skills transfer from other keyboard based interactions. Based on the results provided, it is suggested that keyboard control is a feasible, simple and low-cost control method for the virtual micro-robot.

Design of a virtual reality training system for micro-robotic cell injection

This paper discusses the design of a virtual reality (VR) training system for micro-robotic cell injection. A brief explanation of cell injection and the challenges associated with the procedure are first presented. This is followed by discussion of the skills required by the bio-operator to achieve successful injection, such as accuracy, trajectory and applied force. The design of the VR system which includes the visual display, input controllers, mapping strategies, haptic guidance and output data is then discussed. Initial evaluation of the VR system is presented including analysis and discussion based on conducted user evaluations. Finally, given the findings of the initial evaluation, this paper concludes that an effective haptically-enabled virtual cell injection training system is feasible, and recommendations for improvement and future work are given.

Building the computational virtual reality environment for anaesthetists' training and practice

Understanding the real world based on visualisation and prediction is essential for the decision-maker. We build a computational virtual reality environment to improve visualisation, understanding and prediction of the physical world and to guide action. It develops a five-dimensional, computer-generated, computational Virtual Reality Environment for Anaesthesia (VREA). Our online prediction will be calculated based on the correlation and composition computing with respect to the three dimensions: horizontal, vertical and individual. The novel musical notes based anesthetic simulator is proposed to identify the abnormality and visualize the online medical time series. The experiments with the online ECG data will present a real-time case to show the effectiveness and efficiency of our proposed system and algorithms.

Building computational virtual reality environment for anesthesia

In this paper, a Computational Virtual Reality Environment for Anesthesia (CVREA) is proposed. Virtual reality, data mining, machine learning techniques will be explored to develop (1) an immersive and interactive training platform for anaesthetists, which can greatly improve their training and learning performance; (2) a knowledge learning environment which collects clinical data with greater richness, process data with more efficacy, and facilitate knowledge discovery in anaesthesiology.

Use of active video games to increase physical activity in children: a (virtual) reality?

There has been increased research interest in the use of active video games (in which players physically interact with images onscreen) as a means to promote physical activity in children. The aim of this review was to assess active video games as a means of increasing energy expenditure and physical activity behavior in children. Studies were obtained from computerized searches of multiple electronic bibliographic databases. The last search was conducted in December 2008. Eleven studies focused on the quantification of the energy cost associated with playing active video games, and eight studies focused on the utility of active video games as an intervention to increase physical activity in children. Compared with traditional nonactive video games, active video games elicited greater energy expenditure, which was similar in intensity to mild to moderate intensity physical activity. The intervention studies indicate that active video games may have the potential to increase free-living physical activity and improve body composition in children; however, methodological limitations prevent definitive conclusions. Future research should focus on larger, methodologically sound intervention trials to provide definitive answers as to whether this technology is effective in promoting long-term physical activity in children.

Does a combination of virtual reality, neuromodulation and neuroimaging provide a comprehensive platform for neurorehabilitation? - A narrative review of the literature

In the last decade, virtual reality (VR) training has been used extensively in video games and military training to provide a sense of realism and environmental interaction to its users. More recently, VR training has been explored as a possible adjunct therapy for people with motor and mental health dysfunctions. The concept underlying VR therapy as a treatment for motor and cognitive dysfunction is to improve neuroplasticity of the brain by engaging users in multisensory training. In this review, we discuss the theoretical framework underlying the use of VR as a therapeutic intervention for neurorehabilitation and provide evidence for its use in treating motor and mental disorders such as cerebral palsy, Parkinson’s disease, stroke, schizophrenia, anxiety disorders, and other related clinical areas. While this review provides some insights into the efficacy of VR in clinical rehabilitation and its complimentary use with neuroimaging (e.g., fNIRS and EEG) and neuromodulation (e.g., tDCS and rTMS), more research is needed to understand how different clinical conditions are affected by VR therapies (e.g., stimulus presentation, interactivity, control and types of VR). Future studies should consider large, longitudinal randomized controlled trials to determine the true potential of VR therapies in various clinical populations.

Rhetoric and reality: critical perspectives on education in a 3D virtual world

The emergence of any new educational technology is often accompanied by inflated expectations about its potential for transforming pedagogical practice and improving student learning outcomes. A critique of the rhetoric accompanying the evolution of 3D virtual world education reveals a similar pattern, with the initial hype based more on rhetoric than research demonstrating the extent to which rhetoric matches reality. Addressed are the perceived gaps in the literature through a critique of the rhetoric evident throughout the evolution of the application of virtual worlds in education and the reality based on the reported experiences of experts in the field of educational technology, who are all members of the Australian and New Zealand Virtual Worlds Working Group. The experiences reported highlight a range of effective virtual world collaborative and communicative teaching experiences conducted in members' institutions. Perspectives vary from those whose reality is the actuation of the initial rhetoric in the early years of virtual world education, to those whose reality is fraught with challenges that belie the rhetoric. Although there are concerns over institutional resistance, restrictions, and outdated processes on the one-hand, and excitement over the rapid emergence of innovation on the other, the prevailing reality seems to be that virtual world education is both persistent and sustainable. Explored are critical perspectives on the rhetoric and reality on the educational uptake and use of virtual worlds in higher education, providing an overview of the current and future directions for learning in virtual worlds.

Virtual reality training for micro-robotic cell injection

This research was carried out to fill the gap within existing knowledge on the approaches to supplement the training for micro-robotic cell injection procedure by utilising virtual reality and haptic technologies.

Assets in Accounting: Reality Lost

The aim of this paper is to trace changes in the definitional concept of assets in an attempt to discover why professional accounting bodies in the major English speaking countries have adopted the problematic abstract 'future benefit' notion, which is so far removed from the simple concept of assets as exchangeable things or rights. It is suggested that in the future financial reporting requirements for business entities include a statement of 'separably exchangeable property' and legal obligations at the reporting date.

Realistic grasping of rigid virtual objects through event-based haptics

This research presents a novel haptic grasping interface and demonstrates its ability within multi-point event-based feedback. Through experimental methodology, the dynamics involved in grasp contact interactions are modelled based on first principles. The proposed approach demonstrates a method of realistically representing grasp contact with rigid virtual objects through multi-point interaction.

Haptically enabled interactivity and immersive virtual assembly

Virtual training systems are attracting paramount attention from the manufacturing industries due to their potential advantages over the conventional training practices such as general assembly. Within this virtual training realm for general assembly, a haptically enabled interactive and immersive virtual reality (HIVEx) system is presented. The idea is to imitate real assembly training scenarios by providing comprehensive user interaction as well as by enforcing physical constraints within the virtual environment through the use of haptics technology. The developed system employs a modular system approach providing flexibility of reconfiguration and scalability as well as better utilization of the current multi-core computer architecture. The user interacts with the system using haptics device and data glove while fully immersed into the virtual environment with depth perception. An evaluation module, incorporated into the system, automatically logs and evaluates the information through the simulation providing user performance and improvements over time. A ruggedized portable version of the system is also developed and presented with full system capabilities allowing easy relocation with different factory environments. A number of training scenarios has been developed with varying degree of complexity to exploit the potential of the presented system. The presented system can be employed for teaching and training of existing assembly processes as well as the design of new optimised assembly operations. Furthermore, the presented system can assist in optimizing existing practices by evaluating the effectiveness and the level of knowledge transfer involved in the process. Within the aforementioned conceptual. framework, a working prototype is developed.