Investigating Techniques to Enhance the Sense of Embodiment in Immersive Virtual Reality
Studio Dell'Embodiment In Ambienti Di Realtà Virtuale Immersiva
Embodiment is an important aspect of virtual reality because it affects how natural and engaging the experience feels and can influence performance and learning in VR-based applications, including rehabilitation. In VR, embodiment refers to the extent to which a person feels that a virtual body (avatar) is their own and under their control. It is typically described as having three components: sense of agency (feeling that one is causing the avatar's actions), body ownership (feeling that the avatar's body is one's own), and self-location (feeling located where the avatar is). While many VR systems aim to increase embodiment, there is limited evidence on which specific techniques are most effective-especially in people with acquired neurological injuries, in whom central nervous system damage may alter body perception and multisensory integration.
This study will compare several VR techniques that may enhance embodiment, including synchronized visual and tactile stimulation, heart-rate-based visual biofeedback, increased possibilities to actively control the avatar, and familiarity with the performed action. Participants will include healthy volunteers and individuals with acquired neurological injuries (spinal cord injury or stroke). Across three study days, participants will complete multiple short VR conditions while wearing physiological sensors, and after each VR condition, participants will complete questionnaires about their VR experience. The goal is to identify which VR techniques most effectively increase embodiment and whether embodiment-related responses differ between healthy participants and clinical groups.
Studieoversikt
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Intervensjon / Behandling
Intervensjon / Behandling
Detaljert beskrivelse
This is a prospective, single-center, non-profit interventional study conducted at IRCCS Eugenio Medea (Bosisio Parini, Italy) in collaboration with CNR-STIIMA. The aim is to investigate factors that influence embodiment during immersive virtual reality (VR), in healthy volunteers and in individuals with acquired neurological injuries (spinal cord injury or stroke). The study evaluates the effects of: (1) visuo-tactile stimulation, (2) VR biofeedback synchronized with the participant's heart rate, (3) the degree of active control over the avatar and virtual environment, and (4) familiarity with the performed action.
Each participant completes three experimental days. On Day 1, participants experience multiple short VR conditions, including a baseline condition (no additional stimulation), visuo-tactile stimulation, heart-rate-synchronized biofeedback, and active hand control of the avatar using motion tracking and data gloves. After each condition, participants perform a brief reaction-time task used in the literature as an objective, performance-based measure related to embodiment: brief light stimuli are presented either on the avatar's body or in the surrounding virtual environment, and participants respond as quickly as possible when a light appears. Reaction times to body versus environment stimuli are compared, and the task is repeated after each condition to examine whether performance changes depending on the preceding VR experience.
On Day 2, participants complete immersive VR cycling tasks designed to probe sense of agency and body ownership by manipulating the match between visual feedback and the participant's actual movements (matched vs mismatched feedback) and by comparing active versus passive movement conditions. During Day 2, electroencephalography (EEG) is recorded to investigate neural correlates associated with embodiment and agency under the different VR manipulations.
On Day 3, participants complete first-person VR mobility scenarios (walking or wheelchair) to evaluate embodiment in relation to task familiarity, comparing passive versus active exploration, with and without heart-rate-synchronized biofeedback.
Across all study days, participants wear wearable sensors to record electrodermal activity (EDA), cardiac activity for heart rate variability (HRV), and skin temperature, providing objective physiological measures that may vary with embodiment-related experiences. After each condition on each study day, participants also complete the Virtual Embodiment Questionnaire (VEQ).
Planned analyses will compare experimental conditions and participant groups (within each study day) using both subjective outcomes (VEQ scores) and objective measures (reaction-time task performance, physiological signals, and EEG metrics).
Studietype
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Kontakter og plasseringer
Studiekontakt
Studiekontakt
- Navn: Emilia Biffi, PhD Eng
- Telefonnummer: +39 031 877862
- E-post: emilia.biffi@lanostrafamiglia.it
Studer Kontakt Backup
- Navn: Giorgia Malerba, PhD Candidate
- Telefonnummer: +39 031 877645
- E-post: giorgia.malerba@lanostrafamiglia.it
Studiesteder
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Lecco
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Bosisio Parini, Lecco, Italia, 23842
- Rekruttering
- IRCCS Eugenio Medea
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Ta kontakt med:
- Giorgia Malerba, PhD Candidate
- Telefonnummer: +39 031 877645
- E-post: giorgia.malerba@lanostrafamiglia.it
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Ta kontakt med:
- Emilia Biffi, PhD Eng
- Telefonnummer: +39 031877862
- E-post: emilia.biffi@lanostrafamiglia.it
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Hovedetterforsker:
- Emilia Biffi, PhD Eng
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Deltakelseskriterier
Kvalifikasjonskriterier
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Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria:
- Age 12 to 50 years
- Typically developing participants (healthy volunteers) OR participants with spinal cord injury OR participants with history of stroke
- Score ≥ 7 on the "Vocabulary" subtest of WISC (for minors) or WAIS (for adults)
Exclusion Criteria:
- History of epilepsy or epileptic seizures
- Poor head control
- Visual acuity not correctable with glasses
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Grunnvitenskap
- Tildeling: N/A
- Intervensjonsmodell: Enkeltgruppeoppdrag
- Masking: Ingen (Open Label)
Antall våpen
Våpen og intervensjoner
Deltakergruppe / ArmDeltakergruppe / Arm |
Intervensjon / BehandlingIntervensjon / Behandling |
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Eksperimentell: Immersive VR Embodiment Conditions (Within-Subject)
Participants complete multiple immersive virtual reality conditions across three study days. Conditions manipulate factors expected to influence embodiment. The order of conditions is randomized within each study day. Subjective embodiment is assessed after each condition using questionnaire, together with objective physiological measures. |
Participants undergo multiple immersive virtual reality conditions designed to modulate embodiment. Conditions include synchronized visuo-tactile stimulation, heart-rate-synchronized visual biofeedback, varying degrees of active control of the avatar, and tasks with different levels of familiarity. Conditions are presented as short VR scenarios across three study days, with randomized order within each day. |
Hva måler studien?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
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Virtual Embodiment Questionnaire (VEQ) Subscale Scores (Ownership, Agency, Perceived Change in Body Representation)
Tidsramme: Immediately after each VR condition on Day 1, Day 2, and Day 3.
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Embodiment-related self-report assessed with the Virtual Embodiment Questionnaire (VEQ). Three subscale scores are computed: Ownership, Agency, and Perceived Change in Body Representation. Each subscale score is calculated as the mean of 4 items rated on a 7-point Likert scale (1 = strongly disagree to 7 = strongly agree). Higher scores indicate stronger perceived ownership of the virtual body (Ownership), greater sense of control over the virtual body/actions (Agency), and stronger perceived change in body representation during VR (Perceived Change in Body Representation). |
Immediately after each VR condition on Day 1, Day 2, and Day 3.
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
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Virtual Environment Light Test: Mean Reaction Time by Body vs Environment Locations
Tidsramme: Immediately after each VR condition on Day 1.
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Participants perform a VR reaction-time task in which brief light stimuli are presented at predefined locations: on the avatar's right upper limb, left upper limb, right lower limb, left lower limb, or in the virtual environment outside the avatar. Stimuli occur at randomized intervals (1-5 seconds). Participants respond as quickly as possible when a light appears. The outcome is the mean reaction time (milliseconds) computed separately for each stimulus location category. Location-specific averages are used to capture potential asymmetries relevant to the clinical groups (e.g., right/left differences in stroke due to hemiparesis, and upper vs lower limb differences in spinal cord injury due to predominant lower-limb impairment). |
Immediately after each VR condition on Day 1.
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Electrodermal Activity (EDA) during VR conditions
Tidsramme: During each VR condition (60 seconds on Day 1 and Day 3; 120 seconds on Day 2)
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Electrodermal activity (EDA), a measure of sympathetic arousal, includes a tonic component (skin conductance level, SCL) and a phasic component (skin conductance responses, SCR). EDA is recorded during the VR sessions. For each VR condition, EDA metrics are computed relative to the baseline. The tonic component is summarized as the mean SCL during the condition. Phasic activity is summarized by SCR measures, including the number of SCR peaks and the mean SCR peak amplitude during the condition. Baseline-referenced values are computed as change from baseline for each metric. |
During each VR condition (60 seconds on Day 1 and Day 3; 120 seconds on Day 2)
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Skin Temperature During Virtual Reality Conditions
Tidsramme: During each VR condition (60 seconds on Day 1 and Day 3; 120 seconds on Day 2)
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Chest skin temperature will be analyzed as a slow physiological indicator that may vary with embodiment-related experiences in VR; based on prior findings, decreases in peripheral skin temperature have been reported with stronger embodiment. For each VR condition, skin temperature will be summarized as the mean value and condition values will be expressed relative to the baseline period (change from baseline). |
During each VR condition (60 seconds on Day 1 and Day 3; 120 seconds on Day 2)
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Heart Rate Variability (HRV) From ECG During VR Conditions
Tidsramme: During each VR condition (60 seconds on Day 1 and Day 3; 120 seconds on Day 2)
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Electrocardiogram (ECG) is recorded continuously during each study session; on Day 1 and Day 3, the ECG-derived heart rate is also used to provide real-time heart-rate visual biofeedback in VR. R-peaks are detected to derive the RR-interval time series, with artifact beat correction prior to analysis. Heart rate variability (HRV) is quantified for each VR condition and compared with baseline. Planned HRV metrics include standard time-domain indices (e.g., mean RR, SDNN, RMSSD) and frequency-domain indices (e.g., LF and HF power and LF/HF ratio). In the literature, HRV frequency components have been reported as sensitive to embodiment-related manipulations, with higher LF activity associated with lower embodiment and higher HF activity associated with moderate/high embodiment. |
During each VR condition (60 seconds on Day 1 and Day 3; 120 seconds on Day 2)
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EEG Spectral Power and Derived Cognitive Indices During VR Cycling Tasks (Day 2)
Tidsramme: During each VR condition on Day 2 (120 seconds)
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Electroencephalography (EEG) is recorded during the second study day using the eego mylab system with a 32-channel cap. EEG data will be pre-processed and analyzed in MATLAB using EEGLAB and custom scripts to remove artifacts and restrict the frequency content to the bands of interest. Power spectral density is computed and summarized within standard EEG bands (Delta, Theta, Alpha, and Beta). From band-power features, indices reflecting cognitive state are derived. For each VR condition, EEG-derived indices are compared with the preceding resting baseline segment to quantify condition-related deviations. In prior VR research, spectral features-particularly in the alpha and beta bands, including spatio-spectral patterns-have been investigated as potential correlates of embodiment-related processes. |
During each VR condition on Day 2 (120 seconds)
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Samarbeidspartnere og etterforskere
Sponsor
Sponsor
Samarbeidspartnere
Samarbeidspartnere
Etterforskere
Etterforskere
- Hovedetterforsker: Emilia Biffi, PhD Eng, IRCCS Eugenio Medea (Associazione La Nostra Famiglia)
Publikasjoner og nyttige lenker
Generelle publikasjoner
- McAnally K, Wallis G. Visual-haptic integration, action and embodiment in virtual reality. Psychol Res. 2022 Sep;86(6):1847-1857. doi: 10.1007/s00426-021-01613-3. Epub 2021 Oct 28.
- Guy, M., Normand, J. M., Jeunet-Kelway, C., & Moreau, G. (2023). The sense of embodiment in virtual reality and its assessment methods. Frontiers in Virtual Reality, 4, 1141683.
- Kilteni, K., Groten, R., & Slater, M. (2012). The sense of embodiment in virtual reality. Presence: Teleoperators and Virtual Environments, 21(4), 373-387.
- Giangualano, A., Boffi, P., Osimo, S. A., Yavari, M., Gabbiadini, A., Lanzi, P. L., & Gallace, A. (2025, October). Embodiment in Nature: How Avatar Choice Shapes an Underwater Virtual Reality Experience. In 2025 IEEE International Conference on Metrology for eXtended Reality, Artificial Intelligence and Neural Engineering (MetroXRAINE) (pp. 506-511). IEEE.
- Esteves D, Valente M, Bendor SE, Andrade A, Vourvopoulos A. Identifying EEG biomarkers of sense of embodiment in virtual reality: insights from spatio-spectral features. Front Neuroergon. 2025 May 12;6:1572851. doi: 10.3389/fnrgo.2025.1572851. eCollection 2025.
- HASSARD, A. (2023). The Sense of Embodiment in Virtual Reality Explored Through Presence, Narrative Immersion and Physical Effort.
- Marin-Morales J, Higuera-Trujillo JL, Guixeres J, Llinares C, Alcaniz M, Valenza G. Heart rate variability analysis for the assessment of immersive emotional arousal using virtual reality: Comparing real and virtual scenarios. PLoS One. 2021 Jul 1;16(7):e0254098. doi: 10.1371/journal.pone.0254098. eCollection 2021.
- Crivelli D, Polimeni E, Crotti D, Bottini G, Salvato G. Bilateral skin temperature drop and warm sensibility decrease following modulation of body part ownership through mirror-box illusion. Cortex. 2021 Feb;135:49-60. doi: 10.1016/j.cortex.2020.11.015. Epub 2020 Dec 3.
- Salomon R, Lim M, Pfeiffer C, Gassert R, Blanke O. Full body illusion is associated with widespread skin temperature reduction. Front Behav Neurosci. 2013 Jul 25;7:65. doi: 10.3389/fnbeh.2013.00065. eCollection 2013.
- Ronca, V., Ricci, A., Capotorto, R., Di Donato, L., Freda, D., Pirozzi, M., Palermo, E., Mattioli, L., Di Gironimo, G., Coccorese, D., Buonocore, S., Massa, F., Germano, D., Di Flumeri, G., Borghini, G., Babiloni, F., & Aricò, P. (2024). How Immersed Are You? State of the Art of the Neurophysiological Characterization of Embodiment in Mixed Reality for Out-of-the-Lab Applications. Applied Sciences, 14(18), 8192. https://doi.org/10.3390/app14188192
- Hagni K, Eng K, Hepp-Reymond MC, Holper L, Keisker B, Siekierka E, Kiper DC. Observing virtual arms that you imagine are yours increases the galvanic skin response to an unexpected threat. PLoS One. 2008 Aug 28;3(8):e3082. doi: 10.1371/journal.pone.0003082.
- Haggard P. Sense of agency in the human brain. Nat Rev Neurosci. 2017 Apr;18(4):196-207. doi: 10.1038/nrn.2017.14. Epub 2017 Mar 2.
- Scandola M, Togni R, Tieri G, Avesani R, Brambilla M, Aglioti SM, Moro V. Embodying their own wheelchair modifies extrapersonal space perception in people with spinal cord injury. Exp Brain Res. 2019 Oct;237(10):2621-2632. doi: 10.1007/s00221-019-05618-8. Epub 2019 Aug 2.
- Roth D, Latoschik ME. Construction of the Virtual Embodiment Questionnaire (VEQ). IEEE Trans Vis Comput Graph. 2020 Dec;26(12):3546-3556. doi: 10.1109/TVCG.2020.3023603. Epub 2020 Nov 10.
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