Virtual reality experiences, embodiment, videogames and their dimensions in neurorehabilitation

Daniel Perez-Marcos, Daniel Perez-Marcos

Abstract

Background: In the context of stroke rehabilitation, new training approaches mediated by virtual reality and videogames are usually discussed and evaluated together in reviews and meta-analyses. This represents a serious confounding factor that is leading to misleading, inconclusive outcomes in the interest of validating these new solutions.

Main body: Extending existing definitions of virtual reality, in this paper I put forward the concept of virtual reality experience (VRE), generated by virtual reality systems (VRS; i.e. a group of variable technologies employed to create a VRE). Then, I review the main components composing a VRE, and how they may purposely affect the mind and body of participants in the context of neurorehabilitation. In turn, VRS are not anymore exclusive from VREs but are currently used in videogames and other human-computer interaction applications in different domains. Often, these other applications receive the name of virtual reality applications as they use VRS. However, they do not necessarily create a VRE. I put emphasis on exposing fundamental similarities and differences between VREs and videogames for neurorehabilitation. I also recommend describing and evaluating the specific features encompassing the intervention rather than evaluating virtual reality or videogames as a whole.

Conclusion: This disambiguation between VREs, VRS and videogames should help reduce confusion in the field. This is important for databases searches when looking for specific studies or building metareviews that aim at evaluating the efficacy of technology-mediated interventions.

Keywords: Neurorehabilitation; Videogames; Virtual embodiment; Virtual reality; Virtual reality experience; Virtual reality system.

Conflict of interest statement

Authors’ information

DPM is a Senior Scientist investigating on neurotechnologies for healthcare, with special focus on virtual reality-based rehabilitation after brain damage.

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

DPM is employee of MindMaze SA.

Glossary

Exergame: A game that involves physical exercise and that integrate motion-tracking technology (e.g., using Nintendo Wii Remotes or Microsoft Kinect) that enables interaction with the game and real-time feedback of user’s performance.

Immersion: Deep mental involvement in something [61]. In the context of virtual reality, and in a technical acceptation of the term, immersion is achieved by removing as many real-world sensations as possible and substituting these with the sensations corresponding to the virtual reality experience [62].

Plausibility illusion: The illusion that the scenario being depicted is actually occurring [17].

Presence: Commonly defined as “the feeling of being there” [8], presence is the psychological product of technological immersion. The level of presence is usually proportional to the level of immersion provided. Also referred to as Place Illusion [17].

Videogame: A game played by electronically manipulating images produced by a computer program on a monitor or other display [48].

Virtual embodiment: The illusion of having (i.e. feeling as if real) a body in a virtual reality experience.

Virtual reality experience: An experience on a virtual reality medium and composed of a set of qualities, including immersion, interaction, sensorimotor contingencies, and illusions.

Virtual reality system: A set of physical solutions or means to generate virtual reality experiences.

Publisher’s Note

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References

    1. Laver KE, Lange B, George S, Deutsch JE, Saposnik G, Crotty M. Virtual reality for stroke rehabilitation. Cochrane Database Syst Rev. 2017;11:CD008349.
    1. Lohse KR, Hilderman CGE, Cheung KL, Tatla S, der Loos HFMV. Virtual reality therapy for adults post-stroke: a systematic review and meta-analysis exploring virtual environments and commercial games in therapy. PLoS One. 2014;9:e93318. doi: 10.1371/journal.pone.0093318.
    1. Darekar A, McFadyen BJ, Lamontagne A, Fung J. Efficacy of virtual reality-based intervention on balance and mobility disorders post-stroke: a scoping review. J Neuroeng Rehabil 2015;12. doi:.
    1. da Silva Ribeiro NM, Ferraz DD, Pedreira É, Pinheiro Í, da Silva Pinto AC, Neto MG, et al. Virtual rehabilitation via Nintendo Wii® and conventional physical therapy effectively treat post-stroke hemiparetic patients. Top Stroke Rehabil. 2015;22:299–305. doi: 10.1179/1074935714Z.0000000017.
    1. Saposnik G, Cohen LG, Mamdani M, Pooyania S, Ploughman M, Cheung D, et al. Efficacy and safety of non-immersive virtual reality exercising in stroke rehabilitation (EVREST): a randomised, multicentre, single-blind, controlled trial. The Lancet Neurology. 2016;15:1019–1027. doi: 10.1016/S1474-4422(16)30121-1.
    1. Choi Y-H, Ku J, Lim H, Kim YH, Paik N-J. Mobile game-based virtual reality rehabilitation program for upper limb dysfunction after ischemic stroke. Restor Neurol Neurosci. 2016;34:455–463.
    1. Steuer J. Defining virtual reality: dimensions determining telepresence. J Commun. 1992;42:73–93. doi: 10.1111/j.1460-2466.1992.tb00812.x.
    1. Sanchez-Vives MV, Slater M. From presence to consciousness through virtual reality. Nat Rev Neurosci. 2005;6:332–339. doi: 10.1038/nrn1651.
    1. Weiss PL, Rand D, Katz N, Kizony R. Video capture virtual reality as a flexible and effective rehabilitation tool. J Neuroeng Rehabil. 2004;1:12. doi: 10.1186/1743-0003-1-12.
    1. Henderson A, Korner-Bitensky N, Levin M. Virtual reality in stroke rehabilitation: a systematic review of its effectiveness for upper limb motor recovery. Top Stroke Rehabil. 2007;14:52–61. doi: 10.1310/tsr1402-52.
    1. Bohil CJ, Alicea B, Biocca FA. Virtual reality in neuroscience research and therapy. Nat Rev Neurosci. 2011;12:752–762. doi: 10.1038/nrn3122.
    1. Slater M, Sanchez-Vives MV. Enhancing our lives with immersive virtual reality. Front Robot AI. 2016;3. 10.3389/frobt.2016.00074.
    1. Hsu C-T, Conrad M, Jacobs AM. Fiction feelings in Harry potter: haemodynamic response in the mid-cingulate cortex correlates with immersive reading experience. Neuroreport. 2014;25:1356–1361. doi: 10.1097/WNR.0000000000000272.
    1. Leeb Robert, Friedman Doron, Müller-Putz Gernot R., Scherer Reinhold, Slater Mel, Pfurtscheller Gert. Self-Paced (Asynchronous) BCI Control of a Wheelchair in Virtual Environments: A Case Study with a Tetraplegic. Computational Intelligence and Neuroscience. 2007;2007:1–8. doi: 10.1155/2007/79642.
    1. Groenegress C, Spanlang B, Slater M. The physiological mirror—a system for unconscious control of a virtual environment through physiological activity. Vis Comput. 2010;26:649–657. doi: 10.1007/s00371-010-0471-9.
    1. Aspell JE, Heydrich L, Marillier G, Lavanchy T, Herbelin B, Blanke O. Turning body and self inside out: visualized heartbeats alter bodily self-consciousness and tactile perception. Psychol Sci. 2013;24:2445–2453. doi: 10.1177/0956797613498395.
    1. Slater M. Place illusion and plausibility can lead to realistic behaviour in immersive virtual environments. Philos Trans R Soc Lond Ser B Biol Sci. 2009;364:3549–3557. doi: 10.1098/rstb.2009.0138.
    1. Buhrmann T, Paolo ED. The sense of agency – a phenomenological consequence of enacting sensorimotor schemes. Phenom Cogn Sci. 2017;16:207–236. doi: 10.1007/s11097-015-9446-7.
    1. Hartcher-O’Brien J. Multisensory integration of redundant and complementary cues. Diss. University of Oxford; 2012. . Accessed 16 Nov 2018.
    1. Adamovich SV, Fluet GG, Tunik E, Merians AS. Sensorimotor training in virtual reality: a review. NeuroRehabilitation. 2009;25:29.
    1. Definition of illusion. Oxford Dictionaries. . Accessed 16 Nov 2018.
    1. Gonzalez-Franco M, Lanier J. Model of illusions and virtual reality. Front Psychol. 2017;8. 10.3389/fpsyg.2017.01125.
    1. Botvinick M, Cohen J. Rubber hands “feel” touch that eyes see. Nature. 1998;391:756. doi: 10.1038/35784.
    1. Lenggenhager B, Tadi T, Metzinger T, Blanke O. Video ergo sum: manipulating bodily self-consciousness. Science. 2007;317:1096–1099. doi: 10.1126/science.1143439.
    1. Slater M, Pérez Marcos D, Ehrsson H, Sanchez-Vives MV. Towards a digital body: the virtual arm illusion. Front Hum Neurosci. 2008;2. 10.3389/neuro.09.006.2008.
    1. Kilteni K, Maselli A, Kording KP, Slater M. Over my fake body: body ownership illusions for studying the multisensory basis of own-body perception. Front Hum Neurosci. 2015;9. 10.3389/fnhum.2015.00141.
    1. Riva G. The key to unlocking the virtual body: virtual reality in the treatment of obesity and eating disorders. J Diabetes Sci Technol. 2011;5:283–292. doi: 10.1177/193229681100500213.
    1. Pozeg P, Palluel E, Ronchi R, Solcà M, Al-Khodairy A-W, Jordan X, et al. Virtual reality improves embodiment and neuropathic pain caused by spinal cord injury. Neurology. 2017;89:1894–1903. doi: 10.1212/WNL.0000000000004585.
    1. Kilteni K, Groten R, Slater M. The sense of embodiment in virtual reality. Presence Teleop Virt. 2012;21:373–387. doi: 10.1162/PRES_a_00124.
    1. Blanke O, Slater M, Serino A. Behavioral, neural, and computational principles of bodily self-consciousness. Neuron. 2015;88:145–166. doi: 10.1016/j.neuron.2015.09.029.
    1. Samad M, Chung AJ, Shams L. Perception of body ownership is driven by Bayesian sensory inference. PLoS One. 2015;10:e0117178. doi: 10.1371/journal.pone.0117178.
    1. Gorisse G, Christmann O, Amato EA, Richir S. First- and third-person perspectives in immersive virtual environments: presence and performance analysis of embodied users. Front Robot AI. 2017;4. 10.3389/frobt.2017.00033.
    1. González-Franco M, Peck TC, Rodríguez-Fornells A, Slater M. A threat to a virtual hand elicits motor cortex activation. Exp Brain Res. 2014;232:875–887. doi: 10.1007/s00221-013-3800-1.
    1. Spanlang B, Normand J-M, Borland D, Kilteni K, Giannopoulos E, Pomés A, et al. How to build an embodiment lab: achieving body representation illusions in virtual reality. Front Robot AI. 2014;1. 10.3389/frobt.2014.00009.
    1. Teo W-P, Muthalib M, Yamin S, Hendy AM, Bramstedt K, Kotsopoulos E, et al. Does a combination of virtual reality, neuromodulation and neuroimaging provide a comprehensive platform for neurorehabilitation? – a narrative review of the literature. Front Hum Neurosci. 2016;10. 10.3389/fnhum.2016.00284.
    1. Freeman D, Reeve S, Robinson A, Ehlers A, Clark D, Spanlang B, et al. Virtual reality in the assessment, understanding, and treatment of mental health disorders. Psychol Med. 2017;47:2393–2400. doi: 10.1017/S003329171700040X.
    1. Perez-Marcos D, Solazzi M, Steptoe W, Oyekoya W, Frisoli A, Weyrich T, et al. A fully immersive set-up for remote interaction and neurorehabilitation based on virtual body ownership. Front Neurol. 2012;3. 10.3389/fneur.2012.00110.
    1. Garipelli G, Rossy T, Bellone M, Liakoni V, Perez-Marcos D, Kinzer H, et al. Annual meeting of American Society of Neurorehabilitation. San Diego (CA) 2016. Neural mechanisms of upper limb virtual Mirror visual feedback (VR-MVF) in acute stroke: a single-case study.
    1. Adamovich SV, August K, Merians A. Tunik E. a virtual reality-based system integrated with fmri to study neural mechanisms of action observation-execution: a proof of concept study. Restor Neurol Neurosci. 2009;27:209–223.
    1. Llorens R, Borrego A, Palomo P, Cebolla A, Noé E, i Badia SB, et al. Body schema plasticity after stroke: subjective and neurophysiological correlates of the rubber hand illusion. Neuropsychologia. 2017;96:61–69. doi: 10.1016/j.neuropsychologia.2017.01.007.
    1. Ballester BR, Nirme J, Duarte E, Cuxart A, Rodriguez S, Verschure P, et al. The visual amplification of goal-oriented movements counteracts acquired non-use in hemiparetic stroke patients. J Neuroeng Rehabil. 2015;12:50. doi: 10.1186/s12984-015-0039-z.
    1. Ballester BR, Maier M. San Segundo Mozo RM, Castañeda V, duff a, M. J. Verschure PF. Counteracting learned non-use in chronic stroke patients with reinforcement-induced movement therapy. J Neuroeng Rehabil. 2016;13:74. doi: 10.1186/s12984-016-0178-x.
    1. Prochnow D, Bermúdez i, Badia S, Schmidt J, Duff A, Brunheim S, Kleiser R, et al. A functional magnetic resonance imaging study of visuomotor processing in a virtual reality-based paradigm: rehabilitation gaming system. Eur J Neurosci. 2013;37:1441–1447. doi: 10.1111/ejn.12157.
    1. Sale P, Franceschini M. Action observation and mirror neuron network: a tool for motor stroke rehabilitation. Eur J Phys Rehabil Med. 2012;48:313–318.
    1. Kwakkel G, Lannin NA, Borschmann K, English C, Ali M, Churilov L, et al. Standardized measurement of sensorimotor recovery in stroke trials: consensus-based core recommendations from the stroke recovery and rehabilitation roundtable. Int J Stroke. 2017;12:451–461. doi: 10.1177/1747493017711813.
    1. Demers M, Levin MF. Do activity level outcome measures commonly used in neurological practice assess upper-limb movement quality? Neurorehabil Neural Repair. 2017;31:623–637. doi: 10.1177/1545968317714576.
    1. Kitago T, Liang J, Huang VS, Hayes S, Simon P, Tenteromano L, et al. Improvement after constraint-induced movement therapy: recovery of Normal motor control or task-specific compensation? Neurorehabil Neural Repair. 2013;27:99–109. doi: 10.1177/1545968312452631.
    1. Definition of video game. Oxford Dictionaries. . Accessed 16 Nov 2018.
    1. Granic I, Lobel A, Engels RC. The benefits of playing video games. Am Psychol. 2014;69:66–78. doi: 10.1037/a0034857.
    1. Stanmore E, Stubbs B, Vancampfort D, de Bruin ED, Firth J. The effect of active video games on cognitive functioning in clinical and non-clinical populations: a meta-analysis of randomized controlled trials. Neurosci Biobehav Rev. 2017;78:34–43. doi: 10.1016/j.neubiorev.2017.04.011.
    1. Anguera JA, Boccanfuso J, Rintoul JL, Al-Hashimi O, Faraji F, Janowich J, et al. Video game training enhances cognitive control in older adults. Nature. 2013;501:97–101. doi: 10.1038/nature12486.
    1. Mishra J, Anguera JA, Gazzaley A. Video games for neuro-cognitive optimization. Neuron. 2016;90:214–218. doi: 10.1016/j.neuron.2016.04.010.
    1. Webster D, Celik O. Systematic review of Kinect applications in elderly care and stroke rehabilitation. J Neuroeng Rehabil. 2014;11:108. doi: 10.1186/1743-0003-11-108.
    1. Galna B, Barry G, Jackson D, Mhiripiri D, Olivier P, Rochester L. Accuracy of the Microsoft Kinect sensor for measuring movement in people with Parkinson’s disease. Gait & Posture. 2014;39:1062–1068. doi: 10.1016/j.gaitpost.2014.01.008.
    1. Kühn S, Gleich T, Lorenz RC, Lindenberger U, Gallinat J. Playing super Mario induces structural brain plasticity: gray matter changes resulting from training with a commercial video game. Mol Psychiatry. 2014;19:265–271. doi: 10.1038/mp.2013.120.
    1. Bavelier D, Green CS. The brain-boosting power of video games. Sci Am. 2016;315:26–31. doi: 10.1038/scientificamerican0716-26.
    1. Vedamurthy I, Nahum M, Huang SJ, Zheng F, Bayliss J, Bavelier D, et al. A dichoptic custom-made action video game as a treatment for adult amblyopia. Vis Res. 2015;114:173–187. doi: 10.1016/j.visres.2015.04.008.
    1. Levin MF, Weiss PL, Keshner EA. Emergence of virtual reality as a tool for upper limb rehabilitation: incorporation of motor control and motor learning principles. Phys Ther. 2015;95:415–425. doi: 10.2522/ptj.20130579.
    1. Rios DC, Gilbertson T, McCoy SW, Price R, Gutman K, Miller KEF, et al. NeuroGame therapy to improve wrist control in children with cerebral palsy: a case series. Dev Neurorehabil. 2013;16:398–409. doi: 10.3109/17518423.2013.766818.
    1. Lalor EC, Kelly SP, Finucane C, Burke R, Smith R, Reilly RB, et al. Steady-state VEP-based brain-computer Interface control in an immersive 3D gaming environment. EURASIP J Adv Signal Process. 2005;2005:706906. doi: 10.1155/ASP.2005.3156.
    1. Definition of immersion. Oxford Dictionaries. . Accessed 16 Nov 2018.
    1. Mestre DR, Fuchs P. Traité de la Réalité Virtuelle. Third. Paris: Presses de l’Ecole des Mines. 2006. Immersion et présence; pp. 309–338.

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