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Objective: Gait adaptation to environmental challenges is fundamental for independent and safe community ambulation. The possibility of precisely studying gait modulation using standardized protocols of gait analysis closely resembling everyday life scenarios is still an unmet need.
Methods: We have developed a fully-immersive virtual reality (VR) environment where subjects have to adjust their walking pattern to avoid collision with a virtual agent (VA) crossing their gait trajectory. We collected kinematic data of 12 healthy young subjects walking in real world (RW) and in the VR environment, both with (VR/A+) and without (VR/A-) the VA perturbation. The VR environment closely resembled the RW scenario of the gait laboratory. To ensure standardization of the obstacle presentation the starting time speed and trajectory of the VA were defined using the kinematics of the participant as detected online during each walking trial.
Results: We did not observe kinematic differences between walking in RW and VR/A-, suggesting that our VR environment per se might not induce significant changes in the locomotor pattern. When facing the VA all subjects consistently reduced stride length and velocity while increasing stride duration. Trunk inclination and mediolateral trajectory deviation also facilitated avoidance of the obstacle.
Conclusions: This proof-of-concept study shows that our VR/A+ paradigm effectively induced a timely gait modulation in a standardized immersive and realistic scenario. This protocol could be a powerful research tool to study gait modulation and its derangements in relation to aging and clinical conditions.
Measurements of physiological parameters provide an objective, often non-intrusive, and (at least semi-)automatic evaluation and utilization of user behavior. In addition, specific hardware devices of Virtual Reality (VR) often ship with built-in sensors, i.e. eye-tracking and movements sensors. Hence, the combination of physiological measurements and VR applications seems promising. Several approaches have investigated the applicability and benefits of this combination for various fields of applications. However, the range of possible application fields, coupled with potentially useful and beneficial physiological parameters, types of sensor, target variables and factors, and analysis approaches and techniques is manifold. This article provides a systematic overview and an extensive state-of-the-art review of the usage of physiological measurements in VR. We identified 1,119 works that make use of physiological measurements in VR. Within these, we identified 32 approaches that focus on the classification of characteristics of experience, common in VR applications. The first part of this review categorizes the 1,119 works by field of application, i.e. therapy, training, entertainment, and communication and interaction, as well as by the specific target factors and variables measured by the physiological parameters. An additional category summarizes general VR approaches applicable to all specific fields of application since they target typical VR qualities. In the second part of this review, we analyze the target factors and variables regarding the respective methods used for an automatic analysis and, potentially, classification. For example, we highlight which measurement setups have been proven to be sensitive enough to distinguish different levels of arousal, valence, anxiety, stress, or cognitive workload in the virtual realm. This work may prove useful for all researchers wanting to use physiological data in VR and who want to have a good overview of prior approaches taken, their benefits and potential drawbacks.
Mindfulness is considered an important factor of an individual's subjective well-being. Consequently, Human-Computer Interaction (HCI) has investigated approaches that strengthen mindfulness, i.e., by inventing multimedia technologies to support mindfulness meditation. These approaches often use smartphones, tablets, or consumer-grade desktop systems to allow everyday usage in users' private lives or in the scope of organized therapies. Virtual, Augmented, and Mixed Reality (VR, AR, MR; in short: XR) significantly extend the design space for such approaches. XR covers a wide range of potential sensory stimulation, perceptive and cognitive manipulations, content presentation, interaction, and agency. These facilities are linked to typical XR-specific perceptions that are conceptually closely related to mindfulness research, such as (virtual) presence and (virtual) embodiment. However, a successful exploitation of XR that strengthens mindfulness requires a systematic analysis of the potential interrelation and influencing mechanisms between XR technology, its properties, factors, and phenomena and existing models and theories of the construct of mindfulness. This article reports such a systematic analysis of XR-related research from HCI and life sciences to determine the extent to which existing research frameworks on HCI and mindfulness can be applied to XR technologies, the potential of XR technologies to support mindfulness, and open research gaps. Fifty papers of ACM Digital Library and National Institutes of Health's National Library of Medicine (PubMed) with and without empirical efficacy evaluation were included in our analysis. The results reveal that at the current time, empirical research on XR-based mindfulness support mainly focuses on therapy and therapeutic outcomes. Furthermore, most of the currently investigated XR-supported mindfulness interactions are limited to vocally guided meditations within nature-inspired virtual environments. While an analysis of empirical research on those systems did not reveal differences in mindfulness compared to non-mediated mindfulness practices, various design proposals illustrate that XR has the potential to provide interactive and body-based innovations for mindfulness practice. We propose a structured approach for future work to specify and further explore the potential of XR as mindfulness-support. The resulting framework provides design guidelines for XR-based mindfulness support based on the elements and psychological mechanisms of XR interactions.
This article presents a novel method for controlling a virtual audience system (VAS) in Virtual Reality (VR) application, called STAGE, which has been originally designed for supervised public speaking training in university seminars dedicated to the preparation and delivery of scientific talks. We are interested in creating pedagogical narratives: narratives encompass affective phenomenon and rather than organizing events changing the course of a training scenario, pedagogical plans using our system focus on organizing the affects it arouses for the trainees. Efficiently controlling a virtual audience towards a specific training objective while evaluating the speaker’s performance presents a challenge for a seminar instructor: the high level of cognitive and physical demands required to be able to control the virtual audience, whilst evaluating speaker’s performance, adjusting and allowing it to quickly react to the user’s behaviors and interactions. It is indeed a critical limitation of a number of existing systems that they rely on a Wizard of Oz approach, where the tutor drives the audience in reaction to the user’s performance. We address this problem by integrating with a VAS a high-level control component for tutors, which allows using predefined audience behavior rules, defining custom ones, as well as intervening during run-time for finer control of the unfolding of the pedagogical plan. At its core, this component offers a tool to program, select, modify and monitor interactive training narratives using a high-level representation. The STAGE offers the following features: i) a high-level API to program pedagogical narratives focusing on a specific public speaking situation and training objectives, ii) an interactive visualization interface iii) computation and visualization of user metrics, iv) a semi-autonomous virtual audience composed of virtual spectators with automatic reactions to the speaker and surrounding spectators while following the pedagogical plan V) and the possibility for the instructor to embody a virtual spectator to ask questions or guide the speaker from within the Virtual Environment. We present here the design, and implementation of the tutoring system and its integration in STAGE, and discuss its reception by end-users.
Effects of Acrophobic Fear and Trait Anxiety on Human Behavior in a Virtual Elevated Plus-Maze
(2021)
The Elevated Plus-Maze (EPM) is a well-established apparatus to measure anxiety in rodents, i.e., animals exhibiting an increased relative time spent in the closed vs. the open arms are considered anxious. To examine whether such anxiety-modulated behaviors are conserved in humans, we re-translated this paradigm to a human setting using virtual reality in a Cave Automatic Virtual Environment (CAVE) system. In two studies, we examined whether the EPM exploration behavior of humans is modulated by their trait anxiety and also assessed the individuals’ levels of acrophobia (fear of height), claustrophobia (fear of confined spaces), sensation seeking, and the reported anxiety when on the maze. First, we constructed an exact virtual copy of the animal EPM adjusted to human proportions. In analogy to animal EPM studies, participants (N = 30) freely explored the EPM for 5 min. In the second study (N = 61), we redesigned the EPM to make it more human-adapted and to differentiate influences of trait anxiety and acrophobia by introducing various floor textures and lower walls of closed arms to the height of standard handrails. In the first experiment, hierarchical regression analyses of exploration behavior revealed the expected association between open arm avoidance and Trait Anxiety, an even stronger association with acrophobic fear. In the second study, results revealed that acrophobia was associated with avoidance of open arms with mesh-floor texture, whereas for trait anxiety, claustrophobia, and sensation seeking, no effect was detected. Also, subjects’ fear rating was moderated by all psychometrics but trait anxiety. In sum, both studies consistently indicate that humans show no general open arm avoidance analogous to rodents and that human EPM behavior is modulated strongest by acrophobic fear, whereas trait anxiety plays a subordinate role. Thus, we conclude that the criteria for cross-species validity are met insufficiently in this case. Despite the exploratory nature, our studies provide in-depth insights into human exploration behavior on the virtual EPM.
Slot machines are one of the most played games by players suffering from gambling disorder. New technologies like immersive Virtual Reality (VR) offer more possibilities to exploit erroneous beliefs in the context of gambling. Recent research indicates a higher risk potential when playing a slot machine in VR than on desktop. To continue this investigation, we evaluate the effects of providing different degrees of embodiment, i.e., minimal and full embodiment. The avatars used for the full embodiment further differ in their appearance, i.e., they elicit a high or a low socio-economic status. The virtual environment (VE) design can cause a potential influence on the overall gambling behavior. Thus, we also embed the slot machine in two different VEs that differ in their emotional design: a colorful underwater playground environment and a virtual counterpart of our lab. These design considerations resulted in four different versions of the same VR slot machine: 1) full embodiment with high socio-economic status, 2) full embodiment with low socio-economic status, 3) minimal embodiment playground VE, and 4) minimal embodiment laboratory VE. Both full embodiment versions also used the playground VE. We determine the risk potential by logging gambling frequency as well as stake size, and measuring harm-inducing factors, i.e., dissociation, urge to gamble, dark flow, and illusion of control, using questionnaires. Following a between groups experimental design, 82 participants played for 20 game rounds one of the four versions. We recruited our sample from the students enrolled at the University of Würzburg. Our safety protocol ensured that only participants without any recent gambling activity took part in the experiment. In this comparative user study, we found no effect of the embodiment nor VE design on neither the gambling frequency, stake sizes, nor risk potential. However, our results provide further support for the hypothesis of the higher visual angle on gambling stimuli and hence the increased emotional response being the true cause for the higher risk potential.
Impaired decision-making leads to the inability to distinguish between advantageous and disadvantageous choices. The impairment of a person’s decision-making is a common goal of gambling games. Given the recent trend of gambling using immersive Virtual Reality it is crucial to investigate the effects of both immersion and the virtual environment (VE) on decision-making. In a novel user study, we measured decision-making using three virtual versions of the Iowa Gambling Task (IGT). The versions differed with regard to the degree of immersion and design of the virtual environment. While emotions affect decision-making, we further measured the positive and negative affect of participants. A higher visual angle on a stimulus leads to an increased emotional response. Thus, we kept the visual angle on the Iowa Gambling Task the same between our conditions. Our results revealed no significant impact of immersion or the VE on the IGT. We further found no significant difference between the conditions with regard to positive and negative affect. This suggests that neither the medium used nor the design of the VE causes an impairment of decision-making. However, in combination with a recent study, we provide first evidence that a higher visual angle on the IGT leads to an effect of impairment.
Background: The rehabilitation of gait disorders in patients with multiple sclerosis (MS) and stroke is often based on conventional treadmill training. Virtual reality (VR)-based treadmill training can increase motivation and improve therapy outcomes. The present study evaluated an immersive virtual reality application (using a head-mounted display, HMD) for gait rehabilitation with patients to (1) demonstrate its feasibility and acceptance and to (2) compare its short-term effects to a semi-immersive presentation (using a monitor) and a conventional treadmill training without VR to assess the usability of both systems and estimate the effects on walking speed and motivation. Methods: In a within-subjects study design, 36 healthy participants and 14 persons with MS or stroke participated in each of the three experimental conditions (VR via HMD, VR via monitor, treadmill training without VR). Results: For both groups, the walking speed in the HMD condition was higher than in treadmill training without VR and in the monitor condition. Healthy participants reported a higher motivation after the HMD condition as compared with the other conditions. Importantly, no side effects in the sense of simulator sickness occurred and usability ratings were high. No increases in heart rate were observed following the VR conditions. Presence ratings were higher for the HMD condition compared with the monitor condition for both user groups. Most of the healthy study participants (89%) and patients (71%) preferred the HMD-based training among the three conditions and most patients could imagine using it more frequently. Conclusions For the first time, the present study evaluated the usability of an immersive VR system for gait rehabilitation in a direct comparison with a semi-immersive system and a conventional training without VR with healthy participants and patients. The study demonstrated the feasibility of combining a treadmill training with immersive VR. Due to its high usability and low side effects, it might be particularly suited for patients to improve training motivation and training outcome e. g. the walking speed compared with treadmill training using no or only semi-immersive VR. Immersive VR systems still require specific technical setup procedures. This should be taken into account for specific clinical use-cases during a cost-benefit assessment.
In this paper, we present a virtual audience simulation system for Virtual Reality (VR). The system implements an audience perception model controlling the nonverbal behaviors of virtual spectators, such as facial expressions or postures. Groups of virtual spectators are animated by a set of nonverbal behavior rules representing a particular audience attitude (e.g., indifferent or enthusiastic). Each rule specifies a nonverbal behavior category: posture, head movement, facial expression and gaze direction as well as three parameters: type, frequency and proportion. In a first user-study, we asked participants to pretend to be a speaker in VR and then create sets of nonverbal behaviour parameters to simulate different attitudes. Participants manipulated the nonverbal behaviours of single virtual spectator to match a specific levels of engagement and opinion toward them. In a second user-study, we used these parameters to design different types of virtual audiences with our nonverbal behavior rules and evaluated their perceptions. Our results demonstrate our system’s ability to create virtual audiences with three types of different perceived attitudes: indifferent, critical, enthusiastic. The analysis of the results also lead to a set of recommendations and guidelines regarding attitudes and expressions for future design of audiences for VR therapy and training applications.
Visual stimuli are frequently used to improve memory, language learning or perception, and understanding of metacognitive processes. However, in virtual reality (VR), there are few systematically and empirically derived databases. This paper proposes the first collection of virtual objects based on empirical evaluation for inter-and transcultural encounters between English- and German-speaking learners. We used explicit and implicit measurement methods to identify cultural associations and the degree of stereotypical perception for each virtual stimuli (n = 293) through two online studies, including native German and English-speaking participants. The analysis resulted in a final well-describable database of 128 objects (called InteractionSuitcase). In future applications, the objects can be used as a great interaction or conversation asset and behavioral measurement tool in social VR applications, especially in the field of foreign language education. For example, encounters can use the objects to describe their culture, or teachers can intuitively assess stereotyped attitudes of the encounters.