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Introduction: This paper addresses the need for reliable user identification in Extended Reality (XR), focusing on the scarcity of public datasets in this area.
Methods: We present a new dataset collected from 71 users who played the game “Half-Life: Alyx” on an HTC Vive Pro for 45 min across two separate sessions. The dataset includes motion and eye-tracking data, along with physiological data from a subset of 31 users. Benchmark performance is established using two state-of-the-art deep learning architectures, Convolutional Neural Networks (CNN) and Gated Recurrent Units (GRU).
Results: The best model achieved a mean accuracy of 95% for user identification within 2 min when trained on the first session and tested on the second.
Discussion: The dataset is freely available and serves as a resource for future research in XR user identification, thereby addressing a significant gap in the field. Its release aims to facilitate advancements in user identification methods and promote reproducibility in XR research.
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.
This paper examines the relationship between time and motion perception in virtual environments. Previous work has shown that the perception of motion can affect the perception of time. We developed a virtual environment that simulates motion in a tunnel and measured its effects on the estimation of the duration of time, the speed at which perceived time passes, and the illusion of self-motion, also known as vection. When large areas of the visual field move in the same direction, vection can occur; observers often perceive this as self-motion rather than motion of the environment. To generate different levels of vection and investigate its effects on time perception, we developed an abstract procedural tunnel generator. The generator can simulate different speeds and densities of tunnel sections (visibly distinguishable sections that form the virtual tunnel), as well as the degree of embodiment of the user avatar (with or without virtual hands). We exposed participants to various tunnel simulations with different durations, speeds, and densities in a remote desktop and a virtual reality (VR) laboratory study. Time passed subjectively faster under high-speed and high-density conditions in both studies. The experience of self-motion was also stronger under high-speed and high-density conditions. Both studies revealed a significant correlation between the perceived passage of time and perceived self-motion. Subjects in the virtual reality study reported a stronger self-motion experience, a faster perceived passage of time, and shorter time estimates than subjects in the desktop study. Our results suggest that a virtual tunnel simulation can manipulate time perception in virtual reality. We will explore these results for the development of virtual reality applications for therapeutic approaches in our future work. This could be particularly useful in treating disorders like depression, autism, and schizophrenia, which are known to be associated with distortions in time perception. For example, the tunnel could be therapeutically applied by resetting patients’ time perceptions by exposing them to the tunnel under different conditions, such as increasing or decreasing perceived time.
Virtual reality applications employing avatar embodiment typically use virtual mirrors to allow users to perceive their digital selves not only from a first-person but also from a holistic third-person perspective. However, due to distance-related biases such as the distance compression effect or a reduced relative rendering resolution, the self-observation distance (SOD) between the user and the virtual mirror might influence how users perceive their embodied avatar. Our article systematically investigates the effects of a short (1 m), middle (2.5 m), and far (4 m) SOD between users and mirror on the perception of their personalized and self-embodied avatars. The avatars were photorealistic reconstructed using state-of-the-art photogrammetric methods. Thirty participants repeatedly faced their real-time animated self-embodied avatars in each of the three SOD conditions, where they were repeatedly altered in their body weight, and participants rated the 1) sense of embodiment, 2) body weight perception, and 3) affective appraisal towards their avatar. We found that the different SODs are unlikely to influence any of our measures except for the perceived body weight estimation difficulty. Here, the participants perceived the difficulty significantly higher for the farthest SOD. We further found that the participants’ self-esteem significantly impacted their ability to modify their avatar’s body weight to their current body weight and that it positively correlated with the perceived attractiveness of the avatar. Additionally, the participants’ concerns about their body shape affected how eerie they perceived their avatars. The participants’ self-esteem and concerns about their body shape influenced the perceived body weight estimation difficulty. We conclude that the virtual mirror in embodiment scenarios can be freely placed and varied at a distance of one to four meters from the user without expecting major effects on the perception of the avatar.
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.
Virtual environments (VEs) can evoke and support emotions, as experienced when playing emotionally arousing games. We theoretically approach the design of fear and joy evoking VEs based on a literature review of empirical studies on virtual and real environments as well as video games’ reviews and content analyses. We define the design space and identify central design elements that evoke specific positive and negative emotions. Based on that, we derive and present guidelines for emotion-inducing VE design with respect to design themes, colors and textures, and lighting configurations. To validate our guidelines in two user studies, we 1) expose participants to 360° videos of VEs designed following the individual guidelines and 2) immerse them in a neutral, positive and negative emotion-inducing VEs combining all respective guidelines in Virtual Reality. The results support our theoretically derived guidelines by revealing significant differences in terms of fear and joy induction.
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.
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.
Presence is often considered the most important quale describing the subjective feeling of being in a computer-generated and/or computer-mediated virtual environment. The identification and separation of orthogonal presence components, i.e., the place illusion and the plausibility illusion, has been an accepted theoretical model describing Virtual Reality (VR) experiences for some time. This perspective article challenges this presence-oriented VR theory. First, we argue that a place illusion cannot be the major construct to describe the much wider scope of virtual, augmented, and mixed reality (VR, AR, MR: or XR for short). Second, we argue that there is no plausibility illusion but merely plausibility, and we derive the place illusion caused by the congruent and plausible generation of spatial cues and similarly for all the current model’s so-defined illusions. Finally, we propose congruence and plausibility to become the central essential conditions in a novel theoretical model describing XR experiences and effects.
Obesity is a serious disease that can affect both physical and psychological well-being. Due to weight stigmatization, many affected individuals suffer from body image disturbances whereby they perceive their body in a distorted way, evaluate it negatively, or neglect it. Beyond established interventions such as mirror exposure, recent advancements aim to complement body image treatments by the embodiment of visually altered virtual bodies in virtual reality (VR). We present a high-fidelity prototype of an advanced VR system that allows users to embody a rapidly generated personalized, photorealistic avatar and to realistically modulate its body weight in real-time within a carefully designed virtual environment. In a formative multi-method approach, a total of 12 participants rated the general user experience (UX) of our system during body scan and VR experience using semi-structured qualitative interviews and multiple quantitative UX measures. Using body weight modification tasks, we further compared three different interaction methods for real-time body weight modification and measured our system’s impact on the body image relevant measures body awareness and body weight perception. From the feedback received, demonstrating an already solid UX of our overall system and providing constructive input for further improvement, we derived a set of design guidelines to guide future development and evaluation processes of systems supporting body image interventions.
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.
Realistic and lifelike 3D-reconstruction of virtual humans has various exciting and important use cases. Our and others’ appearances have notable effects on ourselves and our interaction partners in virtual environments, e.g., on acceptance, preference, trust, believability, behavior (the Proteus effect), and more. Today, multiple approaches for the 3D-reconstruction of virtual humans exist. They significantly vary in terms of the degree of achievable realism, the technical complexities, and finally, the overall reconstruction costs involved. This article compares two 3D-reconstruction approaches with very different hardware requirements. The high-cost solution uses a typical complex and elaborated camera rig consisting of 94 digital single-lens reflex (DSLR) cameras. The recently developed low-cost solution uses a smartphone camera to create videos that capture multiple views of a person. Both methods use photogrammetric reconstruction and template fitting with the same template model and differ in their adaptation to the method-specific input material. Each method generates high-quality virtual humans ready to be processed, animated, and rendered by standard XR simulation and game engines such as Unreal or Unity. We compare the results of the two 3D-reconstruction methods in an immersive virtual environment against each other in a user study. Our results indicate that the virtual humans from the low-cost approach are perceived similarly to those from the high-cost approach regarding the perceived similarity to the original, human-likeness, beauty, and uncanniness, despite significant differences in the objectively measured quality. The perceived feeling of change of the own body was higher for the low-cost virtual humans. Quality differences were perceived more strongly for one’s own body than for other virtual humans.
Artificial Intelligence (AI) covers a broad spectrum of computational problems and use cases. Many of those implicate profound and sometimes intricate questions of how humans interact or should interact with AIs. Moreover, many users or future users do have abstract ideas of what AI is, significantly depending on the specific embodiment of AI applications. Human-centered-design approaches would suggest evaluating the impact of different embodiments on human perception of and interaction with AI. An approach that is difficult to realize due to the sheer complexity of application fields and embodiments in reality. However, here XR opens new possibilities to research human-AI interactions. The article’s contribution is twofold: First, it provides a theoretical treatment and model of human-AI interaction based on an XR-AI continuum as a framework for and a perspective of different approaches of XR-AI combinations. It motivates XR-AI combinations as a method to learn about the effects of prospective human-AI interfaces and shows why the combination of XR and AI fruitfully contributes to a valid and systematic investigation of human-AI interactions and interfaces. Second, the article provides two exemplary experiments investigating the aforementioned approach for two distinct AI-systems. The first experiment reveals an interesting gender effect in human-robot interaction, while the second experiment reveals an Eliza effect of a recommender system. Here the article introduces two paradigmatic implementations of the proposed XR testbed for human-AI interactions and interfaces and shows how a valid and systematic investigation can be conducted. In sum, the article opens new perspectives on how XR benefits human-centered AI design and development.
This article introduces the Off-The-Shelf Stylus (OTSS), a framework for 2D interaction (in 3D) as well as for handwriting and sketching with digital pen, ink, and paper on physically aligned virtual surfaces in Virtual, Augmented, and Mixed Reality (VR, AR, MR: XR for short). OTSS supports self-made XR styluses based on consumer-grade six-degrees-of-freedom XR controllers and commercially available styluses. The framework provides separate modules for three basic but vital features: 1) The stylus module provides stylus construction and calibration features. 2) The surface module provides surface calibration and visual feedback features for virtual-physical 2D surface alignment using our so-called 3ViSuAl procedure, and surface interaction features. 3) The evaluation suite provides a comprehensive test bed combining technical measurements for precision, accuracy, and latency with extensive usability evaluations including handwriting and sketching tasks based on established visuomotor, graphomotor, and handwriting research. The framework’s development is accompanied by an extensive open source reference implementation targeting the Unity game engine using an Oculus Rift S headset and Oculus Touch controllers. The development compares three low-cost and low-tech options to equip controllers with a tip and includes a web browser-based surface providing support for interacting, handwriting, and sketching. The evaluation of the reference implementation based on the OTSS framework identified an average stylus precision of 0.98 mm (SD = 0.54 mm) and an average surface accuracy of 0.60 mm (SD = 0.32 mm) in a seated VR environment. The time for displaying the stylus movement as digital ink on the web browser surface in VR was 79.40 ms on average (SD = 23.26 ms), including the physical controller’s motion-to-photon latency visualized by its virtual representation (M = 42.57 ms, SD = 15.70 ms). The usability evaluation (N = 10) revealed a low task load, high usability, and high user experience. Participants successfully reproduced given shapes and created legible handwriting, indicating that the OTSS and it’s reference implementation is ready for everyday use. We provide source code access to our implementation, including stylus and surface calibration and surface interaction features, making it easy to reuse, extend, adapt and/or replicate previous results (https://go.uniwue.de/hci-otss).
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.
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.
Psycho-pathological conditions, such as depression or schizophrenia, are often accompanied by a distorted perception of time. People suffering from this conditions often report that the passage of time slows down considerably and that they are “stuck in time.” Virtual Reality (VR) could potentially help to diagnose and maybe treat such mental conditions. However, the conditions in which a VR simulation could correctly diagnose a time perception deviation are still unknown. In this paper, we present an experiment investigating the difference in time experience with and without a virtual body in VR, also known as avatar. The process of substituting a person’s body with a virtual body is called avatar embodiment. Numerous studies demonstrated interesting perceptual, emotional, behavioral, and psychological effects caused by avatar embodiment. However, the relations between time perception and avatar embodiment are still unclear. Whether or not the presence or absence of an avatar is already influencing time perception is still open to question. Therefore, we conducted a between-subjects design with and without avatar embodiment as well as a real condition (avatar vs. no-avatar vs. real). A group of 105 healthy subjects had to wait for seven and a half minutes in a room without any distractors (e.g., no window, magazine, people, decoration) or time indicators (e.g., clocks, sunlight). The virtual environment replicates the real physical environment. Participants were unaware that they will be asked to estimate their waiting time duration as well as describing their experience of the passage of time at a later stage. Our main finding shows that the presence of an avatar is leading to a significantly faster perceived passage of time. It seems to be promising to integrate avatar embodiment in future VR time-based therapy applications as they potentially could modulate a user’s perception of the passage of time. We also found no significant difference in time perception between the real and the VR conditions (avatar, no-avatar), but further research is needed to better understand this outcome.
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.
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.
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.