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Assessing balance through the use of a low-cost head-mounted display in older adults: a pilot study.

ABSTRACT: As the population ages, the prevention of falls is an increasingly important public health problem. Balance assessment forms an important component of fall-prevention programs for older adults. The recent development of cost-effective and highly responsive virtual reality (VR) systems means new methods of balance assessment are feasible in a clinical setting. This proof-of-concept study made use of the submillimeter tracking built into modern VR head-mounted displays (VRHMDs) to assess balance through the use of visual-vestibular conflict. The objective of this study was to evaluate the validity, acceptability, and reliability of using a VRHMD to assess balance in older adults.Validity was assessed by comparing measurements from the VRHMD to measurements of postural sway from a force plate. Acceptability was assessed through the use of the Simulator Sickness Questionnaire pre- and postexposure to assess possible side effects of the visual-vestibular conflict. Reliability was assessed by measuring correlations between repeated measurements 1 week apart. Variables of possible importance that were found to be reliable (r?0.9) between tests separated by a week were then tested for differences compared to a control group. Assessment was performed as a cross-sectional single-site community center-based study in 13 older adults (?65 years old, 80.2±7.3 years old, 77% female, five at risk of falls, eight controls). The VR balance assessment consisted of four modules: a baseline module, a reaction module, a balance module, and a seated assessment.There was a significant difference in the rate at which participants with a risk of falls changed their tilt in the anteroposterior direction compared to the control group. Participants with a risk of falls changed their tilt in the anteroposterior direction at 0.7°/second vs 0.4°/second for those without a history of falls. No significant differences were found between pre/postassessment for oculomotor score or total Simulator Sickness Questionnaire score. Both the force plate and the head-mounted display balance-assessment system were able to detect differences between conditions meant to mask visual and proprioceptive information.This VRHMD is both affordable and portable, causes minimal simulator sickness, and produces repeatable results that can be used to assess balance in older adults.

SUBMITTER: Saldana SJ

PROVIDER: S-EPMC5580706 | biostudies-other | 2017

REPOSITORIES: biostudies-other

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Assessing balance through the use of a low-cost head-mounted display in older adults: a pilot study.

Saldana Santiago J SJ Marsh Anthony P AP Rejeski W Jack WJ Haberl Jack K JK Wu Peggy P Rosenthal Scott S Ip Edward H EH

Clinical interventions in aging 20170826

<h4>Introduction</h4>As the population ages, the prevention of falls is an increasingly important public health problem. Balance assessment forms an important component of fall-prevention programs for older adults. The recent development of cost-effective and highly responsive virtual reality (VR) systems means new methods of balance assessment are feasible in a clinical setting. This proof-of-concept study made use of the submillimeter tracking built into modern VR head-mounted displays (VRHMDs ...[more]

PMID: 28883717

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Project description:As our society is ageing globally, neurodegenerative disorders are becoming a relevant issue. Assessment of saccadic eye movement could provide objective values to help to understand the symptoms of disorders. HTC Corporation launched a new virtual reality (VR) headset, VIVE Pro Eye, implementing an infrared-based eye tracking technique together with VR technology. The purpose of this study is to evaluate whether the device can be used as an assessment tool of saccadic eye movement and to investigate the technical features of eye tracking. We developed a measurement system of saccadic eye movement with a simple VR environment on Unity VR design platform, following an internationally proposed standard saccade measurement protocol. We then measured the saccadic eye movement of seven healthy young adults to analyze the oculo-metrics of latency, peak velocity, and error rate of pro- and anti-saccade tasks: 120 trials in each task. We calculated these parameters based on the saccade detection algorithm that we have developed following previous studies. Consequently, our results revealed latency of 220.40 ± 43.16 ms, peak velocity of 357.90 ± 111.99°/s, and error rate of 0.24 ± 0.41% for the pro-saccade task, and latency of 343.35 ± 76.42 ms, peak velocity of 318.79 ± 116.69°/s, and error rate of 0.66 ± 0.76% for the anti-saccade task. In addition, we observed pupil diameter of 4.30 ± 1.15 mm (left eye) and 4.29 ± 1.08 mm (right eye) for the pro-saccade task, and of 4.21 ± 1.04 mm (left eye) and 4.22 ± 0.97 mm (right eye) for the anti-saccade task. Comparing between the descriptive statistics of previous studies and our results suggests that VIVE Pro Eye can function as an assessment tool of saccadic eye movement since our results are in the range of or close to the results of previous studies. Nonetheless, we found technical limitations especially about time-related measurement parameters. Further improvements in software and hardware of the device and measurement protocol, and more measurements with diverse age-groups and people with different health conditions are warranted to enhance the whole assessment system of saccadic eye movement.

Project description:Visual ERP (P300) based brain-computer interfaces (BCIs) allow for fast and reliable spelling and are intended as a muscle-independent communication channel for people with severe paralysis. However, they require the presentation of visual stimuli in the field of view of the user. A head-mounted display could allow convenient presentation of visual stimuli in situations, where mounting a conventional monitor might be difficult or not feasible (e.g., at a patient's bedside). To explore if similar accuracies can be achieved with a virtual reality (VR) headset compared to a conventional flat screen monitor, we conducted an experiment with 18 healthy participants. We also evaluated it with a person in the locked-in state (LIS) to verify that usage of the headset is possible for a severely paralyzed person. Healthy participants performed online spelling with three different display methods. In one condition a 5 × 5 letter matrix was presented on a conventional 22 inch TFT monitor. Two configurations of the VR headset were tested. In the first (glasses A), the same 5 × 5 matrix filled the field of view of the user. In the second (glasses B), single letters of the matrix filled the field of view of the user. The participant in the LIS tested the VR headset on three different occasions (glasses A condition only). For healthy participants, average online spelling accuracies were 94% (15.5 bits/min) using three flash sequences for spelling with the monitor and glasses A and 96% (16.2 bits/min) with glasses B. In one session, the participant in the LIS reached an online spelling accuracy of 100% (10 bits/min) using the glasses A condition. We also demonstrated that spelling with one flash sequence is possible with the VR headset for healthy users (mean: 32.1 bits/min, maximum reached by one user: 71.89 bits/min at 100% accuracy). We conclude that the VR headset allows for rapid P300 BCI communication in healthy users and may be a suitable display option for severely paralyzed persons.

Project description:Background The use of head mounted display (HMD)-based immersive virtual reality (VR) coaching systems (HMD-VRC) is expected to be effective for skill acquisition in radiography. The usefulness of HMD-VRC has been reported in many previous studies. However, previous studies have evaluated the effectiveness of HMD-VRC only through questionnaires. HMD-VRC has difficulties in palpation and patient interaction compared to real-world training. It is expected that these issues will have an impact on proficiency. The purpose of this study is to determine the impact of VR constraints in HMD-VRC, especially palpation and patient interaction, on radiographic skills proficiency in a real-world setting. Methods First-year students (n = 30) at a training school for radiology technologists in Japan were randomly divided into two groups, one using HMD-VRC (HMD-VRC group) and the other practicing with conventional physical equipment (RP group) and trained for approximately one hour. The teachers then evaluated the students for proficiency using a rubric method. Results In this study, it was found that some skills in the HMD-VRC group were equivalent to those of the RP group and some were significantly lower than those of the RP group. There was a significant decrease in proficiency in skills related to palpation and patient interaction. Conclusions This study suggests that HMD-VRC can be less effective than real-world training in radiographic techniques, which require palpation and patient interaction. For effective training, it is important to objectively evaluate proficiency in the real world, even for HMD-VRC with new technologies, such as haptic presentation and VR patient interaction. Trial registration The study was conducted with the approval of the Ethics Committee of International University of Health and Welfare (Approval No.21-Im-035, Registration date: September 28, 2021). Supplementary Information The online version contains supplementary material available at 10.1186/s12909-022-03645-8.

Project description:Introduction Conventional microscopes have certain limitations in terms of posture and ergonomics. Monitor-based exoscopes could solve this problem and thereby lead to less work-related sick leave for surgeons. Research question The aim of this study was to assess the ergonomics, usability, and neurosurgeon's comfort of a novel three-dimensional head-mounted display-based exoscope in a standardized setting. Material & Methods 34 neurosurgeons participated in a workshop on the exoscope, which features a head-mounted display and a head gesture-triggered control panel. After completion of a custom-made 10-step microsurgical exercise, image quality and comfort were assessed using a questionnaire. The participants' posture during the exercise was analyzed using a video motion analysis software. Results 34 participants (median neurosurgical experience: 6 years) were included. The median time to complete the exercise was 12 min [IqR 9.4, 15.0]. Younger participants (p = 0.005) and those with video game experience (p = 0.03) had a significantly steeper learning curve. The median overall satisfaction was at 80% in general and 82% for image quality. The median upper body as well as the median head coronal displacement from the neutral axis were 0°. Participants with less microsurgical experience showed less head/body displacement during the exercise (p = 0.01). Discussion and conclusion Using the microsurgical training tool, we were able to depict a steep learning curve with a sufficient learnability of the most relevant commands. The exoscope excelled in usability, image quality as well as in ergonomic and favorable posture and could thus become an alternative to conventional microscopes due to the potentially elevated surgeons' comfort. Highlights • Overall, the participants were satisfied with the exoscope usability (80%) and image quality (82%).• The custom-made microsurgical exercise tool is an efficient tool for assessment of the participant's performance with the head-mounted display-based exoscope.• Younger participants with video games experience showed a steeper learning curve for the performance of the microsurgical training tool.• After performing theexercise, 88% of the participants felt safe to use the HMD-based exoscope in the OR.

Project description:BackgroundAs the prevalence of trachoma declines worldwide, it is becoming increasingly expensive and challenging to standardize graders in the field for surveys to document elimination. Photography of the tarsal conjunctiva and remote interpretation may help alleviate these challenges. The purpose of this study was to develop, and field test an Image Capture and Processing System (ICAPS) to acquire hands-free images of the tarsal conjunctiva for upload to a virtual reading center for remote grading.Methodology/principal findingsThis observational study was conducted during a district-level prevalence survey for trachomatous inflammation-follicular (TF) in Chamwino, Tanzania. The ICAPS was developed using a Samsung Galaxy S8 smartphone, a Samsung Gear VR headset, a foot pedal trigger and customized software allowing for hands-free photography. After a one-day training course, three trachoma graders used the ICAPS to collect images from 1305 children ages 1-9 years, which were expert-graded remotely for comparison with field grades. In our experience, the ICAPS was successful at scanning and assigning barcodes to images, focusing on the everted eyelid with adequate examiner hand visualization, and capturing images with sufficient detail to grade TF. The percentage of children with TF by photos and by field grade was 5%. Agreement between grading of the images compared to the field grades at the child level was kappa = 0.53 (95%CI = 0.40-0.66). There were ungradable images for at least one eye in 199 children (9.1%), with more occurring in children ages 1-3 (18.5%) than older children ages 4-9 (4.2%) (χ2 = 145.3, p<0.001).Conclusions/significanceThe prototype ICAPS device was robust, able to image 1305 children in a district level survey and transmit images from rural Tanzania to an online grading platform. More work is needed to improve the percentage of ungradable images and to better understand the causes of disagreement between field and photo grading.

Dataset Information

Assessing balance through the use of a low-cost head-mounted display in older adults: a pilot study.

Publications

Assessing balance through the use of a low-cost head-mounted display in older adults: a pilot study.

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