Training outcomes for audiology students using virtual reality or traditional training methods

To determine the impact of clinical and anamnestic data of stroke patients on the rehabilitation process's outcome in virtual reality (VR). To study parameters of postural stability, gait, daily activity and affective functions during motor training in the immersive high-tech polymodal VR system. We examined 34 patients (16 women, 18 men, mean age 51.9±12.5) who had a stroke at least 2 weeks ago and had a degree of disability no more than 3 points on the Rankin scale, mainly due to movement disorders. The patients underwent training in the VR system (Grail, Motekforce) for 10 sessions. Before and after the end of the training, the patient's condition was diagnosed, including indicators of motor and daily activities, affective functions, as well as an instrumental assessment of balance and gait in VR. After training up to 62% of patients showed improvements in physical activity, up to 41% - in daily living activities, up to 73% - in the affective sphere. The results of multiple linear regression analysis showed that gender, the type of stroke and the side of the brain lesion are significant predictors for the rehabilitation of postural stability, while the type of stroke and the period of recovery after stroke predict the restoration of the affective sphere. Groups of patients stratified by gender, the type of stroke, the side of the brain lesion and recovery period, for whom training in the VR system was most effective, are identified. Based on the results of the study, the authors suggest the criteria of inclusion of VR in the individual rehabilitation program of patients with stroke.

PURPOSE: The objective of this study was to determine the effects of virtual reality training on muscle activation in the elderly. METHODS: The subjects were 32 healthy elderly people aged between 65 and 80, who were divided into the VR(virtual reality) training group(n=17) and the control group(n=15). The Virtual reality training group engaged in a 30-minute exercise session using Wii Fit three times a week for eight weeks. Virtual reality training group used the Ski Slalom, Table tile, Balance bubble programs. low-extremity muscle activation of the two groups were measured before and after the intervention. RESULTS: To investigate the effects of the training on lower-extremity muscle activation, biceps femoris, gastrocnemius, tibialis anterior, vastus lateralis were measured. The results revealed that the activation of gastrocnemius and tibialis anterior significantly increased(p<.05), which indicates virtual reality training is effective in improving the activation of the muscles involved in the movement of the ankle joint. CONCLUSION: Virtual reality training is effective in improving the healthy elderly's activation of the muscles involved in the movement of the ankle joint. Thus, virtual reality training can be proposed as a form of fall prevention exercise for the elderly.

There is limited data assessing simulation and virtual reality training as a standardized tool in medical education. This feasibility study aimed to evaluate the effectiveness of virtual reality training and a student-led simulation module in preparing medical students to perform a lumbar puncture. Twenty-five medical students completed a pre-intervention survey, and a baseline video recorded lumbar puncture procedure on a task trainer. Students were randomly distributed into the virtual reality group, or the curriculum's standard student-led procedural instruction group. Participants were then given 45min to practice the lumbar puncture procedure. After the intervention, all participants were video recorded again as they performed a post-intervention lumbar puncture and completed a post-intervention survey. Pre- and post-intervention videos were scored using a critical action checklist in conjunction with time needed to complete the procedure to evaluate proficiency. At baseline, there were no major statistically significant differences between groups. Assessing overall post-intervention performance, both groups showed improvement in aggregate score (p < 0.001) and time required to complete (p = 0.002) the lumbar puncture. Following interventions, the student-led group improved over the virtual reality group in a variety of metrics. The student-led group increased their aggregate score by 3.49 and decreased their time to completion by 34s over the VR group when controlling for baseline measures. Both virtual reality and student-led simulation training were useful training modalities, with hands-on simulation showing better results versus virtual reality training in this setting. The online version contains supplementary material available at 10.1007/s40670-020-01141-6.

Introduction: Previous studies evaluating the effect of virtual reality (VR) training on operating room performance have only analyzed the latter portion of the laparoscopic cholecystectomy (LC), while including many residents beyond their second year of training. The aim of this study was to better understand the impact of VR training on subjects with limited laparoscopic surgical experience during completion of an entire laparoscopic cholecystectomy. Methods: Twelve surgical residents (PGY 1 & 2) were randomized to either standard training (n = 6) or VR training (n = 6). In the VR training group subjects were required to reach expert established performance criterion levels on the manipulation diathermy task of the Minimally Invasive Surgical Trainer (MIST-VR). All subjects then performed a video-recorded LC under the supervision of a surgeon blinded to training status. Recordings were assessed by two blinded surgeon investigators using scores based on expert-defined errors with inter-rater reliability >0.9. Results: VR trained subjects completed the full LC 20% faster than controls (39 min. vs. 31 min.), made half as many errors while exposing cystic structures (5.3 vs 10), and one-third fewer errors in dissecting the gallbladder (5.5 vs. 8.2). Overall, controls made 40% more errors (11.7 vs 19.7, p Conclusions: Criterion based VR training to expert performance levels for junior surgical residents results in fewer intra-operative errors and greater performance consistency during the entire laparoscopic cholecystectomy procedure.

Standard surgical training has traditionally been one of apprenticeship, where the surgical trainee learns to perform surgery under the supervision of a trained surgeon. This is time-consuming, costly, and of variable effectiveness. Training using a virtual reality simulator is an option to supplement standard training. Virtual reality training improves the technical skills of surgical trainees such as decreased time for suturing and improved accuracy. The clinical impact of virtual reality training is not known. To assess the benefits (increased surgical proficiency and improved patient outcomes) and harms (potentially worse patient outcomes) of supplementary virtual reality training of surgical trainees with limited laparoscopic experience. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE and Science Citation Index Expanded until July 2012. We included all randomised clinical trials comparing virtual reality training versus other forms of training including box-trainer training, no training, or standard laparoscopic training in surgical trainees with little laparoscopic experience. We also planned to include trials comparing different methods of virtual reality training. We included only trials that assessed the outcomes in people undergoing laparoscopic surgery. Two authors independently identified trials and collected data. We analysed the data with both the fixed-effect and the random-effects models using Review Manager 5 analysis. For each outcome we calculated the mean difference (MD) or standardised mean difference (SMD) with 95% confidence intervals based on intention-to-treat analysis. We included eight trials covering 109 surgical trainees with limited laparoscopic experience. Of the eight trials, six compared virtual reality versus no supplementary training. One trial compared virtual reality training versus box-trainer training and versus no supplementary training, and one trial compared virtual reality training versus box-trainer training. There were no trials that compared different forms of virtual reality training. All the trials were at high risk of bias. Operating time and operative performance were the only outcomes reported in the trials. The remaining outcomes such as mortality, morbidity, quality of life (the primary outcomes of this review) and hospital stay (a secondary outcome) were not reported. Virtual reality training versus no supplementary training: The operating time was significantly shorter in the virtual reality group than in the no supplementary training group (3 trials; 49 participants; MD -11.76 minutes; 95% CI -15.23 to -8.30). Two trials that could not be included in the meta-analysis also showed a reduction in operating time (statistically significant in one trial). The numerical values for operating time were not reported in these two trials. The operative performance was significantly better in the virtual reality group than the no supplementary training group using the fixed-effect model (2 trials; 33 participants; SMD 1.65; 95% CI 0.72 to 2.58). The results became non-significant when the random-effects model was used (2 trials; 33 participants; SMD 2.14; 95% CI -1.29 to 5.57). One trial could not be included in the meta-analysis as it did not report the numerical values. The authors stated that the operative performance of virtual reality group was significantly better than the control group. Virtual reality training versus box-trainer training: The only trial that reported operating time did not report the numerical values. In this trial, the operating time in the virtual reality group was significantly shorter than in the box-trainer group. Of the two trials that reported operative performance, only one trial reported the numerical values. The operative performance was significantly better in the virtual reality group than in the box-trainer group (1 trial; 19 participants; SMD 1.46; 95% CI 0.42 to 2.50). In the other trial that did not report the numerical values, the authors stated that the operative performance in the virtual reality group was significantly better than the box-trainer group. Virtual reality training appears to decrease the operating time and improve the operative performance of surgical trainees with limited laparoscopic experience when compared with no training or with box-trainer training. However, the impact of this decreased operating time and improvement in operative performance on patients and healthcare funders in terms of improved outcomes or decreased costs is not known. Further well-designed trials at low risk of bias and random errors are necessary. Such trials should assess the impact of virtual reality training on clinical outcomes.

Functional ankle instability (FAI) is a common injury. Traditional training improved the reported balance impairment and subjective sense of instability in athletes with FAI. This study aims to compare the effects of traditional and virtual reality training on a subjective sense of instability and balance in athlete with FAI. In this single-blinded matched randomized clinical trial design, Fifty-four basketball players were randomly assigned in the virtual reality (n=27) or control (n=27) groups. All athletes performed 12 sessions Wii exercises or traditional training in the virtual reality and the control group, respectively, for three days a week. To assess the subjective-sense of instability and balance, we used Cumberland Ankle Instability Tool (CAIT) and Star Excursion Balance Test (SEBT), respectively. Measures were taken at pre- and post-test and one month after training as a follow-up. The between-group comparisons were done by the analysis of Covariance. At the pre-test, the CAIT score was 22.37, 22.04 in the control and virtual reality groups, respectively and at the post-test, these scores increased to 26.63, 27.26. The involved limb showed significant differences in posteromedial and posterior directions of the SEBT and CAIT score in the post-test and in the posterior direction and CAIT score in the follow-up. The virtual reality group had better performance than the control group but the effect size is small (cohen's d<0.2). Based on our results, both training protocols were effective in reducing the subjective-sense of instability and improved balance in athletes with FAI. Moreover, virtual reality training was very attractive for the participants.

Virtual Reality (VR) is increasingly recognised as a transformative tool for safety training, particularly in high-risk fields such as construction and electrical engineering. However, to successfully integrate this technology within established training practices, training outcomes ought to be rigorously validated. By investigating the effects of eXtended Reality (XR) technology upon the delivery of safety training for high-voltage operations, this paper proposes guidelines by which instructor adoption of XR tools may be assessed and seeks to establish a methodology to measure the effectiveness of training delivery. Factors influencing instructor adoption of XR tools and methods by which staff may be prepared to integrate new training methods are discussed. An exploration of relevant performance metrics, including trainee immersion and operational accuracy, informs the design of an experiment to compare the outcomes of different training sequences: participants are allocated into four experimental groups: (1) traditional training only, (2) VR training only, (3) traditional training followed by VR, and (4) VR training followed by traditional training. Immersive Tendencies Questionnaires (ITQs) assess trainee predispositions to immersion and Presence Questionnaires (PQs) assess perceived presence within the VTE. As well as detailing the collection of data, the experiment desgin also proposes statistical analyses to determine whether VR training complements traditional methods, enhances participant confidence, and improves knowledge retention.

Objectives This study is aimed at exploring the effects of virtual reality (VR) training on postural control, measured by anticipatory and compensatory postural adjustments (APAs and CPAs, respectively), in patients with chronic nonspecific low back pain (CNLBP) and the potential neuromuscular mechanism of VR training. Methods Thirty-four patients were recruited and randomly assigned to the VR group (n = 11), the motor control exercise group (MCE, n = 12) and the control group (CG, n = 11). The VR group received VR training using Kinect Xbox 360 systems and magnetic therapy. Besides magnetic therapy, the participants in the MCE group performed real-time ultrasound-guided abdominal drawing-in maneuver (ADIM) and four-point kneeling exercise. The CG only received magnetic therapy. Surface muscle electromyography (sEMG) was used to record the muscle activities of transverse abdominis (TrA), multifidus (MF), lateral gastrocnemius (LG), and tibialis anterior (TA) during ball-hitting tasks. The muscle activation time and integrals of the electromyography activities (IEMGs) during the APA and CPA stages were calculated and used in the data analysis. The visual analogue scale (VAS) and Oswestry dysfunction index (ODI) scores were also recorded. Results A significant interaction effect of time × group was observed on the activation time of TrA (p = 0.018) and MF (p = 0.037). The post-intervention activation time of the TrA was earlier in the VR group (p = 0.029). In contrast, the post-intervention activation time of the MF was significantly delayed in the VR group (p = 0.001). The IEMGs of TrA (p = 0.002) and TA (p = 0.007) during CPA1 significantly decreased only in the VR group after the intervention. The VAS scores of three group participants showed significant decreases after intervention (p < 0.001). Conclusions Patients with CNLBP showed reciprocal muscle activation patterns of the TrA and MF muscles after VR training. VR training may be a potential intervention for enhancing the APAs of the patients with CNLBP.

Cortical excitability of motor anticipatory in subacute stroke patients after virtual reality training: A preliminary movement-related potential study

BackgroundIt appears that active video games (AVGs) and training apps that allow for physical activity (PA) in immersive virtual reality (VR) may be useful for sports, health-enhancing PA, and physical education (PE). Therefore, research is needed to identify their potential.ObjectiveThe study aimed to evaluate the intensity and attractiveness of exercise during table tennis (TT) training in VR in arcade and simulation modes and to assess the potential for using such exercises in health-enhancing PA, sport, and PE.MethodsThe research used the Racket Fury: Table Tennis VR. Exercise intensity during TT training in VR was evaluated by heart rate (HR) monitoring and rating of perceived exertion (RPE 6–20). The effectiveness of short-term TT training in VR was estimated based on the user’s performance in playing against an opponent with artificial intelligence (AI), satisfaction with playing TT was measured using the Physical Activity Enjoyment Scale (PACES), and the potential usefulness of the tested app in PA, sport, and PE was assessed based on a questionnaire for participating PE teachers (30 participants).ResultsPA intensity during TT training in VR expressed as a percentage of maximum heart rate (HRmax) was moderate but was significantly (p < 0.001; d=-0.830) higher in the easier arcade mode (69.50 ± 12.58%HRmax) than in the simulation mode (64.10 ± 9.67%HRmax). Despite the greater fatigue of respondents, user satisfaction was significantly higher in arcade mode. Users’ performance when playing with AI was significantly better after 20 min of training in VR than before training. PE teachers recognize the great potential of the app.ConclusionsThe application tested is characterized by a beneficial PA intensity, with its level depending on the game mode. Facilitating strokes during a game of virtual TT promotes increased intensity of exercise and increased enjoyment of the PA. Short-term TT training in VR improves playing skills in a virtual environment. PE teachers spoke highly of the app and recognized the potential for using VR technology in PA, sports, and school PE.

In recent years, bicycle-related accidents have increased in Japan; and Virtual Reality (VR) training has shown its effectiveness across various domains. This study aims to examine the effectiveness of VR safety training for bicyclists. A safety training program was developed using both VR and video formats with identical content. A randomized controlled experiment involved 30 subjects receiving VR training (VR group) and another 30 receiving video training (control group). The effectiveness was measured in terms of knowledge acquisition, risk prediction ability and enhancement of safety awareness. Although there was no significant difference between the two groups in terms of traffic rule knowledge acquisition, the VR group showed significantly greater enhancement in risk prediction ability for complex scenarios and in safety awareness. In terms of the training method, VR training was rated higher for ease of understanding, immersion and novelty; though it also led to higher eye strain and mental burden. Accordingly, to maximize VR training’s strength and minimize its negative effects, we recommend that VR safety training be designed for complex content, within an appropriate duration and could be served as a supplement or review to video training.

The effect of virtual reality training on the daily participation of patients: A meta-analysis

Immersive virtual reality (VR) technology has brought many new opportunities for training researchers and students. In the traditional training environment, trainees usually follow verbal instructions (lecture) or visual instructions (video tutorial, job manual) as certain training methods. For this research study, we not only tested how much procedural knowledge the trainees could learn from the VR training compared with traditional media training (video plus instruction manual), we also specifically focused on how well the knowledge could retain in a certain amount of time. The finding of this study shows that VR training can help trainees learn procedural knowledge, and also shows that VR training can help enhance procedural knowledge retention in terms of recall error. However, we did not find any significant difference in recall time between VR training group and traditional media training group.

IntroductionLayperson cardiopulmonary resuscitation (CPR) is a key aspect in the chain of survival after cardiac arrest. New, low-cost, easily accessible training methods such as virtual reality (VR) training with a...

Objective The objective of this study is to find and compare the effects of isokinetic training and virtual reality training on sports performances in university football players with chronic low back pain. Design This is a randomized, double-blinded controlled study. Methods The study was conducted on 45LBP participants at university hospital. First group (n = 15) received isokinetic training, second group (n = 15) received virtual reality training, and the control group (n = 15) received conventional training exercises for four weeks. Clinical (pain intensity and player wellness) and sports performance (40 m sprint, 4 × 5 m sprint, submaximal shuttle running, countermovement jump, and squat jump) scores were measured at baseline, after 4 weeks, 8 weeks, and 6 months. Results Four weeks following training VRT group shows more significant changes in pain intensity and player wellness scores than IKT and control groups (p ≤ 0.001). Sports performance variables (such as 40 m sprint, 4 × 5 m sprint, submaximal shuttle running, countermovement jump, and squat jump) scores also show significant improvement in VRT group than the other two groups (p ≤ 0.001). Conclusion Overall, our study suggests that strength training through virtual reality training protocol improves pain and sports performances than isokinetic training and other conventional trainings in university football players with chronic low back pain.