Journal of medical extended reality最新文献

{"title":"Investigating Demographic Barriers Toward Virtual Reality Pain Efficacy in Clinical Trials: An Exploratory Mixed-Methods Study.","authors":"Omer Liran, Allistair Clark, Zoe Krut, Sam Eberlein","doi":"10.1177/29941520251378444","DOIUrl":"10.1177/29941520251378444","url":null,"abstract":"<p><p>Chronic pain affects over 50 million Americans and is frequently managed with pharmacologic interventions, including opioids, which carry misuse risks. Virtual reality (VR) has emerged as a promising non-pharmacological therapy, yet questions persist about equitable access and whether VR could perpetuate existing health care disparities. This exploratory sequential mixed-methods study investigated barriers and facilitators to VR therapy use in diverse chronic pain populations and examined whether these challenges correlated with changes in Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference (PROMIS-PI) scores. We recruited 31 participants from two National Institutes of Health-funded trials, utilizing purposive sampling to ensure a broad demographic range regarding race, ethnicity, gender, socioeconomic status, and geographic location. Participants completed one-on-one interviews regarding VR use, which were qualitatively coded and quantified to explore correlations with changes in PROMIS-PI from baseline to week 8. Six themes emerged from the qualitative analysis: apprehension and familiarity, usability and comfort, application and pain, experiences, personal connection, and community beliefs. Most participants reported at least temporary pain relief with VR, citing distraction-based or mindfulness content as beneficial; however, cost, technological literacy, and cultural familiarity were identified as key barriers. Spearman's $rho$ and point-biserial tests showed no statistically significant relationships between thematic variables or demographics and PROMIS-PI changes. These findings suggest that VR therapy is broadly acceptable and beneficial across diverse patient groups, though cost and cultural apprehension may impede widespread, equitable adoption. Future research should focus on refining VR content for user comfort, expanding technological support, and developing strategies to overcome barriers to access to ensure the therapy's benefits are realized equitably.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"362-370"},"PeriodicalIF":0.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reporting Guideline for Therapeutic Immersive Virtual Reality Interventions: International eDelphi Study (INVIRTUE).","authors":"Syl Slatman, Daniel Harvie, Max van der Heijden, Loes Bulle, Beate Dejaco, Harry van Goor, Tjitske Diederike Groenveld, Peter Alexander van de Hoef, Maaike Kragting, Raymond Ostelo, Brennan Spiegel, J Bart Staal, Zina Trost, Darcy Ummels, Jesper Knoop","doi":"10.1177/29941520251404744","DOIUrl":"10.1177/29941520251404744","url":null,"abstract":"<p><p>With the rising adoption of virtual reality (VR) in health care, research publications on the topic are increasing rapidly. Guidance on reporting VR interventions is limited, which risks misinterpretation of findings, inappropriate data synthesis in reviews and meta-analyses, and reduced reproducibility. This could also result in possible misuse of VR interventions and might hinder further implementation in clinical practice. The aim of this study was to develop a reporting guideline for therapeutic, immersive VR interventions using head-mounted displays in scientific publications. To reach this aim, we intended to achieve expert consensus on key items and categories for reporting these interventions. We conducted a three-round, modified, online Delphi study with a validation meeting to develop a VR intervention reporting guideline. Participants were international experts in therapeutic VR research, working as academic or industrial researchers. Convenience, purposive, and snowball sampling were used to recruit participants. Consensus was defined <i>a priori</i> as ≥75% agreement on each reporting item and category. Of the 280 invited experts, 61 participants (22%) completed all three rounds of this Delphi study. Participants (32 females [52%]) had an average of 6 years' experience with VR research and diverse backgrounds in VR research settings and disciplines. The final consensus-based VR intervention reporting guideline consists of 16 reporting items divided into six categories (i.e., theory, content, deployment, development, safety, and context). The INVIRTUE intervention reporting guideline provides a framework for describing therapeutic VR interventions. Using this tool may enhance the uniformity and completeness of VR intervention reporting and support study replicability and scientific progress. The reporting guideline will also facilitate efficient empirical comparison across existing VR interventions and ultimately contribute to the appropriate use and effective implementation of therapeutic VR in clinical practice.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"345-361"},"PeriodicalIF":0.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treating Lower Phantom Limb Pain in the Postoperative Acute Care Setting Through a Virtual Reality-Based Graded Motor Imagery Program: A Case Series.","authors":"Marinya Roznik, Megan Crooks, Michael Smith, Elizabeth Hammond, Patrick Gross, Thomas Mutter, Renée El-Gabalawy","doi":"10.1177/29941520251410666","DOIUrl":"10.1177/29941520251410666","url":null,"abstract":"<p><strong>Background: </strong>Phantom limb pain (PLP) affects over 70% of people with lower limb amputations (LLAs). Graded motor imagery (GMI) is an established nonpharmacological treatment that targets the cortical mechanisms associated with PLP onset and may be the most effective if it is administered shortly following amputation. However, application of GMI in practice is hindered by the need for trained health care professionals to assist with longitudinal administration and by low patient buy-in (i.e., one's understanding of, and motivation to engage in, a treatment modality). To address these barriers, our research team developed a virtual reality (VR) program to facilitate self-administration of GMI.</p><p><strong>Objectives: </strong>The primary objective of the current case series was to assess initial feasibility of using the VR GMI program in the acute postoperative setting by evaluating recruitment trends. The secondary objective was to describe the satisfaction, usability, and tolerability of the VR GMI program after short-term administration.</p><p><strong>Methods: </strong>Patients undergoing LLAs at a single academic tertiary hospital were screened for eligibility and interest, and consenting individuals underwent daily sessions in the VR GMI program. Adverse events (i.e., any instance in which pain or nausea interrupted VR engagement, as indicated by the Numerical Rating Scale) were monitored to evaluate tolerability. A self-report questionnaire assessed satisfaction and usability.</p><p><strong>Results: </strong>Of 52 individuals screened, 41 were not eligible to participate (79%). Five eligible individuals were not interested in participating due to feeling overwhelmed (10%). Six participants were recruited (12%), and four were able to complete the entire intervention before their hospital discharge (8%). Most participants rated the program as easy to understand, enjoyable, and helpful. However, participant scores also indicated the need to improve usability. Only one participant reported an adverse event (i.e., fatigue in phantom limb).</p><p><strong>Conclusions: </strong>These results will directly inform refinement of the VR GMI prototype and related VR research implemented in the postoperative setting.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"371-383"},"PeriodicalIF":0.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protecting Patient Privacy: A Suggested Framework for Deploying Extended Reality Technologies.","authors":"Rick Beberman, Jesse Courtier, Darren Straker","doi":"10.1177/29941520251400039","DOIUrl":"10.1177/29941520251400039","url":null,"abstract":"<p><p>As extended reality (XR) devices such as head-mounted displays, augmented reality glasses, computers, tablets, smartphones, and their underlying XR applications become widely deployed in HIPAA-regulated environments, clear guidelines are essential to prevent disclosure of protected health information that traditional health care IT security measures do not adequately address. Without proper safeguards, these technologies could expose sensitive patient data through various means, including visual displays, audio capture, data management, and processing, potentially undermining patient trust. This commentary is meant to provide recommendations in advance of more formal guidelines for protecting patient privacy when XR tools are used in clinical settings. Given the emerging nature of these technologies, addressing compliance proactively is crucial to avoid missteps that could undermine adoption and limit the technology's potential in health care.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"338-344"},"PeriodicalIF":0.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning Motivational Interviewing in VR: A Feasibility Study Using Self-Reported Measures.","authors":"Daan J Verhoeven, Floris T J Ferenschild, Bas Henk Verhoeven, Edward C Bosma, Otmar Buyne, Harry van Goor","doi":"10.1177/29941520251380697","DOIUrl":"10.1177/29941520251380697","url":null,"abstract":"<p><p>Competency in motivational interviewing (MI) for addressing lifestyle-related health issues is increasingly important for health care professionals, yet current simulation training is labor-intensive and expensive. Immersive virtual reality (VR) training may offer a cost-effective alternative. We developed a VR MI training, featuring animated virtual patients with common \"lifestyle\" issues (osteoarthritis, weight loss, smoking cessation) and evaluated its feasibility among medical students. The training consisted of two modules (MI basic techniques and MI communication processes). Each module included three scenarios (osteoarthritis, weight loss, smoking cessation). Both modules had to be completed twice within 1 week. Twenty fourth-year medical students (12 female, 8 male) completed two training modules twice at home using the Oculus Quest headset. Usability, learning motivation, VR immersion, discomfort, ability for exercising, learning, and proficiency in MI, were assessed with validated and customized questionnaires. Mean and standard deviation (SD) total exercise time was 99 and 29 min, respectively. Internal consistency of the questionnaires varied between questionable (alpha 0.650, VR immersion) and good (alpha 0.853; attention, relevance, confidence, and satisfaction model, motivation of learning). Mean system usability score was 69.5, with highest agreement on user-friendliness (>80%) and the lowest on frequency of use (30%) and confidence in using the VR application (36%). Only half of participants reported added value for their future profession. Ninety percent reported \"realization being in a virtual environment\"; 40% had empathy with the virtual patient. Outcomes of customized questions supported a well-designed, easy-to-use, time-balanced training tool, increasing self-confidence in motivational interviewing. Speech recognition issues causing unnatural conversational flow were reported as main drawback. VR-based MI training seems feasible and acceptable for unsupervised student use. Proficiency findings vary and should be interpreted with caution. Added value to skills acquisition and professional development is questioned, probably due to limitations in natural conversation. The small homogenous study group limits generalizability.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"290-302"},"PeriodicalIF":0.0,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial Recommendations for Virtual Reality in Mental Health Care from the American Medical Extended Reality Association.","authors":"Jessica Stone, Leslie Baker, Rachel A Altvater, Triton Ong","doi":"10.1177/29941520251394885","DOIUrl":"10.1177/29941520251394885","url":null,"abstract":"<p><p>Mental health care has long been a leading domain for the application of clinical virtual reality (VR) technologies. The recent proliferation of affordable all-in-one VR devices has significantly increased accessibility and created new opportunities for innovative mental health therapies. As immersive technologies become more integrated into daily life, scientific evidence and clinical insights can be synthesized into actionable recommendations. The American Medical Extended Reality Association, in collaboration with the Mental Health Virtual Reality International Coalition, presents these comprehensive recommendations for the use of VR in clinical mental health care. This work summarizes the current state of the field, examines the supporting scientific literature, outlines ethical considerations and their practical applications, and offers research-based and experience-informed recommendations. Additionally, it identifies key collaborative directions to advance the responsible and effective use of VR in mental health care. These recommendations may serve as a foundational resource for clinicians, researchers, developers, and policymakers for the integration of VR in mental health practice.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"325-337"},"PeriodicalIF":0.0,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Telemedicine and Embodied Virtual Reality: A Novel Functional Training Intervention for Chronic Shoulder Pain.","authors":"Kristine Beebe, Anthony Alvarez, Lincoln Nguyen, James Petros, Michael Trujillo, Oytun Aygün","doi":"10.1177/29941520251381338","DOIUrl":"10.1177/29941520251381338","url":null,"abstract":"<p><p>Chronic shoulder pain is a common musculoskeletal pain condition that can have a profound impact on a sufferer's life and a large socioeconomic health care burden to society. The aim of this study was to investigate the effects of a functional rehabilitation therapy using virtual embodiment in VR, on chronic shoulder pain, delivered in a telemedicine format. Ten chronic shoulder pain patients were recruited from local pain clinics. Patients engaged in three rehabilitation sessions per week over the course of 8 weeks. Rehabilitation sessions were delivered using an Oculus Quest head-mounted display and hand controllers. Rehabilitation exercises (virtual embodiment training) leverage techniques from graded motor imagery, such as visual mirror feedback and augmentation of the virtual avatar's movements. Eight assessments on function and psychological aspects relevant to chronic pain were measured prior to the first session, at week 4, and at the end of 8 weeks in order to investigate the effect of the virtual embodiment training on the symptoms of chronic shoulder pain. Range of motion was measured within the virtual environment at each exercise session for shoulder flexion, scaption, and abduction. A one-way repeated measure analysis of variance revealed that virtual embodiment training improved symptoms of disability measured by the disabilities of the arm, shoulder and hand questionnaire (F(2, 9) = 8.054, <i>p</i> = 0.004). Virtual embodiment training improved function as measured by upper extremity functional index (F(2,9) = 6.506, <i>p</i> = 0.009), pain catastrophizing scale (F (2, 9) = 5.792, <i>p</i> = 0.013), fear avoidance beliefs questionnaire (F(2, 9) = 6.722, <i>p</i> = 0.008), pain self-efficacy questionnaire (F (2, 9) = 4.841, <i>p</i> = 0.023) and yellow flag risk form (F(2,9) = 6.563, <i>p</i> = 0.008). No significant effect was observed for the SF-36 questionnaire of quality of life, or the Tampa Scale of Kinesiophobia. These results indicate that telemedicine-enabled functional rehabilitation for chronic shoulder pain may improve chronic pain symptoms such as disability, function, pain catastrophizing, and fear avoidance in chronic pain patients.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"315-324"},"PeriodicalIF":0.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inclusive Co-Design of Augmented Reality Digital Helpers for Autistic Adolescents and Young Adults: A Study on Just-In-Time Augmented Reality Assistance.","authors":"Julie E LeMoine, Jean A Frazier, Benjamin Dadagian-Goldman, Lizbeth Goodman, Kevin Marshall","doi":"10.1177/29941520251380700","DOIUrl":"10.1177/29941520251380700","url":null,"abstract":"<p><p>This study explored inclusive, augmented reality (AR) digital helpers as assistive technology that are codesigned by autistic adolescents and young adults. The study used a participatory design process and partnered with autistic adolescents and young adults to codesign AR digital helper prototypes. The findings indicated a positive impact from the codesign role for autistic participants and high enthusiasm for applied AR digital helpers from all participant groups. The study established new insights into AR digital helper characteristics and their perceived utility as helpers for autistic adolescents and young adults. This article presents a summary of the study's methods, discusses its findings and limitations, and outlines potential future research goals.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"303-314"},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Augmented Reality in Interventional Radiology: A Review of Systems, Ergonomics, Applications, and Outcomes.","authors":"Youssef Ghosn, Javin Schefflein, Yara Jabbour, Debkumar Sarkar, Francois H Cornelis","doi":"10.1177/29941520251377069","DOIUrl":"10.1177/29941520251377069","url":null,"abstract":"<p><p>Interventional radiology (IR) procedures traditionally rely on two-dimensional imaging for guidance. Augmented reality (AR) offers a transformative approach by overlaying two-dimensional radiological images or three-dimensional digital reconstructions onto the real-world environment, potentially improving procedural precision and operator ergonomics. This narrative literature review examines AR systems, procedural workflow, operator ergonomics, current clinical applications, and outcomes. Inclusion criteria include studies investigating AR in IR, excluding articles unrelated to IR procedures. Current literature suggests improved ergonomics, mainly enhanced depth perception, decreased eye movement/fatigue, and decreased cybersickness with overall operator tolerability. Clinical studies demonstrated reductions in radiation exposure and procedural times, with comparable accuracy to standard techniques. Limitations include the lack of large-scale clinical data and standardized evaluation metrics.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"273-289"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"American Medical Extended Reality Association Expert Consensus: Best Practices for Patient and Public Involvement in Medical Extended Reality Research.","authors":"Tom Norris, Ella Tetrault, Muskaan Mehra, Karisma Suchak, Lindsey Ross, Jan Ballesteros, Brennan M R Spiegel","doi":"10.1177/29941520251377071","DOIUrl":"10.1177/29941520251377071","url":null,"abstract":"<p><p>Patient and public involvement (PPI) is critical in medical extended reality (MedXR) research to ensure that interventions are relevant, patient-centered, and impactful. This expert consensus from the American Medical Extended Reality Association offers a practical framework for integrating patient voices throughout the research lifecycle, from study design to post-study feedback. Drawing on principles from the Patient-Centered Outcomes Research Institute, Congressionally Directed Medical Research Programs, and the National Institutes of Health, it highlights strategies for meaningful involvement of patient partners, emphasizing inclusivity, reciprocity, and transparency. Key areas of focus include best practices for recruiting and compensating patient partners, ensuring diversity and representation, simplifying communication, and addressing ethical considerations. The expert consensus addresses challenges in patient engagement specific to MedXR, offering solutions such as iterative feedback loops during prototype development and collaborative safety monitoring. Case studies provide real-world examples of how PPI insights have enhanced MedXR research, improving accessibility, relevance, and equity. This document serves as a comprehensive resource for researchers, developers, and clinicians, supporting the development of MedXR interventions that are not only scientifically rigorous but also deeply aligned with patient and public needs and priorities.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"255-272"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}