Journal of medical extended reality最新文献

{"title":"Media-Dependent Effects in Heart Rate Variability Biofeedback: A Systematic Review of Extended Reality and Screen-Based Training Approaches.","authors":"Nathan Miner, Karmen Gill, Casper Harteveld, Christopher Bono, Darshan H Mehta","doi":"10.1089/jmedxr.2024.0060","DOIUrl":"10.1089/jmedxr.2024.0060","url":null,"abstract":"<p><p>Heart rate variability (HRV) is an indicator of autonomic nervous system function and cardiovascular health. Through biofeedback (BF), individuals can increase their HRV, which is ideal, by using audiovisual cues to monitor and adjust their breathing. HRV-BF training has demonstrated effectiveness in alleviating stress and anxiety, enhancing cardiac autonomic function, and supporting psychological treatments for conditions, such as depression and chronic pain. Despite their benefits, traditional HRV-BF approaches are limited by the need for frequent clinical visits, specialized equipment, and trained personnel, limiting accessibility and scalability. Extended reality (XR) technologies, including virtual reality, augmented reality, and mixed reality, offer a promising alternative by creating immersive, interactive environments that can deliver HRV-BF without traditional constraints. This review examines the available literature on reported differences in user experience (UX), HRV metrics, psychological outcomes, and BF performance, which are documented by research comparing HRV-BF using XR media to traditional screen-based methods. We searched PubMed, PsycINFO, Embase, Cochrane, Science Direct, ACM, and IEEE databases. Our search yielded 382 results. Four studies met our review criteria. Using HRV-BF research reporting guidelines, we extracted and summarized study objectives, design strategies, hypotheses, and related outcomes to evaluate the evidence for media-dependent effects. Findings indicate that both XR and screen-based implementations of HRV-BF positively affect HRV physiology. Furthermore, XR-based HRV-BF implementations showed more pronounced effects on outcomes for psychological and UX variables. These studies suggest that XR media can offer advantages in terms of user engagement and psychological benefits (e.g., stress relief, relaxation) over traditional screen-based modalities. Improvements in UX and psychological outcomes stem from the relaxing, immersive contexts created in XR, supporting user motivation and attentional control during XR-based HRV-BF training. However, design-based inquiries and longitudinal studies are needed to understand the role of design and the potential of the specific mechanisms contributing to these results.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"114-131"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681834","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":"Evaluating the Use of Virtual Reality in Medical School Neuroanatomy Curriculum: A Nonrandomized Pre-Post-Intervention Study with Medical Students.","authors":"Shannon K T Bailey, Antonious Y Rizkalla, Ernesto A Mejias Vazquez, Henry E Blagden, Aditya Garg, Colleen C Reiner, Srinivas Bharadwaj","doi":"10.1089/jmedxr.2024.0036","DOIUrl":"10.1089/jmedxr.2024.0036","url":null,"abstract":"<p><p>The purpose of this study was to examine the effectiveness of including a 1-1.5 h virtual reality (VR) lesson in the neuroanatomy curriculum for first-year medical students. We examined post-VR knowledge of neuroanatomy as our primary outcome measured by neuroanatomy tests, and students' subjective experience of VR as our secondary outcome measured by the System Usability Scale (SUS) and a questionnaire. Neuroanatomy presents a significant challenge for students to learn due to the complexity of brain structures and their spatial relationships. VR offers an immersive platform that could aid in understanding three-dimensional (3D) structures. This study (pre-post-intervention without control) included 12 medical students enrolled in a first-year neuroanatomy course. Participants completed a neuroanatomy knowledge pre-test, then participated in a VR-based neuroanatomy lesson (intervention), followed by a neuroanatomy knowledge post-test using the same content created by the neuroanatomy course instructor. Our intervention was a VR lesson with a narrated walk-through of high-resolution 3D volumetric renderings of brain anatomy, focusing on cortical regions, subcortical structures, and major arteries. Students could pause the narration and manipulate 3D images (i.e., rotate, zoom, and bisect). Percent correct on the neuroanatomy post-test (<i>M</i> = 66.67%, <i>SD</i> = 12.85%) improved significantly from the pre-test (<i>M</i> = 52.08%, <i>SD</i> = 14.99%, <i>p</i> = 0.004, and <i>d</i> = 1.038). Student subjective experience using VR was rated below the benchmark on the SUS. Most rated their subjective experiences of the VR intervention positively (above the midpoint) on questionnaire items. Furthermore, students completed a validated measure of spatial ability (Paper Folding Test), and exploratory analysis revealed that students with lower spatial skills may benefit from the VR intervention and perform comparably to their peers who have higher spatial skills. Results indicated our VR neuroanatomy lesson may be associated with enhanced neuroanatomy knowledge among first-year medical students who have lower spatial skills. Further studies are needed to optimize the effectiveness of implementing VR in neuroanatomy education.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"95-103"},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681819","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":"Navigating Immersion: Usability Study of a Virtual Reality Application Designed for Older Adults with Dementia and Their Caregivers.","authors":"Hira Alizai, Madeline Wong, Danielle Tchao, Lora Appel","doi":"10.1089/jmedxr.2024.0034","DOIUrl":"10.1089/jmedxr.2024.0034","url":null,"abstract":"<p><p>A growing number of therapeutic virtual reality (VR) applications are targeted at older adults, but few are evidence-based and designed together with end-users, thus limiting the adoption of this potentially game-changing technology. There is also little research exploring VR applications developed for dyadic use between older adults and their caregivers, who are commonly a part of the safe and optimal experience. The objective of this study was to evaluate the initial usability of an application designed to make accessing immersive VR easier for older adults with dementia and their caregiver(s). This was a non-randomized, prospective mixed-methods think-aloud study that consisted of a two hour usability session with seven participant dyads (one person living with dementia and their caregiver). Descriptive statistical analyses were conducted on demographic quantitative data, and three researchers conducted thematic analysis on observation notes as well as the participants' qualitative responses. Themes identified included headset comfort and safety, usability and navigation, quality (spanning over sub-themes of video, audio, and connectivity), and content. Our main findings highlighted success in delivering the platform's main function as its immersive experience and ability to accommodate socialization and bonding between older adults and caregivers received positive reception from participants. Additionally, there was a need to improve the application's audio quality, as well as streamline its navigation and enlarge interface elements for easier use. These findings provide a guide for development of future VR interventions targeted toward older adults and their caregivers, of which there is currently a lack of in the commercial market and in evidence-based research, despite their demonstrated potential.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"84-94"},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681837","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":"Understanding the FDA Process Is Critical for Young Companies.","authors":"Jesse Courtier, Rick Beberman","doi":"10.1089/jmedxr.2024.0053","DOIUrl":"10.1089/jmedxr.2024.0053","url":null,"abstract":"<p><p>Our team recently led our augmented reality preoperative planning software application through Food and Drug Administration 510(k) clearance as a class 2 medical device. As augmented and virtual reality play an increasing role in health care, more early-stage companies will be required to seek this clearance. Often founders at these companies lack regulatory experience, which can make the process difficult and inefficient. Our experience was the first time for us. For those in a similar position, it's important to keep a few things in mind that can help lead to a successful process.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"81-83"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681844","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":"AMXRA Guidelines on Extended Reality (XR) and Children: Considerations for Safe and Effective Application Development and Use.","authors":"Asher Marks, Veronica Weser, Thomas Jon Caruso, Susan Persky, Abraham Homer, Jeffrey Gold, Erin Williamson, Kimberly Hieftje","doi":"10.1089/jmedxr.2024.0054","DOIUrl":"10.1089/jmedxr.2024.0054","url":null,"abstract":"<p><p>The extended reality (XR) revolution has ushered in the adoption of head-mounted displays (HMDs), including among children. While well-studied clinical uses of XR hold promise for positive outcomes in pain management, behavioral change, and social connection, unsupervised use and improper implementation of immersive technologies in young populations raise significant concerns. Current age limit recommendations are based primarily on privacy laws and fail to address the potential physical, cognitive, emotional, and other psychosocial implications of XR for children. Commercially available HMDs are ill-suited for young users, leading to discomfort and suboptimal immersive experiences. Further, XR experiences challenge young children's ability to differentiate reality from fantasy, resulting in safety hazards and the potential for confabulated memories. Concerns extend to immersive social experiences, where the impact on mental health and safety is not yet fully understood. While acknowledging the risks, embracing XR technologies with thoughtful consideration is necessary to maximize their potential benefits for all youth, especially those facing adversity and isolation. Balancing accessibility and safety are essential as current and future XR technologies become integrated into children's daily lives. This manuscript represents AMXRA's official position on the responsible use of XR in children and will address the three major components of childhood development - physical, cognitive, and psychosocial - as they relate to the use and development of immersive technologies, in homes, schools, and clinics.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"104-113"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985334","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":"Anticipated Barriers and Facilitators to Engaging in a Novel Virtual Reality Program for Lower Phantom Limb Pain.","authors":"M Crooks, M Smith, K Reynolds, E Hammond, P Gross, L Pankratz, R El-Gabalawy","doi":"10.1089/jmedxr.2024.0047","DOIUrl":"10.1089/jmedxr.2024.0047","url":null,"abstract":"<p><p>While there is promising evidence to suggest certain virtual reality (VR) programs and graded motor imagery (GMI) can independently be administered to treat phantom limb pain (PLP) in people with lower limb amputations (LLAs), there are many barriers preventing their implementation. Long outpatient wait times prevent treatment access in the early postoperative period following amputation, when PLP is the most severe. The integration of GMI in VR offers the opportunity to improve PLP treatment access in the acute period by facilitating self-administration. Accordingly, the present multidisciplinary team used a multi-methods approach to assess a novel head-mounted VR GMI prototype and evaluate areas of improvement according to patient feedback. Twelve people with unilateral LLAs recruited from outpatient physiotherapist and prosthetic clinics were asked to trial the program in a single intensive session. Afterwards, participants completed a semi-structured interview to reflect on barriers and facilitators they expect would affect their use of the VR GMI program. They also completed psychometrically validated self-report questionnaires (including the User Engagement Scale and Presence Questionnaire) that inquired about the engagement and immersion facilitated by the program. Reflexive thematic analysis suggests VR and treatment expectations, in addition to individual priorities, motivation, and resources, may affect one's willingness to use the VR GMI program in the acute period following amputation. Meanwhile, descriptive analysis demonstrates that while the VR GMI program is considered immersive, more focused attention needs to be facilitated to increase engagement. In line with these findings, future development will prioritize embedding psychoeducation to prime realistic expectations about the intervention. These developments will improve the chances of implementing the VR GMI program in clinical settings following a larger study to assess its efficacy in the hospital following amputation. Results may be transferred to our broader understanding of how VR interventions may be implemented in acute postoperative settings.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"61-75"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681784","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":"Feasibility and Acceptability Study of Virtual Reality Support Groups for Transgender and Gender Expansive Youth.","authors":"Nicolas Meade, Allura Ralston, Veronica Weser, Kimberly Hieftje, Christy Olezeski, Asher Marks","doi":"10.1089/jmedxr.2024.0040","DOIUrl":"10.1089/jmedxr.2024.0040","url":null,"abstract":"<p><p>Transgender and gender expansive (TGE) youth are facing unprecedented levels of social and structural stigmatization and discrimination. Antitransgender legislation almost exclusively focuses on limiting affirming supports for TGE youth by utilizing stigmatizing rhetoric surrounding transgender identities based on myths and disinformation. In the face of increasing societal oppression, TGE individuals report higher rates of experienced discrimination, violence, and social rejection. Interventions that promote individual and community resilience are vital to supporting the wellbeing of TGE youth. Virtual support groups and therapies for TGE youth may be essential as in-person access to affirming spaces continues to be limited. In this article, we present feasibility and acceptability data of a social virtual reality (VR) tool to support TGE youth for whom in-person supports may not exist and for whom video-based telehealth platforms may trigger dysphoria. Using a mixed-methods approach, we collected data from 10 TGE youth participants on the feasibility and acceptability of an eight-week, VR social support group, prior to transitioning to a peer-to-peer model based on overwhelming participant feedback. We posit that gender affirming VR support groups and therapies may help increase critical resilience factors for TGE youth that are being restricted from gender affirming supports and call for further research to investigate the usefulness of VR and other immersive platforms to support gender affirmation and community connection.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"51-60"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681809","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":"Evaluation of Learner Engagement Following Virtual Reality Augmented Central Line Training.","authors":"Margaret Sande, Kevin Livingstone, David Moody, David Martin, Kathryn Mutter","doi":"10.1089/jmedxr.2024.0058","DOIUrl":"10.1089/jmedxr.2024.0058","url":null,"abstract":"<p><p>Central line placement is a critical skill for medical students, yet training opportunities are limited. This pilot study evaluated the impact of virtual reality (VR) training on fourth-year medical students' perceived competence for central line placement. Fifty-four students underwent VR training followed by hands-on simulation. Results demonstrated a significant increase in perceived competence post-training, with improvements across multiple dimensions. Students also rated the VR experience as highly valuable for their learning. While engagement with the VR interface was moderate overall, students found the technology appealing and worthwhile. These findings suggest that VR holds promise as a valuable adjunct to traditional central line training, enhancing students' preparedness for clinical practice.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"76-80"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681839","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":"Virtual Reality in Preanesthetic Care: A Case Series on Feasibility and Usability.","authors":"Jose Ferrer Costa, Zeltia Muñoz Cociña, Maria Jose Ciudad, Marta López Fernández","doi":"10.1089/jmedxr.2024.0061","DOIUrl":"10.1089/jmedxr.2024.0061","url":null,"abstract":"<p><p>This case series investigates the feasibility, usability, and acceptability of integrating virtual reality (VR) into perioperative care. Ten adults scheduled for elective surgery participated, with six completing all three VR stages: a 360-degree hospital tour, mindfulness meditation, and immersive relaxation. Usability was assessed using two adapted versions for patients and professionals of the System Usability Scale (SUS) and open feedback collected from patients, caregivers, and health care professionals. Anxiety was measured with the State-Trait Anxiety Inventory-6, heart rate, and blood pressure. Results showed high usability (SUS scores: 90.1 for patients, 75.2 for health care professionals) and positive feedback. Anxiety levels generally decreased with some variability immediately before surgery, and physiological parameters showed a downward trend, suggesting a calming effect. Feedback indicated that VR was most beneficial in the preoperative preparation ward, where it fit more easily into established workflows. However, logistical barriers, including time constraints in the preanesthesia room, highlighted the need for workflow adjustments. These findings suggest that VR is feasible and acceptable in perioperative care. Preliminary results indicate a potential role in anxiety management and reducing sedative use, but further controlled studies with larger samples are necessary to evaluate its clinical impact and refine its integration into routine practice.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"43-50"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681799","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":"Virtually There: A Framework for Immersive Technology to Enable Global Health Engagements-Pioneering Frontiers in Medical Readiness and Global Health Diplomacy.","authors":"Janette Arencibia, Bianca B Miranda, Jenna Watts","doi":"10.1089/jmedxr.2024.0030","DOIUrl":"10.1089/jmedxr.2024.0030","url":null,"abstract":"<p><p>This article examines how virtual reality, augmented reality, and mixed reality are transforming health care education and training, especially in Global Health Engagements (GHEs). It highlights how these technologies can overcome geographic barriers, expand access to medical education, and foster international cooperation. The article introduces a framework, based on the U.S. Department of Defense's \"Doctrine, Organization, Training, Material, Leadership, Personnel, and Facilities\" model, to guide the adoption of these technologies and align them with U.S. GHE goals. The framework covers key areas such as technology terminology, equipment setup, secure online participation, user experience, system capabilities, and cultural considerations. Its goal is to encourage innovation and address challenges to enhance global health outcomes through immersive technologies.</p>","PeriodicalId":517437,"journal":{"name":"Journal of medical extended reality","volume":"2 1","pages":"20-29"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681814","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}