Effect of vestibular exercise and optokinetic stimulation using virtual reality in persistent postural-perceptual dizziness

To determine the effect of customized vestibular exercise (VE) and optokinetic stimulation (OS) using a virtual reality system in patients with persistent postural-perceptual dizziness (PPPD). Patients diagnosed with PPPD were randomly assigned to the VE group or VE with OS group. All participants received VE for 20 min using a virtual reality system with a head mount display once a week for 4 weeks. The patients in the VE with OS group additionally received OS for 9 min. We analysed the questionnaires, timed up-to-go (TUG) test, and posturography scores at baseline and after 4 weeks. A total of 28 patients (median age = 74.5, IQR 66–78, men = 12) completed the intervention. From baseline to 4 weeks, the dizziness handicap inventory, activities of daily living (ADL), visual vertigo analogue scale, and TUG improved in the VE group, but only ADL and TUG improved in the VE with OS group. Patients with severe visual vertigo improved more on their symptoms than patients with lesser visual vertigo (Pearson’s p = 0.716, p < 0.001). Our VE program can improve dizziness, quality of life, and gait function in PPPD; however, additional optokinetic stimuli should be applied for individuals with visual vertigo symptoms.

Cross-Modal Effect of Presenting Visual and Force Feedback That Create the Illusion of Stair-Climbing

Image therapy, which creates illusions with a mirror and a head mount display, assists movement relearning in stroke patients. Mirror therapy presents the movement of the unaffected limb in a mirror, creating the illusion of movement of the affected limb. As the visual information of images cannot create a fully immersive experience, we propose a cross-modal strategy that supplements the image with sensual information. By interacting with the stimuli received from multiple sensory organs, the brain complements missing senses, and the patient experiences a different sense of motion. Our system generates the sense of stair-climbing in a subject walking on a level floor. The force sensation is presented by a pneumatic gel muscle (PGM). Based on motion analysis in a human lower-limb model and the characteristics of the force exerted by the PGM, we set the appropriate air pressure of the PGM. The effectiveness of the proposed system was evaluated by surface electromyography and a questionnaire. The experimental results showed that by synchronizing the force sensation with visual information, we could match the motor and perceived sensations at the muscle-activity level, enhancing the sense of stair-climbing. The experimental results showed that the visual condition significantly improved the illusion intensity during stair-climbing.

Psychophysiological Alteration After Virtual Reality Experiences Using Smartphone-Assisted Head Mount Displays: An EEG-Based Source Localization Study

Brain functional changes could be observed in people after an experience of virtual reality (VR). The present study investigated cyber sickness and changes of brain regional activity using electroencephalogram (EEG)-based source localization, before and after a VR experience involving a smartphone-assisted head mount display. Thirty participants (mean age = 25 years old) were recruited. All were physically healthy and had no ophthalmological diseases. Their corrected vision was better than 20/20. Resting state EEG and the simulator sickness questionnaire (SSQ) were measured before and after the VR experience. Source activity of each frequency band was calculated using the sLORETA program. After the VR experience, the SSQ total score and sub scores (nausea, oculomotor symptoms, and disorientation) were significantly increased, and brain source activations were significantly increased: alpha1 activity in the cuneus and alpha2 activity in the cuneus and posterior cingulate gyrus (PCG). The change of SSQ score (after–before) showed significant negative correlation with the change of PCG activation (after–before) in the alpha2 band. The study demonstrated increased cyber sickness and increased alpha band power in the cuneus and PCG after the VR experience. Reduced PCG activation in alpha band may be associated with the symptom severity of cyber sickness.

Development of a Virtual Reality Experience System for Interior Damage Due to an Earthquake – Utilizing E-Defense Shake Table Test –

To construct a virtual reality (VR) experience system for interior damage due to an earthquake, VR image contents were created by obtaining images, sounds, and vibration data from multiple devices, with synchronization information, in a room at the 10thfloor of 10-story RC structure tested at E-Defense shake table. An application for displaying 360-degree images of interior damage using a head mount display (HMD) was developed. The developed system was exhibited in public disaster prevention events, and then a questionnaire survey was conducted to assess usefulness of VR experience in disaster prevention education.