A Virtual Reality Application of the Rubber Hand Illusion Induced by Ultrasonic Mid-air Haptic Stimulation

Ultrasonic mid-air haptic technologies, which provide haptic feedback through airwaves produced using ultrasound, could be employed to investigate the sense of body ownership and immersion in virtual reality (VR) by inducing the virtual hand illusion (VHI). Ultrasonic mid-air haptic perception has solely been investigated for glabrous (hairless) skin, which has higher tactile sensitivity than hairy skin. In contrast, the VHI paradigm typically targets hairy skin without comparisons to glabrous skin. The aim of this article was to investigate illusory body ownership, the applicability of ultrasonic mid-air haptics, and perceived immersion in VR using the VHI. Fifty participants viewed a virtual hand being stroked by a feather synchronously and asynchronously with the ultrasonic stimulation applied to the glabrous skin on the palmar surface and the hairy skin on the dorsal surface of their hands. Questionnaire responses revealed that synchronous stimulation induced a stronger VHI than asynchronous stimulation. In synchronous conditions, the VHI was stronger for palmar stimulation than dorsal stimulation. The ultrasonic stimulation was also perceived as more intense on the palmar surface compared to the dorsal surface. Perceived immersion was not related to illusory body ownership per se but was enhanced by the provision of synchronous stimulation.

Active strategies for multisensory conflict suppression in the virtual hand illusion

The perception of our body in space is flexible and manipulable. The predictive brain hypothesis explains this malleability as a consequence of the interplay between incoming sensory information and our body expectations. However, given the interaction between perception and action, we might also expect that actions would arise due to prediction errors, especially in conflicting situations. Here we describe a computational model, based on the free-energy principle, that forecasts involuntary movements in sensorimotor conflicts. We experimentally confirm those predictions in humans using a virtual reality rubber-hand illusion. Participants generated movements (forces) towards the virtual hand, regardless of its location with respect to the real arm, with little to no forces produced when the virtual hand overlaid their physical hand. The congruency of our model predictions and human observations indicates that the brain-body is generating actions to reduce the prediction error between the expected arm location and the new visual arm. This observed unconscious mechanism is an empirical validation of the perception–action duality in body adaptation to uncertain situations and evidence of the active component of predictive processing.

Visual feedback improves movement illusions induced by tendon vibration after chronic stroke

Background Illusion of movement induced by tendon vibration is commonly used in rehabilitation and seems valuable for motor rehabilitation after stroke, by playing a role in cerebral plasticity. The aim was to study if congruent visual cues using Virtual Reality (VR) could enhance the illusion of movement induced by tendon vibration of the wrist among participants with stroke. Methods We included 20 chronic stroke participants. They experienced tendon vibration of their wrist (100 Hz, 30 times) inducing illusion of movement. Three VR visual conditions were added to the vibration: a congruent moving virtual hand (Moving condition); a static virtual hand (Static condition); or no virtual hand at all (Hidden condition). The participants evaluated for each visual condition the intensity of the illusory movement using a Likert scale, the sensation of wrist’s movement using a degree scale and they answered a questionnaire about their preferred condition. Results The Moving condition was significantly superior to the Hidden condition and to the Static condition in terms of illusion of movement (p < 0.001) and the wrist’s extension (p < 0.001). There was no significant difference between the Hidden and the Static condition for these 2 criteria. The Moving condition was considered the best one to increase the illusion of movement (in 70% of the participants). Two participants did not feel any illusion of movement. Conclusions This study showed the interest of using congruent cues in VR in order to enhance the consistency of the illusion of movement induced by tendon vibration among participants after stroke, regardless of their clinical severity. By stimulating the brain motor areas, this visuo-proprioceptive feedback could be an interesting tool in motor rehabilitation. Record number in Clinical Trials: NCT04130711, registered on October 17th 2019 (https://clinicaltrials.gov/ct2/show/NCT04130711?id=NCT04130711&draw=2&rank=1).

298 Review of Rapid Implementation of Virtual Hand Therapy Clinics During COVID-19

Aim The COVID-19 pandemic led to the introduction of movement restrictions and the concept of social distancing in Ireland, beginning suddenly on March 12th 2020 (1). Following this, virtual consultation via video-call have been identified and integrated as an alternative to in-person consultation. To follow national recommendations and reduce the risk of patient attendance, video consultations were rapidly integrated by the hand therapy team at University Hospital Galway. This service provides a service to 730,513 people across eight counties (2) and was utilised for a range of upper limb injuries, providing vital care to trauma patients post-operatively and to minor injury cases. We wanted to retrospectively assess the implementation of these virtual clinics and how it affected patients. Method Patients were offered virtual hand therapy appointments. Patients were sent a link with their virtual appointment time and date via email. The patient could accept or decline the option of a virtual appointment at this stage. Patient satisfaction was measured via a bespoke survey. Functional outcomes were assessed via the QuickDASH assessment tool (3). Results 44/74 ( 59.5%) of patients responded to the survey. Subjectively, the vast found the service user-friendly, convenient and beneficial. Objectively, the QuickDash score demonstrated low disability and high upper limb function return post injury. Conclusions Implementation of virtual hand therapy was integrated into practise without major issues. Patient satisfaction was very high. Virtual health services have obvious economic and environmental benefits and are essential to providing safe patient care in a social distancing society.

Exploring the Embodiment of a Virtual Hand in a Spatially Augmented Respiratory Biofeedback Setting

Enhancing the embodiment of artificial limbs—the individuals' feeling that a virtual or robotic limb is integrated in their own body scheme—is an impactful strategy for improving prosthetic technology acceptance and human-machine interaction. Most studies so far focused on visuo-tactile strategies to empower the embodiment processes. However, novel approaches could emerge from self-regulation techniques able to change the psychophysiological conditions of an individual. Accordingly, this pilot study investigates the effects of a self-regulated breathing exercise on the processes of body ownership underlying the embodiment of a virtual right hand within a Spatially Augmented Respiratory Biofeedback (SARB) setting. This investigation also aims at evaluating the feasibility of the breathing exercise enabled by a low-cost SARB implementation designed for upcoming remote studies (a need emerged during the COVID-19 pandemic). Twenty-two subjects without impairments, and two transradial prosthesis users for a preparatory test, were asked (in each condition of a within-group design) to maintain a normal (about 14 breaths/min) or slow (about 6 breaths/min) respiratory rate to keep a static virtual right hand “visible” on a screen. Meanwhile, a computer-generated sphere moved from left to right toward the virtual hand during each trial (1 min) of 16. If the participant's breathing rate was within the target (slow or normal) range, a visuo-tactile event was triggered by the sphere passing under the virtual hand (the subjects observed it shaking while they perceived a vibratory feedback generated by a smartphone). Our results—mainly based on questionnaire scores and proprioceptive drift—highlight that the slow breathing condition induced higher embodiment than the normal one. This preliminary study reveals the feasibility and potential of a novel psychophysiological training strategy to enhance the embodiment of artificial limbs. Future studies are needed to further investigate mechanisms, efficacy and generalizability of the SARB techniques in training a bionic limb embodiment.

Size Perception Bias and Reach-to-Grasp Kinematics: An Exploratory Study on the Virtual Hand With a Consumer Immersive Virtual-Reality Device

While studies have increasingly used virtual hands and objects in virtual environments to investigate various processes of psychological phenomena, conflicting findings have been reported even at the most basic level of perception and action. To reconcile this situation, the present study aimed 1) to assess biases in size perception of a virtual hand using a strict psychophysical method and 2) to provide firm and conclusive evidence of the kinematic characteristics of reach-to-grasp movements with various virtual effectors (whole hand or fingertips only, with or without tactile feedback of a target object). Experiments were conducted using a consumer immersive virtual reality device. In a size judgment task, participants judged whether a presented virtual hand or an everyday object was larger than the remembered size. The results showed the same amplitude of underestimation (approximately 5%) for the virtual hand and the object, and no influence of object location, visuo-proprioceptive congruency, or short-term experience of controlling the virtual hand. Furthermore, there was a moderate positive correlation between actual hand size and perception bias. Analyses of reach-to-grasp movements revealed longer movement times and larger maximum grip aperture (MGA) for a virtual, as opposed to a physical, environment, but the MGA did not change when grasping was performed without tactile feedback. The MGA appeared earlier in the time course of grasping movements in all virtual reality conditions, regardless of the type of virtual effector. These findings confirm and corroborate previous evidence and may contribute to the field of virtual hand interfaces for interactions with virtual worlds.