2018 has been a fruitful year for VR research. This March, during one of the many conferences on advances in VR technology, a group of medical VR enthusiasts convened to discuss the latest developments in the field. Virtual Medicine is a conference held annually in Los Angeles which gathers experts working in immersive therapeutics and researching the medical applications of VR.
Among these experts was Dr. Brennan Spiegel, the director of Health Services Research at the Cedars-Sinai Medical Center, where the event was held. After the conference, Spiegel went on Twitter to announce what were according to him the most impactful VR studies of 2018.
Spiegel has been investigating digital health technologies for a while now. As the director of the Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), he has been exploring the medical applications of emerging technologies, including VR. He is also the Co-Chair of the VR/AR Association Digital Health Committee and a prolific author, having published many bestselling medical textbooks and more than 170 articles in peer-reviewed journals. As one of the top influencers for digital health and VR, he’s been featured in many major publications and continues to share his knowledge as a speaker at major events in his area of expertise.
Curious to know more about Dr. Spiegel’s recommendations? Here’s an overview of what these studies were about and what implications they carry:
1. Having near-death experiences in VR makes people more caring?
A fascinating study on experiencing near-death situations through VR indicated that continuous exposure to such experiences may lead to positive life-attitude changes. The study addressed VR’s unique ability to offer insight on mortality and death-associated phenomena such as out-of-body (OBE) or near-death experiences (NDEs), an unattainable area of research up until now.
The focus was placed particularly on NDEs and the profound effects that they seem to have on individuals who experience them. Immersive VR was used to create a realistic illusion of embodiment and cause the participants to gradually identify and feel ownership over their virtual bodies. After witnessing the deaths of their virtual companions, the participants experienced their own virtual deaths with all of the features common to NDEs such as OBE, life review, and tunnels ending with white light. After this they would briefly observe the continuing activities in the virtual world on an external screen.
Following the experiment, participants reported life-attitude changes and an increase in concern for other people and global issues, as it is often the case with actual near-death experiences. While the study was based on a small sample size, the results certainly indicate that further research in this area could lead to very interesting discoveries.
2. VR for reducing labour pain
While epidural analgesia is considered to be the most effective method for reducing pain during childbirth, the side effects associated with it can be avoided by using nonpharmacologic methods. Up to 75% of women in the United States are willing to try such methods for labour pain, and research has been conducted on VR’s potential to be added to the list.
A pilot study on the use of VR during childbirth investigated if VR could treat pain during childbirth. The researchers were motivated to undertake the study by the fact that immersive VR distraction has proven effective for reducing acute pain in many different clinical settings.
The researchers observed 27 women during unmedicated contractions in the first stage of labour both with and without VR. It was reported that with VR, women experienced significantly less sensory, affective, and cognitive pain as well as anxiety.
This was one of the first studies to research immersive VR analgesia for childbirth pain and unsurprisingly had its limitations, but the results clearly indicate that VR has the potential to be used as a safe and accessible nonpharmacologic method for reducing labour pain and anxiety.
3. Virtual Tai Chi improves cognitive impairment?
Cognitive impairment and dementia are increasing globally in the elderly population. Investigating potential treatments is therefore becoming more important, both because of the negative effects on quality of life and the significant costs related to the condition.
Exercise has great potential for improving cognitive and physical function in older people with cognitive impairment and dementia. The only issue is that it seems very difficult to get people to adhere to their exercise regimen. Because of this, it has become necessary to develop strategies for this population that can encourage physical activity and induce sufficient levels of motivation for continued investment.
VR-based Tai Chi has recently been studied for this purpose. Tai Chi, a type of Chinese internal martial art consisting of simple mind-body exercises, has been shown to have physical and psychological benefits for older people, whether or not they have cognitive impairment. The benefits include improved aerobic capacity, muscle strength, and balance, along with cognitive improvements in executive function, language, learning, memory, and global cognition.
Why do it in virtual reality? Other than the potential for raising motivation levels due to its immersive qualities, VR can provide fast guidance and feedback during exercises which can be useful, particularly for the elderly.
The study intervention involved 60 older adults with cognitive impairment twice weekly for 6 months: half were assigned to a control group and asked to maintain their usual physical activities and the other half practiced VR-based Tai Chi. The results demonstrated that a VR-based Tai Chi exercise program had significant protective effects on abstract thinking and judgment, aerobic endurance, lower extremity endurance, gait speed, and most prominently—balance.
4. VR for awe-inspiring, transformative experiences
Transformative experiences have been described as profound, potentially life-changing events which reconstruct people’s worldviews and alter their notions of their own identity. Similarly to the previously mentioned NDEs, these changes in life-attitude are often permanent. Awe has been identified as the key emotion to accompany transformative experiences. It is linked with experiences of self-transcendence and induces feelings of enhanced social interconnectivity and life satisfaction.
Both awe and transformative experiences in general are far from being mundane occurrences. Recreating them in a lab environment is very difficult, so they haven’t been common subjects of study so far. As a potential solution to this, researchers in one particular study turned to VR in order to simulate awe-inspiring conditions. Their proposition was that feelings of awe and potentially transformative experiences could be made more accessible through the use of VR.
Participants explored various locations of the planet in an interactive VR system. Goosebumps were successfully used as a physiological indicator of awe experiences. Results showed that VR is very capable of inducing awe, especially in self-selected environments. It was also noted that this capacity could be expanded further by designing interfaces that don’t interfere with the experience of awe.
5. VR as a phobia treatment modality
A third of people suffering from phobias report that their fears are severe enough to interfere with daily functioning. Exposure-based treatment has been established as one of the most effective methods for treating various anxiety disorders, phobias included, and technological developments are introducing many new possibilities as well. Immersive VR exposure might bring significant improvements to existing exposure-based treatment methods.
In a one-of-its-kind randomised controlled trial, participants with a fear of spiders were placed in a virtual environment using stereoscopic 3D video. This type of VR uses real footage instead of simulations in order to achieve a more realistic appearance. Following the treatment, participants outperformed the control group on behavioural and self-reported spider fear measures. Only thirty minutes of exposure to the 3D virtual environment significantly reduced participants’ fear.
This has demonstrated that VR-based exposure has a very promising future as a fear treatment method. In-vivo exposure treatment is already known to be highly effective, but being able to simulate it in VR has a number of benefits—from logistics and safety concerns to better control over stimuli.
So, against this backdrop of scientific literature and the calculated opinions of industry experts, when we at Rescape say that we are thrilled with what VR has to offer in healthcare and the positive impact DR.VR can play in patient’s lives, it is not an exercise in speculation but from a position based on hard facts and convincing evidence.
- Barberia I, Oliva R, Bourdin P, Slater M (2018) Virtual mortality and near-death experience after a prolonged exposure in a shared virtual reality may lead to positive life-attitude changes. PLoS ONE 13(11): e0203358. https://doi.org/10.1371/journal.pone.0203358
- Frey D, Bauer M, Bell C, et al. Virtual Reality Analgesia in Labor: The VRAIL Pilot Study—A Preliminary Randomized Controlled Trial Suggesting Benefit of Immersive Virtual Reality Analgesia in Unmedicated Laboring Women. Anesthesia & Analgesia. Publish Ahead of Print():, JUL 2018. DOI: 10.1213/ANE.0000000000003649
- Hsieh C, -C, Lin P, -S, Hsu W, -C, Wang J, -S, Huang Y, -C, Lim A, -Y, Hsu Y, -C: The Effectiveness of a Virtual Reality-Based Tai Chi Exercise on Cognitive and Physical Function in Older Adults with Cognitive Impairment. Dement Geriatr Cogn Disord 2018;46:358-370. doi: 10.1159/000494659
- Quesnel D and Riecke BE. Are You Awed Yet? How Virtual Reality Gives Us Awe and Goose Bumps. Front. Psychol., 09 November 2018. https://doi.org/10.3389/fpsyg.2018.02158
- Minns S, Levihn-Coon A, Carl E, et al. Immersive 3D exposure-based treatment for spider fear: A randomized controlled trial. J Anxiety Disord. 2019 Jan;61:37-44. doi: 10.1016/j.janxdis.2018.12.003