Chantal Zorzi

Objectives: To evaluate the available virtual reality (VR) applications for treating perinatal mental health disorders, focusing on their effectiveness in reducing symptoms such as anxiety and depression, which are common during the perinatal period. Design: Rapid scoping review adhering to the Joanna Briggs Institute guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR), with adjustments based on the Cochrane Rapid Reviews guidelines. Data sources: Medline, PsychInfo, Embase, Evidence-Based Medicine (EBM) Reviews using Ovid and Web of Science were searched through 20 February 2024. Eligibility criteria: Studies were included if they were written in English or French, provided details on the VR technology, described the assessment of perinatal mood disorders and specified the outcomes measured and the methodological approach used. Review and editorial articles were excluded as well as abstracts and posters. Data extraction and synthesis: One reviewer extracted study characteristics (eg, design, participants, VR components, outcomes) and a second reviewer verified accuracy; study quality was assessed using the National Institute of Health (NIH) Quality Assessment of Controlled Intervention Studies tool, and findings were synthesised narratively and in tabular form. Results: A total of 425 records were identified. After removing duplicates, 308 records were screened by title and Of these, 74 full texts were assessed for eligibility, resulting in 10 studies being included for data extraction. These final studies were primarily conducted in high-income countries from 2019 to 2024. 8 of 10 (80%) were randomised controlled trials, employing VR through head-mounted displays. Studies predominantly targeted non-severe cases of anxiety and depression, with VR environments ranging from nature scenes to therapeutic content. Results suggest a positive impact of VR interventions on reducing anxiety and depression levels among participants. Conclusions: Studying VR appears to be a promising avenue for developing options to manage perinatal mental health. The immersive nature of VR may provide opportunities for emotional relief and support during this critical period through engaging experiences which can reduce symptoms of anxiety and depression. However, the body of research remains limited, indicating a need for further studies to explore the long-term benefits and potential integration of VR into perinatal healthcare practices. The promising results from initial studies encourage continued exploration and development within this innovative therapeutic field. Study registration: https://doi.org/10.17605/OSF.IO/VFZC7 .

Training wheelchair skills are vital for enhancing independence and safety. Traditional training methods require significant time and resources, limiting accessibility. Virtual reality (VR) offers an innovative solution by simulating real-life environments for training, reducing risks and costs. However, the effectiveness of VR in complementing real-life training remains underexplored. This review investigates how VR can complement traditional wheelchair training by assessing the strengths and limitations of existing VR systems. A literature review of 28 studies on VR applications for wheelchair training from 2017 to 2024 was conducted, focusing on studies that detailed VR environments and training programs. It was found that most VR systems were designed for powered wheelchair users with joystick navigation. VR environments included tasks from basic navigation to complex real-world scenarios. While VR showed potential in improving skills and engagement, challenges included the lack of standard methods for evaluating effectiveness and cybersickness. Overall, VR can be a valuable complementary tool for wheelchair training, especially for powered users. Future research should standardise protocols, and address side effects.

This study compares the influence of a gamified and a non-gamified virtual reality (VR) environment on wheelchair skills training. In specific, the study explores the integration of gamification elements and their influence on wheelchair driving performance in VR-based training. Twenty-two non-disabled participants volunteered for the study, of whom eleven undertook the gamified VR training, and eleven engaged in the non-gamified VR training. To measure the efficacy of the VR-based wheelchair skills training, we captured the heart rate (HR), number of joystick movements, completion time, and number of collisions. In addition, an adapted version of the Wheelchair Skills Training Program Questionnaire (WSTP-Q), the Igroup Presence Questionnaire (IPQ), and the Simulator Sickness Questionnaire (SSQ) questionnaires were administered after the VR training. The results showed no differences in wheelchair driving performance, the level of involvement, or the ratings of presence between the two environments. In contrast, the perceived cybersickness was statistically higher for the group of participants who trained in the non-gamified VR environment. Remarkably, heightened cybersickness symptoms aligned with increased HR, suggesting physiological connections. As such, while direct gamification effects on the efficacy of VR-based wheelchair skills training were not statistically significant, its potential to amplify user engagement and reduce cybersickness is evident.

Mastering wheelchair driving skills is essential for the safety of wheelchair users (WUs), yet the acquisition of these skills can be challenging, and training resources can be costly or not available. Technologies such as virtual reality (VR) have grown in popularity as they can provide a motivating training environment without the risks found in real-life training. However, these approaches often deploy navigation controllers which are different from the ones WUs utilise, and do not use a standardised approach in assessing the acquisition of skills. We propose a VR training system based on the wheelchair skills training program (WSTP) and utilizing a sensor device that can be retrofitted to any joystick and communicates wirelessly with a Head-Mounted Display. In this paper, we present a first-validation study with fourteen able-bodied participants, split between a VR test group and a non-VR control group. To determine the acquisition of skills, participants complete tasks in real-life before and after the VR training, where completion time and length of joystick movements are measured. We also assess our system using heart rate measurements, the WSTP questionnaire, the simulator sickness questionnaire and the igroup presence questionnaire. We found that the VR training facilitates the acquisition of skills for more challenging tasks; thus, our system has the potential of being used for training skills of powered wheelchair users, with the benefit of conducting the training in safely and in a low-cost setup.