Virtual Worlds

Background: Virtual reality has been shown to reduce pain during labour. We aimed to determine whether virtual reality reduces analgesia use and shortens labour duration. Methods: A non-randomised pilot study was conducted, using a matched case–control design (1:2 ratio). Cases were women who voluntarily used virtual reality alongside standard intrapartum pain management, including non-pharmacological methods and/or epidural analgesia. Controls received standard intrapartum pain management. Results: A total of 108 women were included for analysis (36 cases vs. 72 controls). Perceived pain scores before and after virtual reality use did not differ significantly (p = 0.43, p = 0.73), suggesting a limited immediate analgesic effect under current conditions. Epidural analgesia rates and cervical dilation at initiation of analgesia did not show significant differences between cases and controls (p = 0.13, p = 0.42). After adjusting for induction of labour and cervical dilation at admission, there were no significant differences for duration of epidural analgesia (p = 0.86, p = 0.56), duration of labour (p = 0.64, p = 0.55), or vaginal birth (p = 0.23). Adjusted models indicated a non-significant trend toward shorter durations of labour, birth, and epidural exposure for cases. Conclusions: Our pilot study did not reveal a decrease in perceived pain or epidural analgesia use or an effect on duration of labour and vaginal birth. Full article

Visual virtuality can be seen as involving the processing and perception of pictorial images. The production of such representations has a longer history than speculations about their perception. Pictorial images of objects and scenes lack two dimensions present in their subject matter—depth and motion. Instruments to investigate stereoscopic depth and apparent motion were invented in the early 1830s. Wheatstone devised stereoscopes and conducted experiments with them; Plateau and Stampfer independently crafted devices for presenting sequences of slightly different patterns that created the impression of motion. Wheatstone later proposed how moving and stereoscopic images could be combined. Thereafter, interpretations of virtual depth and motion perception became more concerned with central processing rather than being based on geometrical optics. Full article

Virtual reality (VR) is becoming an increasingly popular tool across a range of domains, from education and healthcare to entertainment and workforce development. Organizations are now beginning to adopt VR for personnel management purposes, including training, evaluation, and decision-making. However, little is known about how such uses influence public perceptions of the organizations themselves. To address this gap, we conducted a three-study investigation examining how individuals perceive organizations that implement VR for various workplace applications. Across the studies, participants were presented with scenarios involving fictitious companies using VR in either low-stakes (e.g., team meeting) or high-stakes (e.g., job interview) contexts. Our findings suggest that people generally view VR technology and the organizations who use the technology positively. However, the context of use significantly shapes perceptions, where organizations that used VR in high-stakes applications were evaluated more negatively than those using it in low-stakes settings. This pattern suggests that while VR carries a general technological appeal, its application in high-stakes contexts may lead to skepticism or concern. We discuss the implications of these findings for organizations considering the integration of VR into personnel practices, highlighting the importance of context and transparency in shaping stakeholder perceptions. Full article

Natural walking locomotion in virtual reality (VR) allows intuitive movement through a virtual environment (VE), lower rates of simulator sickness, and increased immersion. However, it is limited by available play-space. Impossible spaces are VEs that use self-overlapping geometry to imitate larger play-spaces within a smaller area. Understanding how users interact with impossible spaces requires understanding how they perceive and remember VEs. However, it is unknown how impossible spaces impact users’ memory. An experiment was conducted comparing 32 participants’ memory from two conditions: natural walking in an impossible space and joystick movement in a similar non-impossible space. Participants were given up to 20 min to explore a virtual museum and were not instructed on what to remember. The experience was designed to allow participants to freely explore the VE at their own pace, allowing engagement duration to vary naturally. No significant differences were found between conditions for object or spatial memory; however, participants in the natural walking condition spent more time in the environment, revisited more areas, and were more confident identifying objects not encountered in the VE. This suggests natural walking in impossible spaces may be a viable alternative to traditional locomotion techniques. Full article

Herein, we report a USB-powered VR-HMD prototype integrated with our 33 mm aperture varifocal liquid lenses and electronic drive components, all assembled in a conventional VR-HMD form-factor. In this volumetric-display-based VR system, a sequence of virtual images are rapidly flash-projected at different plane depths in front of the observer and are synchronized with the correct accommodations provided by the varifocal lenses for depth-matched focusing at chosen sweep frequency. This projection mechanism aids in resolving the VAC that is present in conventional fixed-depth VR. Additionally, this system can address refractive error corrections like myopia and hyperopia for prescription users and do not require any eye-tracking systems. We experimentally demonstrate these lenses can vibrate up to frequencies approaching 100 Hz and report the frequency response of the varifocal lenses and their focal characteristics in real time as a function of the drive frequency. When integrated with the prototype’s 120 fps VR display system, these lenses produce a net diopter change of 2.3 D at a sweep frequency of 45 Hz while operating at ~70% of its maximum actuation voltage. The components add a total weight of around 50 g to the off-the-shelf VR set, making it a cost-effective but lightweight minimal solution. Full article

Virtual Reality (VR) is a useful educational tool in healthcare, allowing students to practise and improve practical skills. In speech therapy (ST), the need to revise academic curricula to adapt them to university contexts and integrate them into advanced clinical practices has highlighted the need to analyse the use of VR in this sector. The objective of this scoping review was to investigate whether research has considered using VR to support ST students’ training and highlight potential gaps in the literature. The study followed the JBI methodology for scoping reviews and was reported according to PRISMA-ScR guidelines. A protocol to conduct the current review was developed and registered on the Open Science Framework. The articles considered were retrieved from databases specialising in healthcare, computer science, and education, and were enhanced by results found with the help of AI-based tools. No constraints were applied and all study types were considered. Fourteen studies were included in the review and analysed under four core subjects: VR technology, ST context, training purposes, and main outcomes and assessment methods. The VR types identified in the studies were grouped into four categories, i.e., non-immersive VR (6/14, 42.9%), immersive VR (5/14, 35.7%), non-specified VR type (2/14, 14.3%), and semi-immersive VR (1/14, 7.1%). Most studies (5/14, 35.7%) focused on clinical skills acquisition, others addressed communication and interpersonal collaborative skills (3/14, 21.4%), while the remaining focused on person-centred care and awareness, clinical interviewing or reasoning skills, and performance knowledge (2/14 each, 14.3%). VR is still in its early stages in ST education. Some recent studies suggest VR supports students’ communication, interdisciplinary, and clinical skills. Although still limited in the context of ST education, the increasing affordability and ease of development of VR, along with its growing use in other healthcare fields, suggest that its underuse might be due to institutional barriers and lack of standardised frameworks. Overall, the findings suggest that VR offers promising support for experiential and skills-based learning. Full article

Traditionally, formal education has favored boys, while girls, in the past, were relegated to the domestic sphere. This has been the case for centuries, without considering the possible specific cognitive needs of girls, which have been ignored. In Western countries, this has generated significant educational problems, especially in the learning of more technical subjects, with which girls not only do not identify but also often exclude themselves with the excuse that “it is not for them” (i.e., they tend to display a strong stereotype, a false belief, regarding these disciplines). The consequences have not been long in coming. Currently, in many Western countries, the low percentage of women in technical careers (such as Physics, Engineering, and Computer Science) is alarming. Is it possible to change stereotypes? This article addresses this complex issue, placing particular emphasis on the learning of spatial abilities, so important in all STEM careers (i.e., science, technology, engineering, and mathematics). This study concludes with examples of other stereotypes (mainly cultural) that have been eliminated or significantly reduced thanks to virtual reality (VR) and the help of artificial intelligence (AI). Could the same be achieved in the spatial domain? Full article

Due to the effect of room acoustics on musical interpretation, a musician’s rehearsal may be greatly enhanced by leveraging virtual and augmented reality technology. This paper presents a preliminary study on a rehearsal tool designed for musicians, enabling practice in a virtual acoustic environment with audience-positioned playback. Fourteen participants, both professional and non-professional musicians, were recruited to practice with the rehearsal tool prior to performing in an unfamiliar venue. Throughout the rehearsal, the subjects either played in a virtual environment that matched the acoustics of the performance venue or one that was acoustically different. A control group rehearsed in an acoustically dry room with no virtual acoustic environment. The tool’s effectiveness was evaluated with two 16-item questionnaires that assessed quality, usefulness, satisfaction with the rehearsal, and aspects of the performance. Findings indicate that rehearsing in a virtual acoustic environment that matches the performance venue improves acoustic awareness during the performance and enhances ease and comfort on stage compared to practising in a different environment. These results support the integration of virtual acoustics in rehearsal tools to help musicians better adapt their performance to concert settings. Full article

Background: Current methods of postural control assessments and interventions to improve postural stability and thereby prevent falls often fail to incorporate the hazardous perturbation situations that frequently accompany falls. Virtual environments can safely incorporate these hazards. The purpose of the study was to identify if virtual slip and trip perturbations can be used as an exposure paradigm in place of real slip and trip perturbations to improve postural control. Methods: Fifteen healthy young adults were included in this study. Two paradigms, real gait exposure (real) and virtual environment gait exposure (virtual), consisting of real and virtual slip and trip trials, were performed by each participant in a counterbalanced order to avoid order effects. At baseline and following real and virtual paradigms, the modified clinical test for sensory integration and balance (mCTSIB), limits of stability (LOS), and single-leg stance (SLS) using BTracks balance plate were administered. Separate one-way (baseline vs. Real vs. Virtual) repeated measures analysis of variance were conducted on response variables. Results: In the posterior left quadrant of the LOS, significant differences were found after the real paradigm compared to baseline (p = 0.04). For the anterior left quadrant and total LOS, significant differences post real paradigm (p = 0.002 and p < 0.001) and virtual paradigm (p = 0.007 and p < 0.001) compared to baseline were observed. For the SLS, the left-leg significant differences were observed post real paradigm (p = 0.019) and virtual paradigm (p = 0.009) compared to BL in path length, while significant main effects were found for mean sway velocity for the left leg only (p = 0.004). For the right leg, significant differences were only observed after the virtual paradigm (p = 0.01) compared to BL. Conclusions: Both virtual and real paradigms were identified to improve postural control. The virtual paradigm led to increased postural control in the right-leg SLS condition, while the real paradigm did not, without any adverse effects. Findings suggest virtual reality perturbation exposure acutely improves postural control ability compared to baseline among healthy young adults. Full article

This paper introduces Planogen, a modular procedural generation plug-in for the Unity game engine, which is composed of two primary components: a character generation module (CharGen) and an airplane generation module (PlaneGen). Planogen facilitates the rapid generation of varied and interactive aircraft cabin environments populated with diverse virtual passengers. The presented system is intended for use in research experiment scenarios, particularly those targeting the fear of flying (FoF), where environmental variety and realism are essential for user immersion. Leveraging Unity’s extensibility and procedural content generation techniques, Planogen allows for flexible scene customization, randomization, and scalability in real time. We further validate the realism and user appeal of Planogen-generated cabins in a user study with 33 participants, who rate their immersion and satisfaction, demonstrating that Planogen produces believable and engaging virtual environments. The modular architecture supports asynchronous updates and future extensions to other VR domains. By enabling on-demand, repeatable, and customizable VR content, Planogen offers a practical tool for developers and researchers aiming to construct responsive, scenario-specific virtual environments that can be adapted to any research domain. Full article

Exercise plays a key role in managing type 1 diabetes mellitus (T1DM), and virtual reality (VR)-based exercise offers an innovative solution to increase motivation and deliver meaningful health benefits to patients who are often hesitant to engage in physical activity. The purpose of this study was to assess the acceptability, usability, intention for future use, and preference of a VR-based cycling application, as well as to investigate the effects of VR-based exercise on the physiological, biochemical, and psychological parameters of individuals with T1DM compared to conventional exercise. This study represents a preliminary investigation with a small sample size of 11 patients with T1DM. Each participant underwent two 20 min low-intensity exercise trials. One session involved conventional cycling on a stationary ergometer, while the other used a VR-based cycling application. The two exercise conditions were conducted 48 h apart, without a formal washout period. According to the results, high scores were observed for preference, acceptance, and usability of the VR-based cycling application, and statistically significant improvements in mood and enjoyment were observed following the VR-based cycling compared to conventional cycling. Additionally, while no statistically significant differences were found in physiological parameters (blood glucose, blood pressure, and heart rate) between the two conditions, the VR-based session showed a trend toward greater reductions. In conclusion, the use of VR technology in the field of cycling exercise has great significance in improving the mood and engagement of T1DM patients in exercise programs, providing a user-friendly and well-accepted VR cycling application; subsequently, it has also shown preliminary potential for the regulation of biological parameters. Healthcare professionals could easily expand exercise protocols with the strengths of the VR technologies along with other health-related programs. Full article

The advent of mixed reality (MR) systems has revolutionized human–computer interactions by seamlessly integrating virtual elements with the real world. Devices like the HoloLens 2 (HL2) enable intuitive, hands-free interactions through advanced hand-tracking technology, making them valuable in fields such as education, healthcare, engineering, and training simulations. However, despite the growing adoption of MR, there is a noticeable lack of comprehensive comparisons between the hand-tracking accuracy of the HL2 and high-precision benchmarks like motion capture systems. Such evaluations are essential to assess the reliability of MR interactions, identify potential tracking limitations, and improve the overall precision of hand-based input in immersive applications. This study aims to assess the accuracy of HL2 in tracking hand position and measuring kinematic hand parameters, including joint angles and lateral pinch span (distance between thumb and index fingertips), using its tracking data. To achieve this, the Vicon motion capture system (VM) was used as a gold-standard reference. Three tasks were designed: (1) finger tracing of a 2D pattern in 3D space, (2) grasping various common objects, and (3) lateral pinching of objects with varying sizes. Task 1 tests fingertip tracking, Task 2 evaluates joint angle accuracy, and Task 3 examines the accuracy of pinch span measurement. In all tasks, HL2 and VM simultaneously recorded hand positions and movements. The data captured in Task 1 were analyzed to evaluate HL2’s hand-tracking capabilities against VM. Finger rotation angles from Task 2 and lateral pinch span from Task 3 were then used to assess HL2’s accuracy compared to VM. The results indicate that the HL2 exhibits millimeter-level errors compared to Vicon’s tracking system in Task 1, spanning in a range from 2 mm to 4 mm, suggesting that HL2’s hand-tracking system demonstrates good accuracy. Additionally, the reconstructed grasping positions in Task 2 from both systems show a strong correlation and an average error of 5°, while in Task 3, the accuracy of the HL2 is comparable to that of VM, improving performance as the object thickness increases. Full article

Desktop Virtual Worlds (DVWs) offer unique spatial affordances for education, yet understanding of how these environments support meaningful learning experiences remains limited. This study introduces the Socio-Spatial Embodiment Model, a novel framework conceptualizing learning in DVWs as shaped by the interconnection of embodied presence, place-making, and community formation. Through semi-structured interviews conducted with 14 experienced educators from the Virtual Worlds Education Consortium, we investigated how these dimensions intersect and what design strategies facilitate this integration. Thematic analysis revealed that strategic design employs cognitive offloading techniques and biophilic metaphors to enhance embodied presence, balance familiar elements with spatial innovations to create meaningful places, and leverage synchronous engagement with institutional identity markers to facilitate learning communities. Our findings identified design strategies that facilitate stronger perceived student connections to the learning environment and community, when DVW designs address spatial, emotional, social, and cultural factors while reinforcing both cognitive and perceptual processes. This research advances understanding of embodied learning in virtual environments by identifying the dynamic interdependence among presence, place, and community, providing practical strategies for educators in creating more meaningful virtual learning experiences. Full article

This bibliometric analysis aims to provide a comprehensive overview of the use of 360-degree video in healthcare, identifying key research trends and emerging topics in this field. Data was sourced from the Web of Science Core Collection, Scopus, and PubMed, and analyses were performed using the Biblioshiny package. Network visualization was conducted using VOSviewer. A total of 272 studies on 360-degree video were included in the analysis. The number of publications has shown a consistent upward trend from 2009 to 2024. Most publications (n = 234) were articles, indicating a maturing field. Institutions in North America and Germany lead the list of top affiliations. Research areas reflect interdisciplinary use of 360-video in healthcare, led by computer science (20.2%), followed by education (14.3%), healthcare sciences (10.7%), psychology (10.3%), and nursing (8.1%), demonstrating broad applicability across sectors. Recent emerging topics, such as empathy, stress, and well-being, indicate a growing research interest in the holistic aspects of healthcare interventions, particularly the psychological and emotional dimensions. Additionally, the concept of “presence” has gained increasing attention, reflecting its psychological and emotional impact. The findings suggest that further research is needed to evaluate the effectiveness of interactive learning and user engagement in 360-degree video experiences. Full article

This paper evaluates a new interaction mode for object manipulation tasks in virtual reality (VR) utilizing an aircraft cockpit simulation. Building on prior research, this study examines the effectiveness and user experience of a mixed-interaction mode that involves the combination of handheld controllers with hand gestures. Qualitative interviews with participants provided detailed feedback on the combined input approach. The analysis highlights the strengths and challenges of the mixed-interaction mode, indicating a perceived increase in task completion efficacy and enhanced user experience. As an outcome of the research, design guidelines were developed based on participants’ insights, focusing on the optimal balance of naturalness and precision for mixed interaction in VR that can also be utilized more generally. This study offers practical implications for creating immersive virtual environments and informs future research in VR interaction modes and user experience. Full article

Introduction: This study examines the combined use of objective physiological measures (heart rate [HR], heart rate variability [HRV]) and subjective self-reports to gain a comprehensive understanding of anxiety reduction mechanisms—specifically, habituation—in the context of Virtual Reality Exposure (VRE) for public speaking anxiety (PSA). The present study evaluated whether a single-session, personalized VRE intervention could effectively reduce PSA. Methods: A total of 39 university students (mean age = 20.97, SD = 3.05) with clinically significant PSA were randomly assigned to a VRE group or a control group. Participants completed a 2 min speech task before and after the intervention and reported subjective distress (Subjective Units of Distress, SUDs), public speaking confidence (Personal Report of Confidence as a Speaker, PRCS), and willingness to speak in public. Heart rate (HR) and heart rate variability (HRV; RMSSD) were recorded at baseline and during speech tasks. The VRE protocol used personalized, hierarchical exposure to virtual audiences, with repeated trials until a criterion reduction in SUDs was achieved. Non-parametric analyses assessed group and time effects. Results: VRE participants showed significant reductions in subjective distress (p < 0.001) and HR (p < 0.001), with HR returning to baseline post-intervention. No such reductions were observed in the control group. Willingness to speak improved significantly only in the VRE group (p = 0.001). HRV did not differ significantly across time or groups. Conclusions: A single, personalized VRE session can produce measurable reductions in PSA, particularly in subjective distress and autonomic arousal, supporting habituation as a primary mechanism of change, even after one session. The lack of HRV change suggests that emotion regulation may require more prolonged interventions. These findings support VRE’s potential as an efficient and scalable treatment option for PSA. Full article

Mobile technology advancements have led to cellphone bans in some school jurisdictions. The basis of these bans is judging their utilization by students as unhealthy, antisocial, and educationally controversial. Banning student cellphones neglects the positive mental health of cellphone use that comes from self-directed learning in students using them in the co-creation of virtual worlds through online communities. This scoping review examines peer-reviewed research from 2021–2025 demonstrating positive mental health value in self-directed mobile technology use through co-creating virtual worlds. The searches are of seven primary databases and one supplementary database, using the keywords “self-directed learning AND mobile technology AND co-creation AND virtual worlds”. Excluded are reviews, book chapters, abstracts, and conference proceedings. The assessment of the findings is that cellphone use promotes a combination of self-directed learning and consensus decision-making, and provides mental health benefits when virtual worlds are co-created by students permitted their use. Appraising these results—regarding self-directed learning, consensus decision-making, and student mental health—the conclusion is that in contemplating the school cellphone use of mobile technology, educators rethink banning their classroom use. The aim would be to support the co-creation of virtual worlds to promote increased self-direction, consensus decision-making, and positive mental health. Full article

Although virtual reality (VR) was originally conceived of as a multi-sensory experience, most developers of the technology have focused on its visual aspects to the detriment of other senses such as hearing. This paper presents design patterns to make virtual reality fully accessible to non-visual users, including totally blind users, especially with non-verbal social interactions. Non-visual VR has been present in the blindness audio game community since the early 2000s, but the conventions from those interfaces have never been described to a sighted audience, outside of a few limited sonification interface papers. This paper presents non-visual design patterns created by five of the top English-speaking audio game developers through a three round Delphi method, encompassing 29 non-verbal social interactions grouped into 12 categories in VR, including movement, emotes, and self-expression. This paper will be useful to developers of VR experiences who wish to represent non-verbal social information to their users through non-visual conventions. These methods have only been rigorously tested through the commercial market, and not through scientific approaches. These design patterns can serve as the foundation for future investigation in exploring non-visual non-verbal social interactions in VR. Full article