Guardian science correspondent is put to the test in the panic-inducing VR world of a game that teaches breathing technique
Tethered to a chair, in a gloomy basement, I’m doing my best not to panic – by breathing in for four seconds, holding for seven, and slowly releasing for eight. But when a bloodthirsty monster appears at my feet and starts crawling towards me, I don’t need a dial to tell me that my heart is pounding, and I’m in imminent mortal danger.
Welcome to the future of anxiety treatment: a virtual reality (VR) game that teaches you a breathing technique to help calm your nerves, and then pits you against a monstrous humanoid that wants to eat you, to practise deploying it in genuinely panic-inducing situations.
Researchers in France used virtual reality to test the impact of tweaks made to urban settings
Having bright colours and greenery in our cities can make people happier and calmer, according to an unusual experiment involving virtual reality headsets.
A team of researchers at the University of Lille, in France, used VR to test how volunteers reacted to variations of a minimalist concrete, glass and metal urban landscape. The 36 participants walked on the spot in a laboratory wearing a VR headset with eye trackers, and researchers tweaked their surroundings, adding combinations of vegetation, as well as bright yellow and pink colours, and contrasting, angular patterns on the path.
People living in a Lagos care home are enjoying a break in routine with a virtual mix of therapy and entertainment delivered via headset
In the living room of the Regina Mundi care home in Lagos, 70-year-old Baba Raphael hauls himself up from his chair and puts on a virtual reality headset. For nine minutes, Raphael dances to the folksy tones of his favourite singer, the late Ayinla Omowura, while watching a music video.
“Are you enjoying it?” one of the staff asks Raphael. He doesn’t answer, oblivious as he sings along.
Sessions with virtual-reality headset helped people overcome anxiety and complete everyday tasks
It’s a sunny day on a city street as a green bus pulls up by the kerb. Onboard, a handful of passengers sit stony-faced as you step up to present your pass. But you cannot see your body – only a floating pair of blue hands.
It might sound like a bizarre dream, but the scenario is part of a virtual reality (VR) system designed to help people with agoraphobia – those for whom certain environments, situations and interactions can cause intense fear and distress.
It’s fair to say that augmented reality (AR) hasn’t quite caught the public imagination in the same way virtual reality (VR) has. It’s one of those technologies that forever seems to be being hyped while simultaneously always being a few years away.
Indeed, according to one study, in 2018 the AR market was worth $4bn to VR’s $7bn. But while consumer adoption of augmented reality may be lagging some way behind, it is in industry where AR is proving to have the most impact – leading the same study to conclude that by 2030, AR will be larger than VR, reaching $76bn in comparison to VR’s $28bn.
In this series on augmented reality, we’ll be determining how likely that future is by examining the good and bad of AR technology across a number of industries, starting today with healthcare.
Surgery
One exciting area for AR in medicine is surgery. In high-stakes procedures, it’s easy to imagine the utility of technology that can guide the surgeon’s hand while still affording them a view of the situation. As such, mixed reality headsets allow surgeons to operate on patients more effectively, blending the real world with projections of computed Tomography (CT), and Magnetic Resonance Imaging (MRI) scans of the patients in order to detect exactly where an operation should be performed.
A prime example of this came in 2017 when the first surgical procedure using Microsoft’s HoloLens was performed by Dr. Gregory Thomas, Head of Orthopedic Surgery and Traumatology at the Hospital Avicenne AP-HP. During the procedure, the doctor was able to view holograms and 3D models of the patient projected in real-time, as well as call on the assistance of other doctors who could appear via proxy holograms.
Image credit: Assistance Publique Hôpitaux de Paris
Thomas likened the technology to having a smartphone in the operating theatre, saying: “I realized that I was able to use the HoloLens as a computer or a smartphone to get any information I need when I need it, during surgery. That allows surgeons to be quicker, to be more efficient and to improve performance.” AR’s utility for surgery is further proven by the virtue of hands-free control, with manual gestures and voice commands being used to access information that would otherwise be inaccessible to an operating surgeon in a sterile room.
Since that time, there have been numerous initiatives to make use of the technology in a surgical setting, as well as before the surgery actually takes place. Holographic representations of the area being operated on can be constructed and observed in 3D before surgery takes place, affording surgeons a much more visceral understanding of what they need to do while also allowing infinite practice attempts.
“Medicine, particularly surgery, is still an apprenticeship. You watch a person operate 100 times before you’re allowed to,” said Dr. John Sledge, an orthopaedic surgeon in Louisiana who makes use of augmented reality. “But now we can have residents run through 100 operations on the HoloLens, complete with rare complications and their solutions. We can do worst-case scenario training. With the HoloLens, we can make a problem occur and the doctor in training has to solve it.
Problems remain, however, not least the potential of issues with the cleanliness of augmented reality headsets in an operating theatre as well as the question of how they can be restored if they stop working. Other approaches to AR bypassing the use of a head-mounted display have duly been tested, including an advanced form of projection onto a patient’s body. That solution requires 3D reconstruction of a bodily region so that a flat X-ray image can be properly projected onto the skin without distortion.
Telehealth
During the COVID-19 pandemic and its associated lockdowns, telehealth has risen to the fore as a means of accessing healthcare without being somewhere physically. While this can be achieved with a simple video call, bringing AR into the mix opens up more meaningful interaction possibilities. Case in point being the Alder Hey Children’s NHS Foundation Trust, which brought in AR to reduce physical contact between staff, patients and visitors with virtual ward rounds. That enabled one clinician to make the rounds wearing a HoloLens 2 device with others joining in remotely via Microsoft Teams – enabling them to see what the clinician sees as well as engage in two-way audio and video communication.
The capacity for remote collaboration in augmented reality also opens up many training possibilities, allowing more experienced but not physically present doctors to witness and even holographically appear to trainees as they learn – potentially a huge boon to healthcare professionals in developing parts of the world.
Aside from educating professionals, AR has taken on a role in educating ordinary members of the public about their health, as demonstrated by the recent BBC television programme Your Body Uncovered. Away from the television cameras, the technology is being used to prepare patients for surgery by demonstrating to them exactly what the problem is and how it will be fixed via a virtual twin of their bodies.
Mental Health
One area where AR can best demonstrate its unique capabilities is in so-called “exposure therapy”, whereby a therapist attempts to help a patient overcome fears, anxieties and phobias. With AR, patients can be exposed to a virtual representation of something that scares them while knowing that they are in a safe environment and that the object of their fears isn’t real.
Image credit: Phobys
One study using an augmented reality smartphone app to reduce fear of spiders found the “intervention led to significantly lower subjective fear” over a controlled two-week trial. While virtual reality could be used for similar purposes, using AR means that a user is able to see their own body and surroundings while interacting with virtual elements, helping them to better engage in the treatment. The fact that AR can be so readily accessed from a smartphone means such exposure therapy can also be accessed as a self-help tool, not requiring the presence of a therapist.
The practice of using AR for such treatments is certainly in its infancy, but there are signs that AR is gaining ground as a method of treatment. According to GlobalData’s 2021 poll on digital health in neurology, 18% of 109 industry respondents thought AR and VR solutions would be the most suitable technology to treat mental and behavioural health conditions.
Summary
While augmented reality technology may currently be lagging behind the bigger brother that is VR, it has found a natural home in the world of medicine, where it has enjoyed a long and fruitful history. Despite that, it has very much yet to reach its full potential. As new approaches to AR continue to be developed and barriers to entry are lowered further, expect augmented reality to play an ever more prominent role in the healthcare of the future.
Smoother skin, slimmer faces, plumper lips … how unattainable ideals are harming young users
Popping a beautifying filter on the TikTok video she was filming seemed harmless to Mia. It made it look as though she had done her makeup, took away the hint of a double chin that always bothered her, and gently altered her bone structure to make her just that bit closer to perfect.
After a while, using filters on videos became second nature – until she caught a glimpse of herself in the mirror one day and realised, to her horror, she no longer recognised her own face.
VirZOOM has been in the virtual reality (VR) fitness game for quite a while now, starting off with a bike controller in 2016. But hardware – especially VR peripherals – is a difficult business to be in, seeing VirZOOM pivot to being a software company that allows you to cycle around the world on a standard exercise bike. Today, VirZOOM has announced the launch of VZfit, its complete fitness app for Oculus Quest.
Fitness has become an exciting part of the VR industry, with apps like Supernatural and FitXR heavily promoting their healthy credentials whilst others including Beat Saber, Synth Riders, Audio Trip and more equally provide energetic sessions which can be tracked using Oculus Move or YUR. But they all tend to be rhythm action experiences, whereas VZfit is still sticking to its cycling roots whilst expanding its potential by removing the bike altogether.
VZfit‘s unique feature is the use of Google Maps so you can cycle around almost anywhere in the world, following pre-created routes or your own. If you have an exercise bike then an additional cadence sensor is all that’s required to connect the app to the bike. However, VZfit’s latest addition is the ‘exerboard’ which allows you to follow a virtual trainers workout routine with feedback and encouragement along the route.
“We wanted to combine the limitless possibilities of the world around us with the limitless possibilities of VR,” said Eric Janszen, Co-founder and CEO, VirZOOM in a statement. “Take a selfie at the Coliseum or in front of the Sydney Opera House, or simply take a trip down memory lane – whatever location you choose, with VZfit a world of adventure is literally at your fingertips. Our experiences have always been an exhilarating mix of the real world and the fantastical, but this is the most accessible VR fitness app that uses global exploration as a key motivator, making it so fresh and engaging that exercise almost becomes the side product. Especially in a time when none of us can travel in reality, it already has our community completely hooked.”
“After the success of VZplay and Explorer, we wanted to reduce the friction of needing special cardio hardware so we could expand our reach to anyone wanting to stay fit and healthy,” adds Eric Malafeew, Co-founder and CTO, VirZOOM. “We also wanted to expand beyond pure game play to tap into those travel aspirations and the endless options available to us in the real world.”
VZfit is available today for Oculus Quest. The app is free to download with a 7-day trial period available to test it out. After that it’s a subscription service costing $9.99 USD per month with VirZOOM also planning on rolling out a discounted annual membership in the near future. For further updates on VZfit, keep reading VRFocus.
When we think of virtual reality I tend to think of gaming and fun virtual experiences. But the benefits of VR stretch far wider than just entertainment – Both virtual and augmented reality (VR/AR) have been used in a range of industries like sport, surgery and even dogs in the military. And, one other area that is seeing an increased benefit is mental health.
Mental health continues to be a growing concern nationally, with mental illness estimated to be costing the UK economy up to £100billion a year with it being reported that 1 in 4 people in England will experience a mental health problem of some kind each year. In addition, it’s predicted that the impact of Covid-19 will see up to 10 million people needing mental health support as a direct consequence of the crisis. That’s almost 20% of the population of England needing additional support from an already burdened system.
Virtual reality has already been assisting treatments for mental illnesses, such as phobias, anxiety, eating disorders and post-traumatic stress disorder. Digital apps are already widely being used by the NHS to support patient’s mental health and with the cost of technologies falling, it’s predicted that medical care and therapy will seek to further utilise digital technologies to include wider use of VR in mental health care.
VR therapy and its promising impact
There is currently a clinical trial taking place across NHS trusts throughout the UK, the largest of its kind, led by the University of Oxford and Oxford Health NHS Foundation Trust, which sees participants with severe mental health disorders challenge their fears through VR therapy. Under the guidance of a virtual coach, the gameChange VR study aims to allow participants to complete everyday tasks that they might have otherwise felt overwhelmed by.
Dr Rob Dudley, consultant clinical psychology and lead for the gameChange VR study at Northumberland, Tyne and Wear NHS Foundation Trust explained: “By using virtual reality technology treatment people can experience feared places like a local shop, cafe or GP surgery in a virtual environment which feels real enough to allow people learn how to manage, and that they are safer than they feel.”
Although the trial is still in early stages and continuing over the course of 18 months, it is hoped that by users experiencing challenges in a realistic virtual environment, they will be able to manage their fears and anxieties in a controlled way without the added real-world stressors.
VR therapy vs. face-to-face therapy
OxfordVR is one of the partners of the gameChange VR study. Founded by Daniel Freeman, the team behind OxfordVR believe that an effective mental health treatment plan is an active one, where the patient can practice helpful behaviours in realistic situations, something that is not always possible during face-to-face therapy.
Daniel Freeman is a pioneer in the use of VR treatments for mental health patients after he first began working with VR in 2001. In 2017 he conducted research by reviewing 285 studies from a 25 year period that had used VR to treat mental health conditions. His review concluded that: “the results unequivocally confirm that VR is a proven modality for delivering rapid, lasting improvements for patients.”
This research was followed up by a trial in 2018 conducted by OxfordVR and University of Oxford, where Freeman is professor of Clinical Psychology. The trial saw 100 people with a prolonged fear of heights either receive VR therapy or no treatment. Those who received VR therapy experienced 5 treatment sessions guided by a virtual assistant, resulting in an average 68% reduction in their fear of heights.
Freeman explained: “Virtual reality is transforming psychological therapy in all sorts of areas…There are very few conditions VR can’t help because, in the end, every mental health problem is about dealing with a problem in the real world, and VR can produce that troubling situation for you.”
The benefits of VR therapy
VR systems produce a controlled environment, with therapists able to control what a patient sees and hears. They are also able to make adjustments and provide a tailored approach to the individual needs of the patient. Guided virtually, patients experience a safe space to develop their emotional responses.
VR therapy offers an accessible solution to people seeking help for their mental health. While many can hit a stumbling block finding a therapist, or meeting a therapist face-to-face, VR allows the user to access therapists from home without wait times with systems even able to be used with mobile devices and smartphones.
Dr Albert “Skip” Rizzo, the Director of Medical Virtual Reality at USC’s Institute for Creative Technologies, spoke at the Psych Congress Elevate conference in 2020, stating that VR should be used as a tool in conjunction with traditional methods: “We’re not eliminating the need for well-trained clinicians,” he said. “In fact, what we’re really doing is giving clinicians tools to extend their skills. Technology doesn’t fix anyone. It’s a tool in the hands of a well-trained clinician.”
Where does VR therapy go from here?
When I first started investigating VR within therapy I was taken back by how much positive influence the technology had already impacted the industry. And like most industries, it’s not about replacing the current working methods, but instead, it’s about enhancing them and making life better.
With VR therapy being more cost-effective and easy to use, it’s looking to be a promising solution to the growing mental health crisis in the UK in 2021. Although more studies need to be completed, as evidence of its efficacy continues to rise, VR therapy will become more available and be used more widely.
Our writer dons a headset and turns boxer, air guitarist and saber wielder in a bid to shake off his lockdown lassitude
Like many people, by May I was having a difficult time in lockdown: struggling with homeschooling; stressing about work; tired out by Zoom calls; comfort eating; drinking too much; and feeling nervous about venturing out for short walks, let alone exercise.
And then I strapped a computer to my face and gave thin air a damn good pummelling and everything improved a little. Virtual reality’s role in helping me to clamber out of the lockdown blues has changed the way I think about the technology and its potential to play a meaningful role in day-to-day life.
A flock of students stumbling after a consultant on a ward round has long been a familiar sight in hospitals. Perhaps not for much longer though – a university has pioneered the use of augmented reality to allow students to take part from home.
Imperial College has conducted what it said is the world’s first virtual ward round for medical students, which means an entire class of 350 students can watch a consultant examining patients rather than the three or four who have been able to accompany them in person.
