Study on the impact of VR on cognitive training

Study on the impact of VR on cognitive training
Virtual reality is now commonly used in a wide range of areas. Thanks to it, we are allowed to move and explore many spaces, worlds, interact with various objects, change, and manipulate them. A virtual environment is a computer-generated graphical environment with which we can remove many limits, whether it is spatial properties or human skills.
It brings an immersive form of relaxation and play. Its fun form is also very effective, for example, in the process of learning new skills or during memory training and other cognitive functions.

Through virtual reality, it is possible to help people in many areas, whether these are mental or somatic issues or staff training in new employment. In a typical environment, we often encounter danger associated with certain activities. We can avoid this by training in virtual reality, which allows for safe skills self-training.

A significant advantage of virtual reality also lies in overcoming the limits with human imagination, which can be used in various healthcare areas or, for example, during the mentioned process of staff training. Creating images leads to the creation of memory tracks. If we use virtual reality to get a basic idea of a given object, process, or activity performed, we better store this information in memory and then use it more effectively. Many studies around the world clearly show that in virtual reality, the participant can practice the skill much more effectively during the scenarios than when playing classic scenes. By adding gamification factors, it becomes a fun interactive form for training program participants and, at the same time, works effectively with motivation.

NASA also uses virtual reality in its space programs. It is possible to combine it with zero-gravity physical simulations and thus achieve convincingly realistic results. NASA uses virtual reality as an aid for using specific stimuli that are otherwise very difficult to present or completely unavailable.

Virtual reality is also very beneficial during the training of surgical skills and, in general, in the field of medical and psychotherapeutic disciplines. It is also used during the therapy for anxiety disorders, specific phobias, depressive symptoms, and in classical cognitive-behavioral therapy. It is also widely used to heal and restore lost brain function after neurological disorders, such as stroke, cerebral palsy, multiple sclerosis, or Parkinson’s disease (Baram, 2013). Stimulation of the brain can potentially bring its function back to healthy levels (Wright, 2014).

There are many procedures in a medical setting that cause pain or anxiety. These human experiences can cause a low willingness or complete aversion to undergoing another medical procedure. Many people postpone visiting doctors precisely because they expect pain and other unpleasant experiences due to anticipatory anxiety.

In medical facilities, it is a current practice to use televisions or radios to alleviate anxiety, whether in waiting rooms or as a distraction during a medical procedure. Recent technical advances have made virtual reality distraction increasingly available and used in acute pain management (Garrett et al., 2014; Hoffman et al., 2006; Rutter, Dahlquist, & Weiss, 2009). Using virtual reality has shown to reduce pain in burn-injured patients for whom pharmacologic analgesics need to be complemented with nonpharmacologic techniques due to the high levels of pain they experience (Guo, Deng and Yang, 2015; Kipping, Rodger, Miller and Kimble, 2012; Schmitt et al., 2011). Recent research in dental care context demonstrated that distracting children with 3D virtual glasses during the administration of local anesthesia resulted in anxiety reduction (Nuvvula, Alahari, Kamatham, & Challa, 2015).

Interaction with nature, which helps against anxiety and also in recovery, is problematic and restricted in healthcare contexts. Growing body of work has examined the possibility of introducing natural elements into healthcare facilities to reduce pain, stress, and anxiety. In a pioneering study, Ulrich (1984) was the first to provide evidence of the effects of a window view on trees (vs. a brick wall), on pain medication intake, and length of stay. More recent studies demonstrated the effects of reducing stress when using indoor plants in a waiting room (Beukeboom, Langeveld, and Tanja-Dijkstra, 2012) and effects distractions with natural images and sounds on pain control during a medical procedure (Diette, Lechtzin, Haponik, Devrotes, & Rubin, 2003). Although these studies demonstrate only small size effects, they offer indications of the potential benefits of nature-based interventions in healthcare. Combining nature stimuli with advances in VR technology avoids issues with real plants and natural products in healthcare, especially concerning the sterility of the environment.

Virtual reality training has helped us to reduce key training processes by up to 60%. ― Libor Pyskaty, McDonald's.
Within the human experience and memory, mental images, and therefore also memories, may be particularly important. They motivate, evoke, and predict behavior. Boomsma, Pahl and Andrade (2016) recently outlined the motivational role of mental images in pro-environmental behavior, describing how such images have the potential to translate abstract values into positive action through the same elaboration process. Despite very different contexts, this theoretical approach emphasizes the crucial role of mental imagery in determining behavioral outcomes. This opens an interesting link to using virtual reality. If virtual reality could be used to disrupt the formation of negative mental images, its use should, on the contrary, lead to better management of medical procedures and even perhaps to less remembered and conscious pain. Elaborating threatening images and experiences is likely to undermine future attendance in examinations and contribute to negative health outcomes. We can encounter this phenomenon not only in healthcare settings.

Last but not least, virtual reality is also used in rehabilitation to increase physical activity. Virtual reality is a very useful tool in weight reduction, obesity, during increased adaptation to stress and cardiovascular diseases as their prevention or alleviation of issues. However, virtual reality is also suitable for physically disabled people, as there is no condition for movement in virtual space. Walking can be programmed as part of a video. At the same time, we reduce the condition to physical space, in which it is necessary to move while walking in virtual reality.

Virtual reality also seems useful in shaping changes in attitudes, opinions towards minorities, or racist attitudes. If, in a virtual environment, people can change to the opposite sex, race, or age, as a result of this experience, it may change their attitude to social situations, as well as their interpretation. Mel Slater, an expert in virtual reality from the University of Barcelona, presented the possibility of using virtual reality even for personal transformation. His research focused on the illusion of one’s own body. In one of his studies, the participants were embodied in Albert Einstein’s body. The Einstein body participants performed better on a cognitive task, with the improvement greatest for those with low self-esteem.

Deterioration of memory, attention, and orientation can be prevented, treated, or alleviated by virtual reality. Virtual reality also helps with neurological problems in the elderly, such as dementia or Alzheimer’s disease. In the virtual world, seniors have the task to perform common tasks such as buying or visiting a post office. They can practice memory and orientation intensively and entertainingly. Virtual reality also serves as a prevention of cognitive impairment during aging through cognitive training. Thanks to virtual reality, people also have better feedback to perform their tasks than in a typical environment, because we do not have such control of all variables. At the same time, there is more control over the delivered stimuli, which also allows the modification of the sensory load, if necessary. Virtual reality represents a very safe environment that minimizes failure, which is also widely used in the psychology of work.

Within virtual reality, cognitive processes such as sensitization or habituation can be actively used. Sensitization represents the enhancement of a response to the desired stimulus. Habituation, as becoming accustomed, on the other hand, makes it possible to filter out the perception of a stimulus that is disturbing or unnecessary.

At the neurological level, based on mirror neurons, it was demonstrated that simple observation of a motor act of others activates our cerebral cortex, including neural pathways in the same way as of the person we observe (Merians et al., 2015). Even the observation of images or videos can affect the cortico-cortical connection of the motor and premotor areas in an inhibitory or facilitative way if they are presented intentionally and repeatedly (Adamovich et al., 2010). Virtual reality also applies this principle.

Using virtual reality, we can increase perception or partially compensate for the impairment in a given brain area and thus improve brain function. Feedback, which provides information about the success of acts performed in a virtual environment, about mistakes or significant moments, represents an essential factor for learning. With virtual reality, feedback can be very effective, primarily due to its good control of variables as compared to those of everyday life. Using visual feedback may increase the interconnection of individual cortical areas, such as the intrahemispheric cortico-cortical connection, which connects the occipital, parietal, and frontal lobes. A significant number of motor, parietal, and premotor neurons are also modulated by visual information. Visual information can, therefore, provide a potent signal for reorganization of sensorimotor circuits (Adamovich et al., 2010).