Gear vr

The two videos chosen – an awe-inducing video and a neutral video - were manipulated to the two different mediums of display. Each video was displayed as immersive VR or on a 2D screen. This resulted in 4 conditions:

Neutral video on a 2D screen;

Awe-inducing video on a 2D screen;

Neutral video on immersive screen;

Awe-inducing video on immersive screen.

Specifically, each of the four videos was composed of the following subsections: (i) a black screen lasting 6000 milliseconds; (ii) a sound (lasting 500 milliseconds) that served as a signal to the experimenter to start physiological recordings; (iii) a black screen lasting 8000 milliseconds after the sound; (iv) the beginning of the video.
Videos were displayed using Samsung Gear VR, a head mounted virtual reality display. Each video lasted 2 minutes (excluding the i, ii, iii subsections). KolorEyes App was used to manipulate the dimension of immersion, by using the “immersive” option (to activate immersive display) or “2D” to display video on a 2D screen. Kolor Eyes 1.5 App is a free immersive video-player for Windows, Mac, HTML5, iOS and Android. This app allows tracking participants’ head orientation both in the 2D screen condition and in the immersive video condition.

This study used an open, randomized, two-period, two-treatment crossover design. The study process consisted of a baseline phase, stress phase, and relaxation phase, and was aimed to compare the differences of subjective stress reduction and physiological parameters when VR or biofeedback was applied in the relaxation phase. On day 1, participants underwent a randomly assigned relaxation session. On day 2, the same process was conducted in the stress phase, and the other type of relaxation session was applied in the relaxation phase. We compared the differences in stress reduction and physiological parameters according to the type of relaxation sessions for participants (Figure 1). All research was conducted in a room that was exclusively prepared to block outside noise in the Clinical Trial Center located in Samsung Medical Center. Samsung Gear VR (Samsung Electronics Co., Ltd., Suwon, South Korea) was used in the stress-exposure phase and relaxation phase, and the head-mounted display (HMD) device included separate screens for each eye, integrated head tracking, and stereo earphones (Figures 2, 3).

Two mobile-based VR head-mounted displays were used. Patients used 2 different VR headsets depending on their age group (Samsung Gear VR [Samsung Electronics] for patients aged 13-21 years and Merge VR [Merge Labs] for patients aged 10-12 years). Both age groups played a multisensory (visual and auditory) VR game (Bear Blast; AppliedVR). While playing the game, users traveled on a preset path through a colorful highly interactive 3-dimensional environment filled with animated landscapes, buildings, and clouds, during which the user’s gaze controlled the direction of a cannon fired to knock down teddy bears. For hygiene purposes, patients wore hospital hairnets while using the VR equipment, and all equipment was cleaned with alcohol-based sanitary wipes between patients. The VR intervention was implemented by trained and supervised research staff (including A.S.L.). Over the course of the clinical trial, we did not receive any reports of misuse or mismanagement of the VR equipment.

The distraction-to-exposure hierarchy was built with input from chronic pain program clinical stakeholders [39 (link)]. The hierarchy started with low stimulation intensity and then moved to high movement intensity. Twelve commercially available VR apps, six per head-mounted display (HMD), were then chosen to fit intensity levels. Low-intensity distraction apps included mindfulness meditation [40 (link)] and visual imagery [41 ,42 ], which required minimal movement. Medium-intensity apps included virtual walking or swimming [43 ,44 ] and controlling aircraft or watercraft [45 ,46 ], which required head and neck movement. High-intensity apps were 3D painting [47 ,48 ] and music or rhythmic-based [49 ,50 ], which also required torso and upper extremity movement. Veterans alternated between two commercially available VR HMDs: Oculus Rift [51 ] and Samsung Oculus Gear VR [52 ]. Rift is an HMD with hand-tracking controllers, which is used with commercial gaming computers. Gear VR uses Samsung Galaxy Series mobile phones (S6 and above) to project virtual environments with sound. Both HMDs have been used for pain management research in medical settings [28 (link),53 ,54 (link)]. Figure 1 shows our team members using each HMD.