Efficacy of a Virtual Reality Rehabilitation Protocol Based on Art Therapy in Patients with Stroke: A Single-Blind Randomized Controlled Trial.

Background: Art therapy has a long history of applications in cognitive and motor rehabilitation. More recently, a growing body of scientific literature has highlighted the potential of virtual reality in neurorehabilitation, though it has focused more on the technology itself than on the principles adopted in digital scenarios.

Methods: This study is a single-blind randomized controlled trial conducted on 40 patients with stroke, comparing conventional therapy (physical therapy for the upper and lower limbs, for posture and balance, cognitive therapy, occupational therapy, speech therapy, and specific therapy for swallowing, bowel, and bladder dysfunctions) to a protocol in which the upper limb physical therapy was substituted with art therapy administered by means of virtual reality exploiting the so-called Michelangelo effect.

Does Embodying a Divine Avatar Influence Moral Decisions? An Immersive Virtual Reality Study.

The term Proteus effect refers to the changes in attitudes and behavior induced by the characteristics of an embodied virtual agent. Whether the effect can extend to the moral sphere is currently unknown. To deal with this issue, we investigated if embodying virtual agents (i.

Michelangelo Effect in Virtual Sculpturing: Prospective for Motor Neurorehabilitation in the Metaverse.

We investigated the Michelangelo effect, i.e. the facilitatory effect of a virtual art therapy in motor rehabilitation (Iosa et al.

The Immediate Effects of Immersive Virtual Reality on Autonomic Nervous System Function in Patients with Disorders of Consciousness after Severe Acquired Brain Injury: A Pilot Study.

Disorders of Consciousness (DoCs) after severe acquired brain injury involve substantial impairment of cognition and physical functioning, requiring comprehensive rehabilitation and support. Technological interventions, such as immersive Virtual Reality (VR), have shown promising results in promoting neural activity and enhancing cognitive and motor recovery. VR can induce physical sensations that may activate the Autonomic Nervous System (ANS) and induce ANS-regulated responses.

The effectiveness of an immersive virtual reality and telemedicine-based cognitive intervention on prospective memory in Parkinson's disease patients with mild cognitive impairment and healthy aged individuals: design and preliminary baseline results of a placebo-controlled study.

Introduction: Prospective memory (PM) impairments have been extensively documented in individuals with Parkinson's disease associated with mild cognitive impairment (PD-MCI) and in those with healthy aging. Considering how PM failure decreases individuals' quality of life and functional independence in the activities of daily living, training to enhance this ability could be a prior target of intervention.

Objective: Here, we aimed to present the study protocol and preliminary results of a novel immersive virtual reality (IVR) and telemedicine-based (TM) cognitive intervention focused on executive abilities (i.

Virtual Art Therapy: Application of Michelangelo Effect to Neurorehabilitation of Patients with Stroke.

In neurorehabilitation, some studies reported the effective use of art therapy for reducing psychological disorders and for enhancing physical functions and cognitive abilities. Neuroaesthetical studies showed that seeing an art masterpiece can spontaneously elicit a widespread brain arousal, also involving motor networks. To combine contemplative and performative benefits of art therapy protocols, we have developed an immersive virtual reality system, giving subjects the illusion that they are able to paint a copy of famous artistic paintings.

Embodying the avatar of an omnipotent agent modulates the perception of one's own abilities and enhances feelings of invulnerability.

Immersive virtual reality can give people the illusion of owning artificial bodies (i.e., avatars) and controlling their actions.

Inside the Michelangelo effect: The role of art and aesthetic attractiveness on perceived fatigue and hand kinematics in virtual painting.

It has recently been discovered that during a virtual reality task of painting, if the subjects have the illusion of recreating an artistic masterpiece, they improve their performances and perceive less fatigue compared to simply coloring a virtual canvas. This phenomenon has been called the Michelangelo effect. However, it was unclear if this effect was related to the aesthetic experience of beauty or if it was specific to artistic stimuli.

Challenges and Perspectives for Clinical Applications of Immersive and Non-Immersive Virtual Reality.

The development of rehabilitative technologies able to increase the intensity and the amount of time for daily treatment as well as the patients' motivation and interest is a high-priority area of scientific research [...

The performance monitoring system is attuned to others' actions during dyadic motor interactions.

Interpersonal motor interactions require the simultaneous monitoring of one's own and one's partner's actions. To characterize how the action monitoring system tracks self and other behavior during synchronous interactions, we combined electroencephalography recordings and immersive virtual reality in two tasks where participants were asked to synchronize their actions with those of a virtual partner (VP). The two tasks differed in the features to be monitored: the Goal task required participants to predict and monitor the VP's reaching goal; the Spatial task required participants to predict and monitor the VP's reaching trajectory.

Midfrontal Theta Transcranial Alternating Current Stimulation Facilitates Motor Coordination in Dyadic Human-Avatar Interactions.

Synchronous interpersonal motor interactions require moment-to-moment prediction and proactive monitoring of the partner's actions. Neurophysiologically, this is highlighted by an enhancement of midfrontal theta (4-7 Hz) oscillations. In this study, we explored the causal role of midfrontal theta for interpersonal motor interactions using transcranial alternating current stimulation (tACS).

Feeling of Ownership over an Embodied Avatar's Hand Brings About Fast Changes of Fronto-Parietal Cortical Dynamics.

When we look at our body parts, we are immediately aware that they belong to us and we rarely doubt about the integrity, continuity, and sense of ownership of our body. Despite this certainty, immersive virtual reality (IVR) may lead to a strong feeling of embodiment over an artificial body part seen from a first-person perspective (1PP). Although such feeling of ownership (FO) has been described in different situations, it is not yet understood how this phenomenon is generated at neural level.

Wearing same- and opposite-sex virtual bodies and seeing them caressed in intimate areas.

Immersive virtual reality enables people to undergo the experience of owning an artificial body and vicariously feeling tactile stimuli delivered to it. However, it is currently unknown how such experiences are modified by the sexual congruency between the human and the artificial agent. In two studies, heterosexual men (Experiment 1) and women (Experiment 2) embodied same-sex and opposite-sex avatars and were asked to evaluate the experience (e.

Heterosexual, gay, and lesbian people's reactivity to virtual caresses on their embodied avatars' taboo zones.

Embodying an artificial agent through immersive virtual reality (IVR) may lead to feeling vicariously somatosensory stimuli on one's body which are in fact never delivered. To explore whether vicarious touch in IVR reflects the basic individual and social features of real-life interpersonal interactions we tested heterosexual men/women and gay men/lesbian women reacting subjectively and physiologically to the observation of a gender-matched virtual body being touched on intimate taboo zones (like genitalia) by male and female avatars. All participants rated as most erogenous caresses on their embodied avatar taboo zones.

The Michelangelo Effect: Art Improves the Performance in a Virtual Reality Task Developed for Upper Limb Neurorehabilitation.

The vision of an art masterpiece is associated with brain arousal by neural processes occurring quite spontaneously in the viewer. This aesthetic experience may even elicit a response in the motor areas of the observers. In the neurorehabilitation of patients with stroke, art observation has been used for reducing psychological disorders, and creative art therapy for enhancing physical functions and cognitive abilities.

Visual feedback from a virtual body modulates motor illusion induced by tendon vibration.

Frequency-specific tendon vibration (TV) elicits illusory kinesthetic sensations around the vibrated body parts. Studies indicate that vision plays a fundamental role in modulating such illusions. In our current study, we used immersive virtual reality (IVR) to investigate the role of body-related visual feedback in modulating illusory sensation of movement in the left arm.

Visual appearance of the virtual hand affects embodiment in the virtual hand illusion.

Body ownership (the feeling that one's body belongs to oneself) is commonly studied with Rubber hand illusion (RHI) paradigm that allows inducing a temporary illusory feeling of ownership of a life-sized rubber hand. However, it remains unclear whether illusory ownership of the fake hand relies on the same mechanisms as ownership of one's own real hand. Here, we directly compared ownership of the own hand (OH) and fake hand (FH) in the same set of conditions within immersive virtual reality.

Midline frontal and occipito-temporal activity during error monitoring in dyadic motor interactions.

Discrepancies between sensory predictions and action outcome are at the base of error coding. However, these phenomena have mainly been studied focussing on individual performance. Here, we explored EEG responses to motor prediction errors during a human-avatar interaction and show that Theta/Alpha activity of the frontal error-monitoring system works in phase with activity of the occipito-temporal node of the action observation network.

Stable or able? Effect of virtual reality stimulation on static balance of post-stroke patients and healthy subjects.

Over the last decades, virtual reality (VR) emerged as a potential tool for developing new rehabilitation treatments in neurological patients. However, despite the increasing number of studies, a clear comprehension about the impact of immersive VR-treatment on balance and posture is still scarce. In the present study, we aimed to investigate the effects of VR cues on balance performances of subjects affected by stroke, age-matched healthy subjects, and young healthy subjects.

Characterizing Body Image Distortion and Bodily Self-Plasticity in Anorexia Nervosa via Visuo-Tactile Stimulation in Virtual Reality.

We combined virtual reality and multisensory bodily illusion with the aim to characterize and reduce the perceptual (body overestimation) and the cognitive-emotional (body dissatisfaction) components of body image distortion (BID) in anorexia nervosa (AN). For each participant (20 anorexics, 20 healthy controls) we built personalized avatars that reproduced their own body size, shape, and verisimilar increases and losses of their original weight. Body overestimation and dissatisfaction were measured by asking participants to choose the avatar that best resembled their real and ideal body.

The "embreathment" illusion highlights the role of breathing in corporeal awareness.

Recent theories posit that physiological signals contribute to corporeal awareness, the basic feeling that one has a body (body ownership) that acts according to one's will (body agency) and occupies a specific position (body location). Combining physiological recordings with immersive virtual reality, we found that an ecological mapping of real respiratory patterns onto a virtual body illusorily changes corporeal awareness. This new way of inducing a respiratory bodily illusion, called "embreathment," revealed that breathing is almost as important as visual appearance for inducing body ownership and more important than any other cue for body agency.

Hand blink reflex in virtual reality: The role of vision and proprioception in modulating defensive responses.

Our research focused on the role of vision and proprioception in modulating a defensive reflex (hand blink reflex, HBR) whose magnitude is enhanced when the threatened hand is inside the peripersonal space of the face. We capitalized on virtual reality, which allows dissociating vision and proprioception by presenting a virtual limb in congruent/incongruent positions with respect to the participants' limb. In experiment 1, participants placed their own stimulated hand in far/near positions with respect to their face (postural manipulation task), while observing a virtual empty scenario.

Embodying their own wheelchair modifies extrapersonal space perception in people with spinal cord injury.

Despite the many links between body representation, acting and perceiving the environment, no research has to date explored whether specific tool embodiment in conditions of sensorimotor deprivation influences extrapersonal space perception. We tested 20 spinal cord injured (SCI) individuals to investigate whether specific wheelchair embodiment interacts with extrapersonal space representation. As a measure of wheelchair embodiment, we used a Body View Enhancement Task in which participants (either sitting in their own wheelchair or in one which they had never used before) were asked to respond promptly to flashing lights presented on their above- and below-lesion body parts.

Virtual reality in cognitive and motor rehabilitation: facts, fiction and fallacies.

Introduction: Over recent decades many researchers and clinicians have started to use Virtual Reality (VR) as a new technology for implementing innovative rehabilitation treatments in cognitive and motor domains. However, the expression 'VR' has often also been improperly used to refer to video games. Further, VR efficacy, often confused with that of video-game exercises, is still debated.