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Brain & Heart VR for TBI memory and eye fixation recovery

in using VR for TBI recovery. Focus groups found that TBI the design of immersive VR scenarios for individuals with
patients desired VR scenarios to assist with eye tracking brain injuries.
and prospective memory. Two scenarios were developed
using footage captured with a 360° camera during local 2.2. Focus group findings
hiking and a beach walk by the personal instructor (PI); The initial focus group resulted in the following themes:
these scenarios were edited using Unity EditorXR (2024, accessibility issues, skills, and enjoyable scenario ideas.
Unity Technologies, San Francisco) by two computer These themes were utilized to develop a VR scenario,
science students. Eleven individuals with brain injuries which was shown to members of the second focus group.
tested the scenarios in a randomized control, delayed These themes were confirmed in the second focus group,
intervention pilot study. which confirmed that the scenario met the criteria they
had hoped for in the first focus group.
2.1. Focus group methods
Focus groups are a qualitative research method ideally 2.2.1. Accessibility issues
suited to gathering rich, descriptive data on individuals’ Brain injury survivors reported specific accommodations
perceptions and experiences. They facilitate an in-depth they require, including adjustments for lighting, visual
exploration of a small group of participants’ attitudes, alignment, and affordability. Concerns were raised
beliefs, and reactions, allowing researchers to uncover regarding blue lighting in VR scenarios, with one member
complex dynamics that quantitative methods might expressing, “Brain injury survivors have issues with the
overlook. Focus groups typically include five to seven blue light. I have my TV, my phone, and my computer as
participants and are guided by a structured discussion. In orange-tinted as possible. As far as VR, is there a way to put
this study, focus-group members were recruited from a in that orange tint so it doesn’t cause all the headaches?” In
local non-profit organization supporting individuals with addition, video stability and a minimalist design address
brain injuries in Southern California. Two 1-h focus groups a second concern for visual misalignment issues. One
were conducted over Zoom to discuss designing a free, member noted, “Impaired perception. You know, a lot of us
immersive VR scenario for individuals with brain injuries cannot align ourselves appropriately, so some issues with
was conducted in summer 2021 (n = 6) and spring 2022 visual fields shaking and stuff.” Furthermore, challenges
(n = 6) with a total of 12 brain injury survivors. The focus related to access to rehabilitation due to cost and lack of
group members included 12 adult brain injury survivors transportation were discussed. One person mentioned,
(five males and seven females), a certified brain injury “I recalled they had a cardboard box that made it (a cell
specialist, two physical therapists, and an interdisciplinary phone) a VR, and you only paid like 10 bucks for it.”
research team of a computer scientist, a computer science
student, a kinesiologist, and a social worker. The first 2.2.2. Skills
focus group session began with the social worker showing Five specific skills that brain injury survivors believed
everyone several 360° and VR scenarios and discussing could be improved using VR were eye movement and
current research on VR and brain injury. The purpose of tracking, communication, inhibition control, memory,
developing a VR scenario to help individuals with brain and balance. One survivor highlighted challenges with eye
injuries with skill development was presented, with the fixation and pursuit, stating, “I did have a lot of dizziness.
kinesiologist emphasizing the importance of ensuring It’s a lot of eye-movement work. Tracking things.” Another
that movement and skill development are enjoyable. The individual described undergoing vestibular therapy for eye
social worker underscored the project’s mission to ensure fixation, recounting, “I was doing vision therapy, and she
rehabilitation is accessible and affordable in individuals’ had me looking at her. We had a big window behind us.
homes. The structured discussion guide included prompts Individuals would walk by it. As I focused on her, I could
such as: (i) What daily challenges do you face that VR might not keep my gaze stable. My eyes started tracking the
be able to address? (ii) What activities did you enjoy before person walking by. Anything that’s crowded. Walking on a
your injury that you would like to see incorporated into sidewalk. Going to the mall. Grocery shopping, navigating
VR? and (iii) Is there anything specific that came to mind parking lots. Anything. Noise.” The second reported skill
when you heard about VR? Each brain injury survivor was communication. One person reported, “Conversations
shared their opinions about VR, how they believed it from body language to the words and everything. I think a
should be adapted for individuals with brain injuries, what low-pressure VR conversation could really help individuals
skills they believed it could help them develop, and what with that expectation of social performance. I remember
scenarios they would find enjoyable. Direct quotes from the 1 year how exhausted I would be.” Inhibition control
st
the focus group discussions were incorporated to improve was also expressed as critically important: The number

Volume 2 Issue 2 (2024) 3 doi: 10.36922/bh.2685