Efficacy of Enhancing Low Vision Mobility thru Visual Training in Virtual World

描述（由申请人提供）：NEI的国家眼与视觉研究计划已经确定低视力和失明康复是视力研究中最迫切的需求和机会之一。由于目前大多数低视力患者都有可用的视力，因此低视力康复的一个重要方面是最大限度地利用患者的剩余视力。视觉技能在诸如在繁忙的街道上独立行走等任务中尤为重要，在这些任务中，遥远、快速变化的事件对患者的任务效率和安全有直接影响。患者必须学习新的信息获取技能来弥补视力受损。目前LV对这些技能的培训是在真实的街道上进行一对一的培训师/学员课程。然而，这种培训方式通常不能让客户接触到他们需要处理的所有情况，通常不能提供分级的任务难度和可重复的条件，以促进学习，并且由于LV培训师的短缺和高成本，不能满足大多数LV患者的需求。虚拟现实（VR）技术的进步使构建能够真实模拟复杂动态多感官环境的VR系统成为可能，并且成本低廉，从而促进左室康复。然而，将VR技术应用于左室康复最重要的第一步是确定左室患者的视觉体验是否可以转移到现实世界。只有确认视觉技能的正向转移，后续开发针对左室康复各方面的全面VR培训系统才有价值。拟议研究的目的是完成这第一步。从标准定向和移动课程中选择一套视觉技能来研究虚拟体验转移，以完成最具视觉挑战性的任务，即穿过信号控制的街道。现有技术将用于构建基于台式电脑的VR模拟器，该模拟器可以生成虚拟的十字路口场景，其中包含练习所要学习的技能所需的视觉和听觉信息。48名LV患者将从一所大学LV康复中心招募。他们将被随机分配在真实的、虚拟的或不存在的十字路口练习选定的视觉技能。他们的技能水平将在计划培训前、培训后和培训后一个月的真实十字路口进行评估。研究的主要结果是三组的视觉技能在训练前和训练后的平均变化。还将收集和分析视觉功能、视觉搜索性能、VR中的存在感、任务难度的主观评分以及培训课程的有用性和满意度的数据。长期目标是开发交互式VR训练系统，该系统具有多个感觉和运动输入和输出模块，并结合左室康复专业的集体经验。在LV课程中加入这样的系统，可以大大提高LV康复的可负担性、可及性、效率和范围。

DESCRIPTION (provided by applicant): NEI's National Plan for Eye and Vision Research has identified Low Vision and Blindness Rehabilitation as one of the most pressing needs and opportunities in vision research. Since most low vision (LV) patients nowadays have useable vision, an important aspect of LV rehabilitation is to maximize the use of the patient's remaining vision. Visual skills are especially important in tasks such as traveling independently through busy streets, in which distant, rapidly changing events have direct impact on the patient's task efficiency and safety. The patient has to learn new information acquisition skills to compensate for their impaired vision. Current LV training for such skills is done on real streets in a one-on-one, trainer/trainee sessions. This way of training, however, usually does not expose clients to all the circumstances that they need to deal with, usually does not provide graded levels of task difficulty and repeatable conditions that facilitate learning, and cannot meet the needs of the majority of LV patients because of the shortage and the high cost of LV trainers and. The advances of virtual reality (VR) technology have made it possible and affordable to build VR systems that can realistically simulate complex and dynamic multi-sensory environments to facilitate LV rehabilitation. However, the most important first step in applying VR technologies to LV rehabilitation is to determine whether the visual experiences of a LV person can be transferred to the real world. Only when a positive transfer of visual skills is confirmed, can subsequent development of comprehensive VR training systems for all aspects of LV rehabilitation become worthwhile. The purpose of the proposed study is to accomplish this first step. A set of visual skills for a most visually challenging task, crossing a signal-controlled street, are selected from standard orientation and mobility curriculum to study virtual experience transfer. Existing technology will be used to build a desktop computer based VR simulator that can generate virtual street intersection scenarios that contain visual and auditory information required for practicing the skills to be studied. Forty-eight LV persons will be recruited from a university LV rehabilitation facility. They will be randomly assigned to practicing the selected visual skills at real, virtual or no street intersections. Their skill levels will be evaluated at real intersections before, immediately after and one month after their scheduled trainings. The primary outcome of interest is the mean change of visual skills between pre- and post-training evaluations in the three groups. Data of visual functions, visual search performance, the sense of presence in VR, subjective rating of task difficulties, and the usefulness and satisfaction of the training sessions will also be collected and analyzed. The long-term goal is to develop interactive VR training systems that have multiple sensory and motor input and output modules and that incorporate the collective experiences of the LV rehabilitation profession. Adding such systems to LV curriculum can greatly improved the affordability, accessibility, efficiency and the scope of LV rehabilitation. PUBLIC HEALTH RELEVANCE: Low vision patients have difficulty acquiring sufficient visual information in a timely manner for the purpose of performing challenging daily tasks, such as traveling independently and safely through busy streets. The advance of virtual reality techniques has provided a potential platform for training low vision patients to use their remaining vision more efficiently, but the key issue is always whether the patient's visual experiences in a virtual world can be transferred to the real world. The proposed study is designed to provide definite answer to this question.