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. Areas covered: In this review, we provide the scientific rationale for the advantages of using VR systems in rehabilitation and investigate whether the VR could really be a promising technique for the future of rehabilitation of patients, or if it is just an entertainment for scientists. In addition, we describe some of the most used devices in VR with their potential advantages for research and provide an overview of the recent evidence and meta-analyses in rehabilitation. Expert commentary: We highlight the efficacy and fallacies of VR in neurorehabilitation and discuss the important factors emerging from the use of VR, including the sense of presence and the embodiment over a virtual avatar, in developing future applications in cognitive and motor rehabilitation.

A series of experiments provide evidence that affordances rely not only on the mutual appropriateness of the features of an object and the abilities of an individual, but also on the fact that those features fall within her own reachable space, thus being really ready-to-her-own-hand. We used a spatial alignment effect paradigm and systematically examined this effect when the visually presented object was located either within or outside the peripersonal space of the participants, both from a metric (Experiment 1) and from a functional point of view (Experiment 2). We found that objectual features evoke actions only when the object is presented within the portion of the peripersonal space that is effectively reachable by the participants. Experiments 3 and 4 ruled out that our results could be merely accounted for by differences in the visual salience of the presented objects. Our data suggest that the power of an object to automatically trigger an action is strictly linked to the effective possibility that an individual has to interact with it.

Brain monitoring of errors in one's own and other's actions is crucial for a variety of processes, ranging from the fine-tuning of motor skill learning to important social functions, such as reading out and anticipating the intentions of others. Here, we combined immersive virtual reality and EEG recording to explore whether embodying the errors of an avatar by seeing it from a first-person perspective may activate the error monitoring system in the brain of an onlooker. We asked healthy participants to observe, from a first-or third-person perspective, an avatar performing a correct or an incorrect reach-to-grasp movement toward one of two virtual mugs placed on a table. At the end of each trial, participants reported verbally how much they embodied the avatar's arm. Ratings were maximal in first-person perspective, indicating that immersive virtual reality can be a powerful tool to induce embodiment of an artificial agent, even through mere visual perception and in the absence of any cross-modal boosting. Observation of erroneous grasping from a first-person perspective enhanced error-related negativity and medial-frontal theta power in the trials where human onlookers embodied the virtual character, hinting at the tight link between early, automatic coding of error detection and sense of embodiment. Error positivity was similar in 1PP and 3PP, suggesting that conscious coding of errors is similar for self and other. Thus, embodiment plays an important role in activating specific components of the action monitoring system when others' errors are coded as if they are one's own errors.

The mental representation of one's body typically implies the continuity of its parts. Here, we used immersive virtual reality to explore whether mere observation of visual discontinuity between the hand and limb of an avatar could influence a person's sense of ownership of the virtual body (feeling of ownership, FO) and being the agent of its actions (vicarious agency, VA). In experiment 1, we tested whether placing different amounts of visual discontinuity between a virtual hand and limb differently modulate the perceived FO and VA. Participants passively observed from a first-person perspective four different versions of a virtual limb: (1) a full limb; a hand detached from the proximal part of the limb because of deletion of (2) the wrist; (3) the wrist and forearm; (4) and the wrist, forearm and elbow. After observing the static or moving virtual limb, participants reported their feeling of ownership (FO) and vicarious agency (VA) over the hand. We found that even a small visual discontinuity between the virtual hand and arm significantly decreased participants' FO over the hand during observation of the static limb. Moreover, in the same condition, we found that passive observation of the avatar's actions induced a decrease in both FO and VA. We replicated the same results in a second study (experiment 2) where we investigated the modulation of FO and VA by comparing the visual body discontinuity with a condition in which the virtual limb was partially occluded. Our data show that mere observation of limb discontinuity can change a person's ownership and agency over a virtual body observed from a first-person perspective, even in the absence of any multisensory stimulation of the real body. These results shed new light on the role of body visual continuity in modulating self-awareness and agency in immersive virtual reality.

When we look at our hands we are immediately aware that they belong to us and we rarely doubt about the integrity, continuity and sense of ownership of our bodies. Here we explored whether the mere manipulation of the visual appearance of a virtual limb could influence the subjective feeling of ownership and the physiological responses (Skin Conductance Responses, SCRs) associated to a threatening stimulus approaching the virtual hand. Participants observed in first person perspective a virtual body having the right hand-forearm (i) connected by a normal wrist (Full-Limb) or a thin rigid wire connection (Wire) or (ii) disconnected because of a missing wrist (m-Wrist) or a missing wrist plus a plexiglass panel positioned between the hand and the forearm (Plexiglass). While the analysis of subjective ratings revealed that only the observation of natural full connected virtual limb elicited high levels of ownership, high amplitudes of SCRs were found also during observation of the non-natural, rigid wire connection condition. This result suggests that the conscious embodiment of an artificial limb requires a natural looking visual body appearance while implicit reactivity to threat may require physical body continuity, even non-naturally looking, that allows the implementation of protective reactions to threat.

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. These effects were moderated by individual levels of interoception, as assessed through a standard heartbeat-counting task and a new “pneumoception” task. By showing that respiratory, visual, and spatial signals exert a specific and weighted influence on the fundamental feeling that one is an embodied agent, we pave the way for a comprehensive hierarchical model of corporeal awareness. NEW & NOTEWORTHY Our body is the only object we sense from the inside; however, it is unclear how much inner physiology contributes to the global sensation of having a body and controlling it. We combine respiration recordings with immersive virtual reality and find that making a virtual body breathe like the real body gives an illusory sense of ownership and agency over the avatar, elucidating the role of a key physiological process like breathing in corporeal awareness.

Over the last few years, the efforts to reveal through neuroscientific lens the relations between the mind, body, and built environment have set a promising direction of using neuroscience for architecture. However, little has been achieved thus far in developing a systematic account that could be employed for interpreting current results and providing a consistent framework for subsequent scientific experimentation. In this context, the enactive perspective is proposed as a guide to studying architectural experience for two key reasons. Firstly, the enactive approach is specifically selected for its capacity to account for the profound connectedness of the organism and the world in an active and dynamic relationship, which is primarily shaped by the features of the body. Thus, particular emphasis is placed on the issues of embodiment and motivational factors as underlying constituents of the body-architecture interactions. Moreover, enactive understanding of the relational coupling between body schema and affordances of architectural spaces singles out the two-way bodily communication between architecture and its inhabitants, which can be also explored in immersive virtual reality settings. Secondly, enactivism has a strong foothold in phenomenological thinking that corresponds to the existing phenomenological discourse in architectural theory and qualitative design approaches. In this way, the enactive approach acknowledges the available common ground between neuroscience and architecture and thus allows a more accurate definition of investigative goals. Accordingly, the outlined model of architectural subject in enactive terms—that is, a model of a human being as embodied, enactive, and situated agent, is proposed as a basis of neuroscientific and phenomenological interpretation of architectural experience.

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