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Frontiers in Virtual Reality ·

Volume 7 - 2026 | https://doi.org/10.3389/frvir.2026.1878621

Developing a spherical video-based virtual reality program to facilitate embodiment: a proof-of-concept study

  • Nancy A. Baker1*corresponding author
  • Alexandro Guerrero1
  • Robert R. Edwards2
  1. 1Musculoskeletal Health and Ergonomics Laboratory, Department of Occupational Therapy, Tufts University, Medford, MA, United States
  2. 2Pain Management Center, Department of Anesthesia and Pain Management, Brigham and Women’s Hospital/Harvard Medical School, Boston, MA, United States
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Abstract

There is increasing evidence that embodying patients in fully immersive virtual reality (FIVR) can enhance clinical outcomes such as pain management and motor control. However, developing appropriate embodied virtual reality experiences for clinical use may be beyond the skill level of most clinicians. In this two-phase iterative proof-of-concept study, we developed and assessed the embodiment, engagement, and usability of spherical video-based virtual reality (SVVR) experiences as a potential way to simplify the development of embodied experiences. In Phase 1 six participants trialed beta SVVR experiences, providing qualitative feedback to inform developmental changes. In Phase 2 four participants trialed the redeveloped SVVRs. Quantitative data was collected for both phases to assess changes for user embodiment, engagement, and usability. Data revealed that developmental changes had a positive effect on embodiment, increasing this score from 3.5 ± 0.7 in Phase 1 to 5.2 ± 0.7 in Phase 2, but did not improve the effect of the SVVR on engagement and usability as the SVVRs were rated well in Phase 1. The resulting SVVRs had moderate levels of embodiment. Results suggest that incorporating multimodal stimulation may facilitate embodiment.

Keywords

1 Introduction

Embodiment, the sense of having a body and a mental representation of oneself, is created through the integration and interpretation of complex bottom-up and top-down sensory signals (Matamala-Gomez et al., 2019; Longo et al., 2008) Studies have investigated ways of manipulating embodiment through artificial body parts (Matamala-Gomez et al., 2019). The seminal rubber hand illusion in which a rubber hand located within a participant’s visual field is tactilely stimulated at the same time as a participant’s real hand located outside the visual field (congruent visuotactile stimulation), demonstrated that ownership of a rubber hand could be conferred and that individuals experienced what was happening to the rubber hand as though it was happening to them (Botvinick and Cohen, 1998). Embodiment is a key component of efficacious treatments such as mirror therapy for phantom limb pain, and related neuropathic conditions (Maggio et al., 2025), highlighting the clinical importance of understanding and harnessing this phenomenon. Studies have shown that embodiment can be achieved in fully immersive virtual reality (FIVR) (Slater et al., 2008; Sanchez-Vives et al., 2010; Maselli and Slater, 2013).

Research has demonstrated actions taken on embodied body parts can cause physiological, emotional and physical reactions similar to those experienced if the real limb was involved (Gall et al., 2021; Combalia et al., 2024). Virtual embodiment is showing promise as a method to treat medical conditions characterized by sensory and body image disturbances, for example, anorexia nervosa (Magrini et al., 2022), pain (Baker et al., 2026) and motor planning disruptions due to central nervous system or orthopedic injuries (Tambone et al., 2021; Álvarez de la Campa Crespo et al., 2023). To develop and move this promising area of FIVR use forward, we need to be able to develop appropriate FIVR embodiment content.

Developing FIVR content is challenging as creating digitally modeled virtual environments requires strong technical programming skills, high development costs, and considerable amounts of time (Schmidt et al., 2021). One variant of FIVR is 360-degree video or spherical video-based virtual reality (SVVR). SVVR places users centrally in a spherical video environment. While viewers cannot move around in the SVVR virtual environment nor can they modify objects and characters, they can control the field of view which allows them to interact with the environment via head movements. This control makes them the protagonist of the action (Serino and Repetto, 2018). SVVRs are easier and less expensive to create than digitally modeled virtual environments as they are filmed like traditional videos using specialized 360-degree cameras (Serino et al., 2023). Anything that can be filmed can be turned into a SVVR experience.

SVVRs can support a sense of embodiment. Several studies have successfully used embodied SVVRs to address rehabilitation needs such as pain reduction (Vo et al., 2026; Hwang et al., 2014), training in healthcare skills (Baker et al., 2025), improved motor control (Matamala-Gomez et al., 2022), and exposure therapy (Meindl et al., 2019). Kilteni and colleagues (Kilteni et al., 2012) identified three elements that support a sense of embodiment, self-location, body ownership, and agency, The first person perspective is a key element to achieving self-location in FIVR (Maselli and Slater, 2013) and users should be positioned so that their bodies mimic the orientation of SVVR avatars. Elements that can improve a sense of body ownership include multimodal congruent stimuli, such as visuotactile, sensorimotor, or olfactory stimulation (Maselli and Slater, 2013; Lesur et al., 2020). Congruent stimuli can be incorporated into FIVR experiences by having individuals external to the SVVR coordinate stimuli with images in the SVVR. True agency, the ability for the user to have control of the avatar, is absent from SVVR, as SVVRs are pre-recorded and not under user control. While it is impossible to create SVVRs that allow users to move avatars, users can be instructed to imagine their limbs are moving or actually move their limbs in concert with avatars, if predictable patterns are used.

The purpose of our proof-of-concept study was to develop and refine our SVVR experiences and determine if our users could achieve embodiment. Ultimately, our goal was to contribute to the development process of FIVR programs to facilitate embodiment that could be used to address rehabilitation needs.

2 Methods

This proof-of-concept study was a two-phase iterative development approach to determine if we could develop usable, engaging SVVR experiences that facilitate a sense of embodiment in our sample. In Phase 1, we beta-tested several SVVR experiences and in Phase 2, we used participant feedback from participants in Phase 1 to redesign and reassess the SVVRs. All participants signed Institutional Review Board approved consent forms prior to completing study activities.

2.1 Participants

We recruited a convenience sample of ten graduate students from Tufts University. Six completed Phase 1, and four different participants completed Phase 2. Inclusion criteria: Eighteen or older, English speaking, and be able to travel to the research site.

2.2 Measures

2.2.1 Embodiment Questionnaire (EQ)

A sixteen-item self-report questionnaire designed to measure levels of embodiment in VR contexts (Peck and Gonzalez-Franco, 2021; Gonzalez-Franco and Peck, 2018; Crone and Kallen, 2024). The questionnaire uses a 7-point scale with higher scores indicating greater embodiment (Peck and Gonzalez-Franco, 2021).

2.2.2 User engagement scale (UES)

A 12-item self-report questionnaire that measures the participant’s perception of engagement using a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree) (O’Brien et al., 2018).

2.2.3 System usability scale (SUS)

This 10-item questionnaire gives a global view of subjective assessments of usability using a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). This score is weighted to create a system usability score indicating poor (0) to excellent (100) usability (Brooke, 2013; Brooke, 1996).

2.2.4 Simulator sickness questionnaire (SSQ)

This 16-item scale consists of symptoms which are commonly experienced by users of FIVR systems. Participants rate the severity of these symptoms using a 4-point Likert scale from 1 (none) to 4 (severe). Total scores can be defined as negligible (<5), minimal (5 - 10), significant (10 - 15), and concerning (15 - 20) symptoms (Bimberg et al., 2020; Kennedy et al., 1993).

Participants also completed a short open-ended interview which probed their likes, dislikes, engagement, expectations and mood related to the SVVRs.

2.3 Equipment

The SVVRs were created using an Instax One X2 camera and edited using Adobe Premiere Pro 2026 (version 26.0). For Phase 1, we used an Oculus Rift S (https://www.oculus.com/rift-s/) with an Alienware Gaming Laptop to play the SVVRs. For Phase 2, we used the Meta Quest 2.

2.4 SVVR experiences

We developed two types of content in the SVVR. SVVR focused on different aspects of visuotactile and sensorimotor experiences (intervention SVVRs) and SVVR focused on natural engagement (occupation-based SVVRs). Occupation-based SVVRs were a Meal Preparation activity (making a peanut butter and jelly sandwich), an Art activity (drawing a house on a whiteboard), and a Building activity (constructing a 3D wooden figure) (Table 1). We included synchronous tactile stimulation of the virtual and real arms to promote embodiment, and had the participants see their virtual arms move in consistent and predictable patterns. The SVVR occupation-based activity experiences were created to closely simulate activities of daily living (ADLs) and assess whether the sense of embodiment could be transferred from the intervention (visuotactile stimulation) to occupation-based activities (i.e., meal preparation).

TABLE 1. Title and description of intervention and occupation based spherical video-based virtual reality (SVVRs) in Phase 1 and Phase 2

CategoryTitle and description
Phase 1 and Phase 2 interventionsRange of motion (ROM) – Simulated guided upper extremity range of motion exercises; participants were not required to follow along with the ROM exercisesLight pressure visuotactile stimulation – Facilitated visuotactile stimulation using paintbrush bristles; light pressure stimulation applied congruently on the physical body with seen stimulation in the videoDeep pressure visuotactile stimulation – Facilitated visuotactile stimulation using wooden paintbrush; deep pressure simulation applied congruently on the physical body with seen stimulation in the video
Phase 1 occupation-based activityMeal preparation – Simulated activity of preparing a peanut butter and jelly sandwichArt – Simulated art activity that consisted of drawing a house on a whiteboardBuilding – Simulated activity of constructing a 3D wooden figure
Phase 2 occupation-based activityMeal preparation – Simulated activity of preparing a peanut butter and jelly sandwich; introduced peanut butter and jelly during the SVVR to stimulate olfactory sensesArt – Simulated art activity of painting a sunflower on a canvas; introduced acrylic paints to stimulate olfactory sensesBuilding – Simulated activity of constructing wooden shelves; introduced power drill and wood cleaner to stimulate auditory and olfactory senses, respectively

2.5 Procedures

2.5.1 Phase 1

Participants completed a demographics survey. During the session participants completed three total combinations of an intervention SVVR followed by an occupation-based SVVR while seated in the approximate position depicted in the SVVR. The order of the intervention SVVRs was standardized: range of motion (ROM), light pressure visuotactile stimulation, and deep pressure visuotactile stimulation. Participants were allowed to choose the order in which they experienced the occupation-based SVVRs. After completing all SVVR experiences, participants reported their level of embodiment, engagement, and ease of use. Each SVVR combination lasted ∼10 min with breaks provided between each combination for a total session duration of between 35 and 45 min.

2.5.2 SVVR refinements

Based on participant feedback, we made changes in developmental usability and design, including SVVR content, length, and quality, headset weight and comfort, environment noise, sensation, and limb representation (Table 2) summarizes the qualitative feedback on the SVVRs and the suggested changes to improve embodiment. Additional comments from participants indicated the conditions under which they felt most embodied: with light pressure visuotactile stimulation compared to deep pressure visuotactile stimulation; when they practiced mental rehearsal during the occupation based SVVR; and with occupation-based activities that incorporated multimodal stimulation.

TABLE 2. Feedback on spherical video-based virtual reality (SVVRs) provided by participants after Phase 1 and the changes that were introduced in Phase 2

Intervention componentCategory of suggested changesSample quotesChanges implemented in Phase 2
SVVR experiencesSVVR content“There are moments where it made me feel a lot more tired.”“I did not know when [the whiteboard activity] was going to end. It was me waiting for it to end… After a while it kind of just felt like I was watching something.”More universal occupation-based content and SVVR predictability
SVVR length“I did have a hard time focusing; they were a little long for me.”Shortened length of SVVR to <5 min
SVVR quality“I did feel like at times it was a little blurry, which can be a little disorienting.”“The VR set, if it’s too low, it gets blurry. But if you put it at a certain angle, it’s clear. That was a weird thing because I had to keep moving it.”Updated VR headset (Oculus Rift S to Meta Quest 2) and increased SVVR bitrate when exporting
VR headsetWeight and comfort“The headset was slightly heavy towards the middle. In the beginning I did not really feel it, but I started feeling it towards the end.”Lighter VR headset (Oculus Rift S to Meta Quest 2) and additional headset straps for support
EnvironmentNoise“The computer here was just blowing too loud.”“I felt like the outside environment, hearing the white noise from the laptop, made it kind of hard to be fully embodied.”Placement of laptop in relation to participant
ImmersionSensation“I noticed on the videos where, for example, if I’m drawing something or making something, there’s no sensation on my hand, so it’s hard to associate that.”Incorporation of multimodal stimulation
Limb representation“During the writing activity, the avatar was using their right hand to write, and I’m left handed”“Skin color of hands. They’re white hands and I was like, “I know these are not mine!” I also have smaller hands.”“While I felt it at some points, I would say it was a disjointed experience because it did not look like my arms”Avatars of varied skin tones and sizes

Of the initial three occupation-based activity SVVRs, two were altered to increase predictability and interest and were shortened to under 5 min. The Art activity SVVR was changed from drawing a house on a whiteboard to painting a sunflower on a canvas, while Building activity SVVR was altered from making a 3D wooden figure to building a set of wall shelves (Table 1). The overall SVVR combination (intervention and occupation-based activity) for Phase 2 lasted ∼5 min with breaks between each combination with a total session duration of between 20 to 30 min.

In addition to altering the content and quality we incorporated multimodal stimulations into the SVVRs during Phase 2. Research has demonstrated that different types of stimulation contribute to self-localization and presence (Kilteni et al., 2012; Lopez et al., 2008; Lenggenhager et al., 2007). We added olfactory stimulation by including items that had distinctive smells (i.e., using a peanut butter jar during the meal preparation SVVR). The actual items with the scent were introduced during the interventions to stimulate the participant’s olfactory senses. We increased distinctive SVVR specific auditory stimulation by incorporating functional tasks with varying noise levels, such as adding a drill to the updated Building SVVR.

While participants in both Phase 1 and Phase 2 reported mild symptoms and discomfort during the SVVR experiences, participants completed all combinations and we had no dropouts due to discomfort.

2.5.3 Assessing the redeveloped SVVRs in Phase 2

Participants in Phase 2 of the study trialed the redeveloped SVVR experiences using the same procedures as Phase 1.

2.6 Data analysis

Quantitative data from Phase 1 and Phase 2 were analyzed, compared, and graphed to assess the effect that the SVVR developmental changes had on embodiment, engagement and usability. Total scores and subscales for all measures for both phases were calculated using standard methods. As this was a proof-of-concept study, we did not complete inferential statistics or confidence intervals to determine if the results would translate beyond our sample but instead examined differences in scores from each phase. Qualitative comments were reviewed closely but not formally coded.

3 Results

3.1 Embodiment

In Phase 1, the total score indicated that participants “rarely” felt embodied (3.5 ± 0.7). Subscales also demonstrated low embodiment (Figure 1). In Phase 2, participants were “often” embodied (5.2 ± 0.7). Modal responses on the subscales in Phase 2 ranged from “most of the time” to “often.”

Embodiment Questionnaire results from Phase 1 (n = 6) and Phase 2 (n = 4).
Figure 1. Embodiment Questionnaire results from Phase 1 (n = 6) and Phase 2 (n = 4).

3.2 Engagement

In Phase 1, participants “agreed” with feeling engaged during the SVVR experiences, with an average score of 3.8 (± 0.3). Subscales yielded similar results from “neutral” to “strongly agree” (Figure 2). In Phase 2, we saw few changes, with a stable average of 3.8 (±0.4), although all subscales moved to the “agree” level score.

User Engagement Scale results from Phase 1 (n = 6) and Phase 2 (n = 4).
Figure 2. User Engagement Scale results from Phase 1 (n = 6) and Phase 2 (n = 4).

3.3 Usability

In Phase 1, participants reported on overall that user usability was “good,” with an average SUS score of 72.1 ± 12.6 Similarly, Phase 2 participants reported overall that user usability was also “good” (73.6 ± 16.7). The average of the scores generally were in the neutral to agree range of the scoring.

3.4 Cybersickness

In Phase 1, participants reported only negligible symptoms with an average score of 3.2 (± 1.6). Scores in Phase 2 remained relatively unchanged, with an average SSQ total score of 3.75 (± 2.5). In both phases the largest percentage of participants reported negligible discomfort in the fatigue, focus and concentration subcategories.

4 Discussion

In this study we iteratively develop SVVRs and tested their usability and ability to achieve embodiment. The finalized SVVR experiences appear to be usable and able to create a sense of embodiment in our sample of young healthy graduate students. When we assessed subscales of embodiment, the driving force associated with improvements in embodiment between the two phases was how users responded physiologically (feeling of how their body changed) during the SVVR, although all areas showed improvement.

Embodiment is strongest in FIVR when three areas are met: a sense of self-location, the degree to which the user feels that the virtual limb is located in the environment; a sense of agency, the degree to which the user feels as if they can move or control the virtual limb; and a sense of body ownership (Kilteni et al., 2012). As SVVR does not allow agency over limbs, we had to achieve embodiment through self-location and body ownership. While we cannot identify which of our refinements improved the sense of embodiment from Phase 1 to Phase 2 as we did not isolate and test each one separately, we can speculate on possible reasons. As indicated in the literature (Maselli and Slater, 2013; Lesur et al., 2020), our addition of multimodal stimuli in Phase 2 may have improved self-location and helped the brain to accept the virtual limb as its own. Additionally, having the virtual body similar in appearance (such as skin tone and size) can enhance the feeling of embodiment (Maselli and Slater, 2013), although multiple studies suggest that individuals embodied in avatars very unlike themselves (such as by gender, species or size) and will adapt their behaviors and attitudes to match the avatar’s appearance, referred to as homuncular flexibility (Won et al., 2015). Participants reported that engaging in mental rehearsal improved feelings of embodiment, which may have given them some illusion of agency (Kokkinara et al., 2016).

Engagement ratings were positive and did not change substantially between Phase 1 and 2. The only area that appeared to change was an improvement in focused attention. This change was likely related to the changes in the occupation-based portion of the SVVR which we shortened and made more interesting. The other areas evaluated by our engagement scale were not substantially modified from Phase 1 to Phase 2. Usability remained essentially unchanged, as the SVVR access and interactions were unchanged between Phases. Cybersickness was negligible and remained stable throughout the SVVRs and tended to be identified as lapses in concentration.

Overall, this study suggests that it is possible to develop a usable SVVR that can sufficiently embody an individual. Additionally, these SVVR embodiment videos do not need to be simple, highly predictable repetitive movements, such as flexing/extending and elbow, but can involve more complex and interesting activities that are more likely to engage users. Key elements to promote embodiment included: avatars that closely matched the users; multi-modal sensory stimulation (visual, tactile, and olfactory); encouraging active engagement of users through mental rehearsal; and ensuring a comfortable experience by having high quality, short SVVRs delivered in comfortable surroundings.

While it is possible to develop a sense of embodiment using SVVRs, their lack of agency and their inability to allow complex interactions with the environment potentially limit their usefulness as an embodiment tool. Digitally modeled computer-generated VR experiences, with their six-degrees of freedom, provide greater interactivity and a sense of agency than SVVRs. SVVRs greatest strength is their practicality; they do not require developers to have VR programming skills and can be completed in an afternoon of work rather than months of development. Since they can achieve some level of embodiment, they could be potentially be used to quickly develop client specific embodiment experiences or to trial ideas before digital modelling is undertaken.

There are several limitations of the current study. First, it used a small sample size of generally healthy young participants. The results are sample specific and merely show that it is possible to achieve embodiment in our sample. It is impossible to determine how these results will translate to other populations. Future studies would benefit from using a larger sample size and a wider range of participants, particularly patients, to accurately test the efficacy of the developed SVVR experiences and to determine how the presence of a disability affects embodiment. This study did not control for confounds of time, task familiarity or changes in equipment, nor did we systematically isolate each refinement we made to determine which of the many changes, e.g., type of content, headset type, multimodal stimulation, avatar appearance, etc. Therefore, we cannot causally attribute what drove the improvements in embodiment seen in Phase 2.

This proof-of-concept study demonstrates that a sense of embodiment can be achieved in a young healthy population using SVVR. It lays the foundation for future research in this area and suggests numerous possible areas of study: identifying the design elements to improve usability and engagement; completing systematic tests of what elements of SVVR are most important for achieving embodiment; evaluating the ability to achieve SVVR embodiment in patient populations; determining what clinical utility SVVR embodied experiences have for patients; and identifying the most appropriate SVVR content for different diagnoses. We also anticipate that as the technology around VR improves, we may be able to test and incorporate things like haptics and AI into SVVR development.

5 Conclusion

This proof-of-concept study demonstrates the feasibility of developing a usable SVVR program as well as the elements that might improve a sense of embodiment. Findings suggest that we could effectively create an embodied SVVR experience in our sample of young, healthy adults. While engagement and usability did not increase after the iterative changes to the SVVR intervention, these elements remain important aspects of the VR experience and could be the focus of further developmental research. Embodiment, engagement and usability were ultimately developed through the incorporation of multiple factors, including video quality and content, and multimodal stimulation. These factors may have contributed to the increase in embodiment observed in Phase 2 of the study. Ultimately, this proof-of-concept study demonstrates the potential to develop an embodied SVVR that could be used in clinical practice. Further work in this area, including larger interventional studies in clinical samples, may eventually provide rehabilitation professionals with VR-based integrative therapeutic methods for treating various disorders.

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Supplementary material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/frvir.2026.1878621/full#supplementary-material

Supplementary material Supplementary material at the source

Footnotes

Edited by: Andreu Combalia Aleu, University of Barcelona, Spain

Reviewed by: Giuseppe Turini, Kettering University, United States

Víctor Hernández-Beltrán, University of Extremadura, Spain

Statements

Conflict of interest

The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Funding

The author(s) declared that financial support was received for this work and/or its publication. Funding for this study was supported by the Rheumatology Research Foundation through the Medical and Graduate Student Preceptorship program.

Data availability

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics approval

The studies involving humans were approved by Insitutional Review Borad Mass General Brigham Human Research Committee. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.

Author contributions

NB: Conceptualization, Formal Analysis, Funding acquisition, Methodology, Resources, Supervision, Visualization, Writing – original draft, Writing – review and editing. AG: Conceptualization, Formal Analysis, Funding acquisition, Investigation, Methodology, Project administration, Writing – original draft, Writing – review and editing. RE: Conceptualization, Visualization, Writing – original draft, Writing – review and editing.

Acknowledgements

A special thank you to BWH’s research coordinator, Marise Cornelius for assisting with overall coordination and smooth execution of the research process and to the Rheumatology Research Foundation for the grant support.

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Citation

Baker, N. A., et al. (2026). Developing a spherical video-based virtual reality program to facilitate embodiment: a proof-of-concept study. Frontiers in Virtual Reality, Volume 7. https://doi.org/
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Accepted
Published
Volume
7 - 2026

Copyright

Copyright © 2026 Baker, Guerrero and Edwards.

License: https://creativecommons.org/licenses/by/4.0/

*Correspondence: Nancy A. Baker

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