Virtual Rehablitation

Virtual reality therapy (VRT)

• also known as 
• virtual reality immersion therapy (VRIT), 
• simulation for therapy (SFT), 
• virtual reality exposure therapy (VRET),
and computerized CBT (CCBT).
• use of virtual reality technology for
psychological or occupational therapy. 
• Patients receiving virtual reality therapy navigate
through digitally created environments and complete
specially designed tasks often tailored to treat a
specific ailment.
• Technology can range from a simple PC and keyboard
setup, to a modern virtual reality headset.
• It is widely used as an alternative form of exposure
therapy, in which patients interact with harmless
virtual representations of traumatic stimuli in order to
reduce fear responses.
• used to help stroke patients regain muscle
control,
• to treat body dysmorphia,
• to improve social skills in those diagnosed
with autism.
 Components
• It uses specially programmed computers,
– Displays
– Head mounted displays
– Force feedback devices
– Haptic (tactile or vibro-tactile) devices
– Actuators
– Trackers
– Camera systems
• visual immersion devices
• artificially created environments to give the patient a
simulated experience  
 Used
• to diagnose and treat psychological conditions
that cause difficulties for patients.
• phobias,
– reaction to the perceived hazards,
• heights,
• speaking in public,
• flying,
• close spaces, are usually triggered by visual and
auditory stimuli.
• Treatment
– VR-based therapy systems may allow replaying
virtual scenes, with or without adjustment, to
habituate the patient to such environments
– It may involve adjusting the virtual environment,
such as for example adding controlled intensity
smells or adding and adjusting vibrations, and
allow the clinician to determine the triggers and
triggering levels for each patient's reaction.
 Applications
• Psychological therapy
– Exposure therapy
• Virtual rehabilitation
 Exposure therapy
• a treatment method in which patients are
introduced and then slowly exposed to a
traumatic stimulus.
• Inside virtual environments, patients can
safely interact with a representation of their
phobia, and researchers don't need to have
access to a real version of the phobia itself.
 Virtual rehabilitation
• This term applies to both physical
therapy and cognitive interventions (such as
for patients suffering from Post Traumatic
Stress Disorder, phobias, anxieties, attention
deficits or amnesia).
• simulation exercises
• virtual therapy has been used over regular
therapeutic methods in order to treat a
number of disorders.
 Advantages
• It is entertaining, thus motivating the patient;
• It provides objective outcome measures of therapy efficacy (limb
velocity, range of movement, error rates, game scores, etc.);
• These data are transparently stored by the computer running the
simulation and can be made available on the Internet.
• Thus virtual rehabilitation can be performed in the patient's home
and monitored at a distance (becoming telerehabilitation)
• The client feels more actively involved in the desensitization
• effective for hospitals to reduce their costs
• great impact of virtual reality on pain relief
• a lower cost of medicine and equipment
 Disadvantages
• VR devices were not comfortable
• not useful for patients with some special
symptoms
 Therapeutical targets
• Depression
• In February 2006 the UK's National Institute of Health
and Clinical Excellence (NICE) recommended that VRT
be made available for use within the NHS across
England and Wales, for patients presenting with
mild/moderate depression, rather than immediately
opting for antidepressant medication. 
• At Auckland University in New Zealand, a team led by
Dr. Sally Merry have been developing a computerized
CBT fantasy "serious"game to help tackle depression
amongst adolescents.
 Eating disorders and body
dysmorphia
• Virtual reality therapy has also been used to
attempt to treat eating disorders and body
dysmorphia.
• One study in 2013 had participants complete
tasks; included showing patients the implications
of reaching their desired weight, comparing their
actual body shape to an avatar created using
their perceived body size, and altering a virtual
reflection to match their actual body size.
 Occupational therapy
• Autism
• Post traumatic stress disorder
• Stroke patients
• Chronic pain
• Memory loss
 Autism
• to improve the social skills of young adults
with autism.
• through various social tasks such as
interviewing, meeting new people, and
dealing with arguments.
 Post traumatic stress disorder
• The virtual reality allows the patients to relive
their combat situations at different extremes
as a therapist can be there with them guiding
them through the process.
• Some scholars believe that this is a great way
to treat these patients as it allows for the
recreation of exactly what they went through.
 Stroke patients
• can help bring fine control back to different
muscle groups.
• Therapy often includes games controlled
with haptic-feedback controllers that require
fine movements, such as playing piano with a
virtual hand.
 Chronic pain
• effective in decreasing pain for procedural or
acute pain but to date there have been few
studies on its use in chronic pain. Chronic pain
patients can tolerate the VR session without
the side effects that sometimes come with VR
such as headaches, dizziness or nausea.
 Memory loss
• VR smoothly blurs the demarcation between
the physical world and the computer
simulation as surgeons can use latest versions
of virtual reality glasses to interact in a three-
dimensional space with the organ that
requires surgical treatment, view it from any
desired angle and able to switch between 3D
view and the real CT images.
 Why should rehabilitation
practitioners be interested in VR?
• VR can provide a safe and consistent means of
assessing and improving a wide variety of
functional and cognitive abilities. These systems
can be tailored to an individual's changing
needs, preferences, and abilities. The degree of
difficulty of a particular task can be programmed
by a clinician and the user's performance can be
measured and recorded. VR applications using a
head-mounted display can provide an immersive
visual environment that focuses the user's
attention on the programmed task and can offer a
unique viewing perspective.
 Why should rehabilitation policy makers and
advocates be interested in Virtual Reality?

• VR applications may be able to improve

functional outcomes in a cost-effective
fashion. VR systems can be physically
compact, taking up minimal space in a clinic
and can be used with a minimum complement
of personnel. The instrumentation can
allow direct data streaming into a patient
chart and provide objective evidence of
effectiveness
Why should persons living with a disability
be interested in Virtual Reality?
• Physical interactions with environments that are
partially or wholly computer-generated allow a
person to focus on a particular aspect of
functional recovery without exposure to
potentially dangerous situations.
• For example, practicing stepping over virtual
obstacles during harnessed treadmill walking is
safer than stepping over blocks in the clinic
while aided by a therapist. As proficiency,
coordination, and strength improve, the more
complex realities of real-world situations can be
attempted with increased confidence.