Virtual Reality (VR)

Virtual Reality defintion

a simulation of a real world environment that is generated through computer software and is experienced by the user through a human-machine interface.

T or F. The user of VR has a sense of actual presence in, and control over, the simulated environment. 

TRUE

Sense of Presence definition

a feeling of being in an environment even if one is not physically there, resulting in behavior that is congruent with how the patient would respond if truly in that environment.

VR Benefit Theories - Immersion, Distraction, and Mood

• patients experience a presence in the virtual world

• being in a virtual world is captivation

• VR distracts patient from the actual therapy task thereby lessening exercise discomfort, fear, pain, and/or boredom

• exercising in a virtual world has been demonstrated to induce calm in a group of patient with spinal cord injury

• improving a patient’s mood can increase participation in therapy 

• superior performance with dual or multiple task activities 

• VR can provide unexpected and more challenging scenarios

VR Benefit Theories - Performance Feedback

• Exercises can be adjusted to patient-specific levels ensuring that patients are challenged but will experience a fair degree of success

• VR systems can provide frequent, positive feedback on performance (feedback should be of a positive nature)

• Objective scores can create a sense of competition which drives improvement (intra- patient and/or inter-patient)

VR Benefit Theories - Exercise Volume and Intensity

• VR results in increased volume of exercise and a substantially, greater number of therapeutic repetitions whereas traditional therapy may be limited by tasks found to be boring or ardous

• research demonstrates that improvement in mootr function is related to exercise intensity and the number of repetitions performed 

• research shows that cortical reorganization occurs in response to task-oriented movements and activities

• repeated movements must be linked to a particular goal and result in incremental success

• function based VR exercises can result in patient practicing a high volume of relevant real world tasks

VR Benefit Theories - Physiologic Changes

• video game playing has been shown to increase dopamine levels

  • dopamine is theorized to play a role with learning and VR may stimulate increased production thereby helping with neuromuscular re-education.

• research shows that for stroke survivors, VR may decrease contralesional sensorimotor activity and increase ipsilesional activity, thereby leading to improved movement and function

• evidence exists that VR exercises induce cortical and subcortical changes at a cellular and synaptic level resulting in ner patterns of motor activity 

Afferent Activation

active VR exercises stimulate that same physical senses used in the real world thereby affecting a variety of afferent CNS inputs

Sensory systems involved with afferent activation

• auditory

• visual

• vestibular

• kinesthetic

• proprioceptive

Efferent Activation

active VR exercises stimulate motor responses which can lead to improved muscle recruitment, coordination, and/or strength

T or F. VR Exercises where a patient is largely sedentary will generate substantial physical benefits.

FALSE

VR systems augment traditional therapies by

1. providing visual and auditory feedback that is captivating, fun, and motivating 

2. engaging patients with a wide variety of conditions to perform a higher volume of exercise at greater intensities 

3. offering functional task and goal oriented exercises and activities that provide immediate performance feedback 

Research has produced significant results regarding a variety of patient populations and conditions like - 

• neurological conditions 

• cognitive impairment 

• cardiopulmonary rehab 

• falls and balance 

• incontinence 

• pain and wounds 

• orthopedic conditions 

• dysphagia and speech 

OmniVR 2020

• designed for the needs of medically complex patients

• easily pair with other tools for treatment options and progression including dysphagia and respiratory rehab

• enables engaging intervention for independent sessions and group therapy sessions 

• updates with enhanced visuals, accuracy of movement capture, and efficiency of set-up abd reporting