PTRS 853 - Moving into Virtual Reality

What is Virtual Reality?

- use of interactive stimulations

- created by computer hardware and software

- engage in environments

- that appear and feel similar to real world

example of VR in neurorehabilitation applications

- balance and gait

- upper extremity

- grocery shopping

- cognition

- driving

Pros of VR

- safe

- ecologically valid (resembles the world)

- controlled environment

- digital outcome measures

- personalized and targeted training

- repeated practice

- visual feedback

- enjoyable and motivating

Cons of VR

- simulator adaptation syndrome (cybersickness)

- pixelation

- lag effects

- limited sense of presence

- disadvantages of commercial products

- disadvantages of rehab focused VR

Order of system importance for balance

1. vision

2. somatosensation

3. vestibular function

Purpose of sensory organization test

teases out affect systems

- tells what system is causing fall risk

Cons of sensory organization test

expensive and bulky

What type of treadmill training is more beneficial for normal gait and dual task?

VR treadmill > normal treadmill

Pros of VR walk test

- challenging

- increased adaptation strategies -> increased dynamic balance

- integration of multiple systems and tasks (dual tasks)

- objective progress tracking and feedback (real time sensors and eye tracking)

Virtual walking techniques

- walk in place with virtual interface

- locomotion devices

VR cognition and gait assessment battery (VR-CoGait)

- multimodal tool to assess cognition and gait (auditory and visual interferences with gait parameters)

- well-controlled, ecologically valid environment

- early detection of cognition impairments and falls risk in patient populations

APTA CPG article results on VR

strong evidence for VR with walking training and moderate to high intensities

Choosing VR technology

- what will VR add to clinical practice?

- VR should be used as adjunct to traditional PT

- VR should not distract from clinical goals

- type and intent of equipment should be well understood

- tech savvy helps

Choosing VR tasks / games

- physical / cognitive requirements vs capabilities

- progression of difficulty?

- is feedback provided?

- can the VR be used in the time available?

- can data be saved?

- can VR be used by multiple users?

Patient considerations with VR

- use of mouse, joystick, physical tracking

- controls

- screen size and contrast of game

- instructions

- language