Virtual Reality (VR) in cognitive rehabilitation

Virtual reality (VR) is quickly finding wider acceptance in healthcare as the medical community increasingly becomes aware of its potential benefits as a promising tool for various revolutionary healthcare applications, starting from remote surgical procedures, medical therapy, preventive medicine, medical education, and training to physical and psychosocial rehabilitation.

VR has also been proved to be highly effective as a psychotherapeutic tool often used to distract patients during painful medical procedures or provide graded exposure during treatment for a wide range of anxiety disorders like posttraumatic stress disorder. The VR technology can provide a blend of both distraction and experiential therapies that teach patients these techniques within a structured, safe environment.

Virtual reality (VR), in a nutshell, is a computer simulation system that creates a three-dimensional computer-generated virtual world, providing an immersive interactive experience. In this virtual environment, the visuals change continuously depending upon the orientation and gaze of the users. Because of the superior level of interactivity, the users begin to feel like they are a part of the virtual world and experience it first hand.

A typical VR system usually includes four major elements: a computer of at least 500 MHz with an advanced graphics card, a software program with the virtual environment, a tracking device that tells the computer where the user is looking based on head or body movement, and an image display system such as a large high-resolution digital display or a head-mounted display (HMD).

The potential applications of VR in healthcare have already been demonstrated in the past. Virtual reality has been successfully applied to many healthcare areas, ranging from the visualization of medical databases to surgical procedures. Some of the top VR applications in healthcare include:

  • Remote surgery, telepresence, augmented reality surgery.
  • 3D human anatomy models for education, visualization diagnosis, and planning
  • Architectural design for healthcare facilities
  • Preventive medicine and patient education
  • Haptic aided rehabilitation
  • Visualization of massive medical databases
  • Treatment planning
  • Medical therapy
  • Pain control
  • Psychotherapy through Virtual Reality
  • Virtual patients
  • Surgery simulation for pre-operative planning, computer-aided surgical interventions, interoperative navigation, and image-guided surgery, post-operative planning, education, training, rehearsal, and assessment of surgical competencies.

One of the newest and most exciting VR applications is cognitive rehabilitation, where VR is used for vocational training to train cognitive tasks in brain-damaged patients. VR is a powerful tool in motor rehabilitation for stroke, acquired brain injury, Parkinson’s disease, orthopedic rehabilitation, wheelchair mobility, balance training, and training in functional activities of daily living.

There are many reasons that VR applications are so effective. VR, for one, is an interactive, experiential medium, where the users become directly engaged with the effects of the VR experience.

Another reason is that VR is a unique setting where patients can explore and act without feeling threatened. Patients can confidently make mistakes without fear of dangerous, real, or humiliating consequences.

VR allows people with intellectual disabilities to explore environments without the distracting or restricting presence of other actors. Unlike human trainers, computers are infinitely patient and consistent. VR can also simulate many situations that may otherwise be difficult to control or simulate in real life, such as a fire emergency, resulting in ecologically valid and dynamic assessment and training. While controlling outside distractions, VR can systematically introduce distractions; using this in a virtual classroom has allowed researchers to diagnose ADHD in children. VR can be manipulated in ways that the real world cannot. For instance, VR can convey rules and abstract concepts without using language or symbols for patients with little or no grasp of the language.

In motor rehabilitation, there are three major advantages that VR offers over traditional therapy alone.

  • VR allows a safe, controlled environment for repetitive practice, and repetitive practice is crucial in learning motor tasks.
  • Immediate, real-time feedback about performance.
  • Because of its interactive nature, VR can increase motivation by making the experience fun.

Patients are much more motivated to complete exercises when presented with an engaging virtual reality video game environment than simply gym equipment. Besides, virtual treatments can be individualized to each patient and monitored to test his/her ability to perform certain tasks over time.

As patients begin developing strength and coordination, the tasks can be made increasingly difficult, creating challenges and continual rehabilitation.

Augmenting rehabilitation medicine with VR permits impaired individuals to explore worlds not otherwise available to them, allows accurate assessment and therapy for their disabilities, and helps architects understand their critical needs in public or personal space.

The possibility of VR telerehabilitation is another advantage of VR. The delivery of medical rehabilitation services, such as VR rehabilitation therapy, to a patient’s own home via the Internet would benefit those who live far from the nearest rehabilitation facility or who have trouble securing transportation to such a facility. VR could be combined so that patients could interact with other patients and see each other’s rehabilitation progress from the comforts of their own home.

Such a system would hold many potential advantages. The presence of other people would increase compliance, improve the quality of life, reduce depression, and reduce social isolation.

VR can assist the brain’s ability to reorder neural pathways in response to new experiences or needs. Neuroplasticity processes are assisted with VR simulations that enable patients to work through regaining skills in small and achievable segments. VR can break a skill down into discrete tasks – difficult in real life but easy in VR – and simulate repetitive increments more efficiently than live training.

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