Recovery after an injury or disease can take a long time, from several months to years. Everyday, scientists and clinicians work together to research and implement new and innovative techniques to improve the success of a patient’s recovery. The big challenge is to associate established techniques with engaging and fun therapies. Until recently, virtual reality was not a feasible method for use in therapeutic interventions. New advances in the virtual reality technology have drastically improved this ability. These games are a computed technology that simulates elements and actions of real life, allowing a complex interaction between patient and machine. In this sense, virtual reality instruments have become quite widespread in the field of rehabilitation medicine, playing a key role in the multidisciplinary approach in rehabilitation processes. Specially, health professionals are using the virtual reality game to target the special needs of the patient in their rehabilitation program, by increasing the patients´ motivation and involvement in the therapy.
There is a variety of applications with virtual reality technology. Its use for the rehabilitation specialist is our focus. First, there is a large variety of Virtual Reality tools that to can be used to create a virtual reality game for rehabilitation purposes. With the large variety of Virtual Reality tools available, one should keep in mind that there is no ideal package that is best for a given situation, however, each package can be tailored to the needs of the therapist according to the patients’ rehabilitation needs. So, besides the attractive fun environment, a great contribution of these games are their wide range of use, safety and effectiveness.
Several researchers studying Virtual Reality have demonstrated a great potential to provide novel treatments to patients with a range of disorders from orthopedic to neurological disorders. The virtual reality technology assists in the sensory feedback, cognitive, psychological and motor (coordination) aspects allowing the user to change or manipulate various functional demands. According to the patient’s previous impairment, the use of Virtual Reality games can be guided to promote a specific goal and improve a patient’s functional daily activities, such as postural control, walking pattern, reaction time and balance.
Thus, the key of the virtual reality games is to provide instantaneous feedback to the patient facilitating or challenging the performance of the exercise according to various goals. It is important to know that during all steps of the rehabilitation process the body needs different stimuli and challenges. This way, the virtual reality games activate the different parts of the brain, transmitting the message to the muscular system reestablishing or improving the movements impaired by a disorder or injury. For example, usually in these games, the patient is able to see his movements on the screen and the game will provide a real-time feedback to the direction the movement that should be performed.
Another common goal in the rehabilitation process is enhanced motor performance, which can be achieved by improving the speed of movement, coordination, and balance during a virtual reality game. Also, the activity can become even more challenging by integrating cognitive skills, such as planning tasks, problem solving, attention and memory. The use of virtual reality games has been proven to be effective in different patient populations. Among neurological patients that suffered a stroke, the virtual reality training was effective at improving balance, gait abilities, depression, and interpersonal relationships. Among obese children, virtual reality training increased enjoyment during exercise on a treadmill, promoting an interest that helped the overweight and obese children to engaged a longer time and to enjoy the exercise. Orthopedic patients with ankle sprain, used virtual reality games as part of their exercise therapy which promoted a faster recovery which translated to the ability to perform specific demands of their sport.
A few factors that must be considered to correctly use of virtual reality as a rehabilitation tool. First, the game must engage patients´ interest, if they are to increase their effort. In order to accomplish this goal, it is also important to tailor the game to the age, physical activity level and previous injury or disorder of the patient. Next, the correct choice of equipment, activity planning, duration and frequency used should be appropriate for the patient. This will improve success rate, enhance patient performance and increase the likelihood the patient will continue the activity. Finally, the activity must be frequent and recurring in order to support learning and lasting after-effects which will promote permanent and long-term improvements in function. Like any other activity, the brain and the body need repetitive training to learn and retain the new information. Otherwise, its use will not have the desired long-term effects.
Certainly the use of virtual reality for rehabilitation is a fascinating topic and its use has a great potential. In this way, it is necessary more scientific researchers in this area focusing in the different benefits and viable application of the virtual reality tools for different patient populations. The next steps should focus in the broad integration of research and clinical application in order to help therapists provide the best quality care for patients.
Ms. Ft. Gabriela Borin
Phd Student UMass, Amherst, MA