You can put several Examples in which virtual reality can be applied , From games to the rehabilitation of cognitive functions.
Virtual reality is so useful because it can control all the variables of the environment, which is impossible for traditional research and therapies.
With virtual reality, the same environment can be created for all participants, so the studies are highly replicable. In addition, in this way, the comparison between patients or between these and the controls, is more reliable as you ensure that all participants have gone through the same conditions.
The use of virtual reality in rehabilitation allows patients to train at home, and they do not have to go to the practice so often, which is an advantage especially for people with reduced mobility.
But not all are such significant benefits, the use of virtual reality in clinical and research has also some limitations that will be discussed later in this article.
Virtual reality
According to the dictionary of the RAE (Royal Spanish Academy), the virtual reality Is defined as the"representation of scenes or images of objects produced by a computer system, which gives the impression of their real existence."
That is, virtual reality software creates an environment, similar to the real one, in which the person is introduced. This environment is perceived in a similar way to the real one and, often, the person can interact with him.
This virtual environment can be reproduced in different ways, in monitors, projected on walls or other surfaces, in glasses or helmets... Some types of reproduction, such as projection or glasses, allow the person to move freely through the environment and allows him to act Freely since you do not have to hold anything with your hands.
Although virtual reality is being used in more and more different fields, one of the fields where it has been most used, and still used, is in the training of professionals, such as airplane pilots or nuclear plant workers. Here, virtual reality is especially beneficial, as it reduces the costs of training and also guarantees worker safety while it is being formed.
Another field where it is increasingly being used is in the training of doctors, especially surgeons, not to have to use corpses as is customary. In the future, I trust that all universities will have virtual reality training.
Virtual reality is very useful for treating some psychological disorders that are caused in part by the patient's lack of control of some variables, such as anxiety disorders Or phobias. Because, thanks to virtual reality, they can go training, and gradually reduce their control over the environment knowing that they are in a safe context.
In the research can also be very useful, since it gives the possibility of controlling all the variables of the environment, which makes the experiment highly replicable. In addition, it allows to modify variables that are not modifiable in the real world or that would cost much to modify, like the position of objects grades in a room.
The use of virtual reality in the video game industry may be one of the most popular and most advancing thanks to the growing interest of the people.
You can say that everything started with the Nintendo Wii (Nintendo Co. Ltd., Kyoto, Japan), which allows you to interact with the game by performing the same movements as if you were in a real situation, for example, move the arm as if You were playing tennis
Later appeared another device, the Kinect, Microsoft (Microsoft Corp., Redmond, Washington) which allows you to manage the game with your own body, without any other device.
But the introduction of virtual reality in video games is not just big business, some of the best devices have been created by small businesses and funded by Kickstater, such as the Oculus Rift or Razer Hydra sensor.
The development of virtual reality games is not only used for leisure, they can also be used to stimulate or rehabilitate the patient, a process that in psychology is called Gamification .
Next, some examples of the use of virtual reality will be described to rehabilitate patients through gamification.
1- Evaluation and rehabilitation of the balance
Traditionally, lack of balance (either by age or by a disorder) has been rehabilitated using a system composed of three pendulums.
The exercise that is performed is very simple, the balls of the end of the pendulum are thrown slowly toward the patient, who must dodge them and return to their original position. The use of three pendulums prevents the patient from predicting where the next ball is coming from.
This system has a number of limitations, firstly it must be adapted to the patient's morphological characteristics (height and width) and, secondly, to control the speed with which the balls are to be thrown, this aspect depends on How fast the patient is in dodging the ball.
These adjustments must be made manually, which can be tedious and inaccurate.
Other of its limitations are the high cost of the machinery and the ample space necessary to be able to install it, of which do not have the majority of doctors or therapists.
Creating a virtual representation of this machine can solve all the problems discussed. Using virtual reality you can adjust the size and speed of the balls automatically, in addition you do not need such a large space for your installation.
In a study by Biedeau et al. (2003) found that there were no significant differences between participants' scores on the traditional balance test and the virtual reality test.
to. Traditional rehabilitation, b. Rehabilitation with virtual reality. Source of the image: Morel, Bideau, Lardy, & Kulpa, 2015.
Although it was observed that the movements of the participants were not equal in both conditions, they tended to be slower in the virtual reality, possibly due to the own delay of the program of virtual reality.
The main limitation was that the participants did not receive any feedback In the virtual reality program if the ball touched them or not, but this problem can be solved simply by adding a kind of alarm or beep every time this happens.
So it can be concluded that the use of virtual reality for the evaluation and treatment of patients with balance problems is useful and reliable.
2- Rehabilitation of a stroke
Rehabilitation after a stroke occurs while the person is admitted to the hospital. Upon discharge, this rehabilitation does not continue, although the patient is normally advised to do a series of exercises, called GRASP.
GRASP ( Graded repetitive arm supplementary program ) Is a program that includes physical exercises to improve mobility of arms and hands after suffering a stroke.
Image Source: Kairy, et al., 2016.
In a study by Dahlia Kairy et al. (2016) the improvements of two groups of participants were compared, one received traditional therapy, hospital rehabilitation and GRASP at home, and another with virtual reality and telerehabilitation, hospital rehabilitation and home virtual reality program monitored by a therapist.
The authors concluded that virtual reality and telerehabilitation had been more useful than traditional rehabilitation, since they increased adherence to patient therapy, for two main reasons. The first is that they were monitored by therapists and the second is that the patients felt funny because they saw it as a game.
3- Rehabilitation of multiple sclerosis
The multiple sclerosis Has no cure at present, but there are several therapies that are applied to improve the motor and cognitive functioning of patients and thus to be able to stop future attacks.
These therapies include medications and physical and neuropsychological exercises. Studies to date indicate that there are some symptoms that improve with therapy, but there are no positive results in slowing the development of the disease (Lozano-Quilis et al., 2014).
These therapies present two important limitations. The first is that the motor exercises must be performed with an assistant and many repetitions are necessary, so sometimes it is not possible to perform them (because there is no assistant) and the patient is not very motivated. Their adherence to treatment is quite low.
Secondly, cognitive exercises must be performed in a specific center, under the direct supervision of a therapist, which can present a high temporal and monetary cost to the patient (Lozano-Quilis et al., 2014).
A review of the studies carried out so far that analyzed the use of virtual reality in the rehabilitation of patients with multiple sclerosis found quite positive results (Massetti, et al., 2016).
As for motor functions, it was found that interventions using virtual reality increased mobility and control of the arms, balance and walking ability.
There were also improvements in the processing of sensory information and information integration, which, in turn, increased the mechanisms of anticipation and response of postural control.
The authors concluded that therapies that included a virtual reality program motivated participants more and were more effective than the traditional therapies applied to people with multiple sclerosis, although they considered that more studies are needed to better the virtual reality programs of the That we have.
References
- Bideau, B., Kulpa, R., Ménardais, S., Fradet, L., Multon, F., & Delamarche, P. (2003). Real handball goalkeeper vs. Virtual hadball thrower. Presence, 12 (4), 411-421.
- Eng, J. (s.f.). GRASP: Graded Repetitive Arm Supplementary Program. Retrieved on June 7, 2016, from The University of British Columbia: http://med-fom-neurorehab.sites.olt.ubc.ca/files/2012/01/GRASP-overview-and-evidence-pdf-format .pdf
- Kairy, D., Veras, M., Archambault, P., Hernandez, A., Higgins, J., Levin, M., et al. . . Kaizer, F. (2016). Maximizing post-stroke upper limb rehabilitation using a novel telerehabilitation interactive virtual reality system in the patient's home: a protocol study of a randomized clinical trial. Contemporary Clinical Trials, 47 , 49-53. Doi: 10.1016 / j.cct.2015.12.006
- Lozano-Quilis, J., Gil-Gomez, H., Gil-Gomez, H., Gil-Gomez, J., Albiol-Perez, S., PalaciosNavarro, G.,. . . Mashat, A. (2014). Virtual rehabilitation for multiple sclerosis using a kinect-based system: randomized controlled trial. JMIR Serious Games, 2 (2), e12. Doi: 10.2196 / games.2933
- Massetti, T., Lopes, I., Arab, C., Meire, F., Cardoso, D., & de Mello, C. (2016). Virtual reality in multiple sclerosis - A systematic review. Multiple Sclerosis and Related Disorders, 8 , 107-112. Doi: 10.1016
- Morel, M., Bideau, B., Lardy, J., & Kulpa, R. (2015). Advantages and limitations of virtual reality for balance assessment and rehabilitation. Neurophysiologie Clinique / Clinical Neurophysiology, 45 , 315-326. Doi: 10.1016 / j.neucli.2015.09.007
- Royal Spanish Academy. (S.f.). Virtual reality . Retrieved on June 7, 2016, from RAE: http://dle.rae.es/srv/fetch?id=VH7cofQ
- Wolfe, C., & Cedillos, E. (2015). E-Communications Platforms and E-Learning. In J. D. Wright, International Encyclopedia of the Social & Behavioral Sciences (Pp. 895-902). Amsterdam: Elsevier.