Physiotherapy Gets Virtual

Patients who need physiotherapy following a stroke or accident could soon be put through their paces in a virtual reality (VR) environment.

A very clever person at the University of Portsmouth is creating a rehabilitation programme that places patients on a treadmill and into a virtual world. It works by using moving images to trick the patient’s brain into thinking he or she is walking more slowly than they are which in turn encourages them to walk faster and further.

Wendy Powell, a PhD student in the School of Creative Technologies, is obviously a cyberpunk at heart. But her early results are promising and suggest that patients using virtual rehabilitation may experience less pain than traditional physiotherapy alone. Wendy developed the software which works in conjunction with a specially adapted treadmill. Clinical trials on real patients are taking place in collaboration with experts at the renowned McGill University in Canada. A former chiropractor, Wendy hopes it will pave the way for a new and innovative approach to physiotherapy.

Surprisingly, this isn’t the first time VR has been used for treatment. A virtual reality theatre was built in 2006 for treatment and therapy purposes at the Cleveland Hearing and Speech Center in the U.S. The IVR-Cave is a patient’s own personalised IMAX Theater, complete with three screens which encompass the patient with 180 degrees of high-definition film and surround sound. The patient is able to watch interactive movies on the big screens from an elevated platform in the middle of the room. The interactive movies provide patients with practice in social situations, but also allow the therapist to monitor results.

For example, someone may be undergoing speech therapy for stuttering problems. After stepping into the room, they are presented with a film featuring a McDonald’s worker asking them for their order. Depending on the response from the patient, the therapist can choose particular branch points through the scenario. If the patient is acting belligerent, the worker may go and get the manager, while if the customer’s stuttering becomes overwhelming, the worker may show amused facial expressions.

VR is also being used today by the military. Dr. Greg Reger, a clinical psychologist at the Telehealth and Technology Center of the Defense Center of Excellence, is utilising a virtual world where U.S. soldiers can walk the roads of Iraq with a standard issued M-4 in hand, feel the shockwave from an Improvised Explosive Device (IED) blast, experience the feeling of being ambushed by Iraqi forces and then smell the scent of gunpowder from fired weapons after the battle is finished. Created by developers at the Institute of Creative Technology at the University of Southern California, Reger does not use this virtual world to train soldiers for deployment, but rather to help them after coming home. While some service members are able to easily transition from war to life back home, others may have a more difficult time as a result of post-traumatic stress disorder (PTSD).

Wendy’s virtual system encourages patients to walk more quickly and for longer, almost without them realising it. She said it effectively fools the brain and the body. The environment is apparently stimulating and entertaining and there’s less fear of falling over. Wendy hopes that the system will also help older stoke patients who often find traditional approaches to improving their speed and distance difficult because it relies very much on self-motivation.

After a stroke or fall many older people lack motivation and confidence and they don’t feel steady on their feet so getting out and about can be an issue and they can find the whole process rather dull. Wendy’s system uses a variety of different images from urban landscapes to forest and mountain scenes. She has built a system of rewards into some of the programmes, which encourages the patient to pick up objects and collect points. She said that older people were not at all put off by the ‘computer game’ element but seemed to enjoy it.

Stroke survivors are in luck too. The vast majority of stroke survivors cannot use a normal treadmill because they are not in control and many can only hold on with one hand making it almost impossible. Walking is the best possible exercise for their bodies and this system would help enormously. I can see it working very well on improving strength, endurance and stamina. Consistency and practice are key to making progress and this system has huge potential across a wide range of activities which can be tailored to meet individual rehabilitation needs.

I wish you all the very best with your work Wendy!