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We live in a technological world. Every aspect of our surroundings has transformed from what it was 20 years ago. We now use our smartphones and Alexa to coordinate and plan almost every aspect of our lives and would feel completely lost without the use of wifi and Bluetooth. Luckily for patients, rolling right along with our daily-use technology, healthcare technology is also rapidly evolving. Robotic and virtual reality-based interventions are becoming more popular, improving outcomes in almost every part of the medical field, including occupational therapy.
VR in OT
The use of virtual reality (VR) to accompany traditional physical and cognitive rehabilitation has become increasingly popular in the past decade. While product development is primarily targeted toward clinical use, a smaller subset is also focusing marketing toward specific public populations, such as individuals who have experienced a stroke. As an occupational therapist, I have the rather awesome opportunity to use this new technology with my patients. In regards to the use of VR in rehabilitation and occupational therapy, most research and development for new devices is targeted primarily toward those working to recover from strokes, brain injuries, or other neurological diagnoses.
Traditionally, occupational therapists have used mirrors to assist in rehabilitation following a neurological event. Mirror therapy may consist of placing a full-length mirror in front of an individual so that they can receive visual feedback regarding their movement and posture. Alternatively, small tabletop mirrors used during occupational therapy intervention are also placed perpendicular to an individual’s body, reflecting the uninvolved arm as it moves through a series of patterns or activities. The theory proposes that when the individual attempts to move both arms to complete a task or exercise, the visual feedback received of the “perceived” impaired arm moving (which is actually the reflection of the unimpaired arm) will encourage neuroplasticity and the “re-wiring” of brain connections to improve movement following the injury.
When we compare mirror therapy with the current virtual reality trend, it’s easy to see how they relate. Virtual reality systems used in rehabilitation provide an virtual image of an individual’s impaired arm moving (via the screen) to complete a desired virtual task. This is relying on the same means of visual feedback to help work on motor planning. Couple the relationship between virtual reality and mirror therapy and add evidence supporting mental practice positive influence on improving affected limb recovery and it’s easy to see how the therapy world is jumping on these new and interactive virtual reality products. Guided motor imagery, where an individual imagines and “sees” himself completing an everyday task (such as reaching into a closet for shirt) with only their impaired arm or using both arms has an impressive amount of research backing its efficacy.
So what exactly does today’s virtual reality look like in an occupational therapy setting? Generally, there are two types of products: those that produce an image on the outside of the screen of a simulated activity and those that involve what we typically think of as VR goggles (respectively, non-immersive vs immersive). Neofectmarkets the Smart Glove, a product that uses an exoskeleton type device over the affected hand and wrist, and picks up on an individual’s wrist and hand movements. The device then relays those movements to a virtual hand on a screen, allowing the virtual hand to complete an activity. The REAL system is an example of an immersive virtual reality rehab device and relies on hand/arm sensors to provide a visual image of movement via VR goggles. This, in turn, provides the user with the sense of truly completing a task or movement either bilaterally or with only the impaired arm.
As an occupational therapist, I am excited when my patients are excited. They love being exposed to the latest and greatest technologies as much as I do. If I feel strongly that a particular device will benefit someone, I work hard to try to provide that service clinically as best as I can. I may not regularly use typical computer technology such as specific software or programs on a daily basis, but I have consistent exposure to high-tech products that change peoples’ lives—in my opinion, a much better and more exciting job perk.
Neurological rehabilitation is an exciting field in itself. With the addition of diverse and constantly developing devices and techniques, rehabilitation is proving itself to be at the forefront of technological healthcare.