Hiatus

This blog is on temporary hiatus for a bit as I prepare for the MCAT. However, the world of virtual reality and therapy continues to hurtle forward with exciting new applications, and I would like to direct you to a few reports:

• At the University of Medicine and Dentistry of New Jersey, post-stroke patients manipulated a robot in virtual environments as part of rehabilitative physical therapy. The virtual reality group walked farther and faster than a group that only used the robot. Read more here.

• GestureTek, a company whose innovations have been utilized for previous virtual reality therapeutic applications, was on display this past weekend at the Consumer Electronics Show. Read more about their new 3-D depth tracking system here.

Virtual Reality Treadmills

One of the major rehabilitation challenges for older stroke victims is re-learning how to walk. A new system, designed by a former chiropractor and current University of Portsmouth Ph.D. student Wendy Powell, aims to change that with an innovative virtual reality system, used in conjunction with a treadmill.

As patients walk on a standard treadmill, moving images projected onto a screen in front of them attempt to trick their brains into thinking that they are walking at a slower rate than they are actually walking. This reduces fear of falling and gradually encourages them to walk faster, increasing endurance and speed. The system is expected to enhance speed, endurance, and strength among stroke victims. Clinical trials are being conducted with a research team from Canada's McGill University.

• University of Portsmouth Front Page News
  

Ditto!

Researchers from Australia have designed a new tool in the quest to bring pain relief to burn victims. The project, lead by Dr. Sam Bucolo, involves a hand-held circular device which engages children as they get their burn dressings changed. Previous work for burn victims has involved goggles, headsets, or other types of immersive virtual reality settings, but this device, Ditto, is designed specifically for small children, aged three to eight. Preliminary data indicate that Ditto can engage children in less than a minute and keep them preoccupied throughout a full bandage replacement, which typically takes around 20 minutes. The results also show that Ditto had more success reducing pain scores during treatment as opposed to traditional distraction tools, such as videos or computer games. Clinical trials are underway, and Ditto is expected to be released for commercial use within the year.

• ScienceAlert Article
  

Virtual Reality Loses A Hero

Dr. Randy Pausch, a talented, generous, and inspiring researcher and educator, passed away on Friday, July 25. The field lost a true hero whose contributions to virtual reality will live on in his imaginative projects, including computer programming teaching tool ALICE. You can read my tribute to him here.

More Information:
PC World
Wall Street Journal (written by Jeffrey Zaslow, co-author of "The Last Lecture," the novel form of Dr. Pausch's lecture)

VR + Students with Special Needs

The journal Topics in Language Disorders has a review by Sue Cobb of projects that utilize virtual reality to teach students with special needs. One of the most promising aspects of VR education is its capacity to teach skills that can be transferred to real-world situations. In the late 90s, researchers from the University of Nottingham and VIRART (Brown, Kerr, and Wilson, 1997) designed and tested virtual ski, driving, home, and supermarket environments. Since then, a variety of others have followed suit, examining the impact of virtual reality settings on everything from social skills to language learning to daily life skills. Cobb summarizes the results; while many studies found that students learned within the setting, and others found evidence that the skills were transferred, the studies have not followed students or interventions for long enough time periods to fully conceive the generalization ability of such programs. The article is a terrific summary of the progress that has been made thus far as well as future areas to examine more.

• Cobb, Sue V.G. Topics in Language Disorders. Virtual Reality: Exploring New Dimensions for Conversation, Language, and Learning. 27(3):211-225, July/September 2007.

VR in the News

This summer has been full of exciting new developments and reports from the intersection of virtual reality and therapy.

Stuff.co.nz has an article following the rehabilitation of three patients at a Ryde, Australia hospital. It provides examples of how the Nintendo Wii offers an engaging and challenging platform for physical and emotional progress after debilitating injuries or illnesses. One of the patients, trained as a physiotherapist, designed a glove that allows less mobile people to access the handheld Wii remote.

VR and Burn Wounds: Hydrotank Research

Researchers from University of Washington's HITLab have published a new study on virtual reality pain control during the removal of burnt tissue in The Clinical Journal of Pain. In burn treatment, patients often experience extreme pain during the earliest treatment sessions, which are often held in hydrotherapy tanks. Although medications are used to reduce pain, analgesics are not always effective and can lead to other side effects. Based on a model in which attention is a requirement for pain, the VR treatment used in this study attempts to distract users with images and sounds that are engaging and positive.

In this experiment, 11 patients (ranging in age from 9 to 40 years of age) were studied during the painful bandage removal and wound cleansing sessions. For part of the treatment, they received no distraction and were asked to report the worst pain they felt, the amount of time they spent thinking about pain, and the unpleasantness of their experience. Two additional ratings that measured 'fun' and 'presence' in the virtual world were also administered. In another part of the treatment, the patients were immersed in a world filled with icy, cool images called SnowWorld. During this phase, the participants were given the same ratings scales as in the other phase. However, treatment sequence was randomized, so some patients received the control treatment first, then the VR treatment; others received it in the opposite order.

The study demonstrated that in the VR condition, participants spent less time thinking about the pain and experienced lower pain intensity and less unpleasantness. The virtual reality condition was rated, unsurprisingly, as more 'fun' than the control condition, which involved no distraction. Interestingly, patients with higher presence ratings - the extent to which they became cognitively involved in the virtual environment - experienced less pain. Pain was reduced from 'severe' to 'moderate' on average, but in the group of the six most engaged participants, ratings dropped from 'severe' to 'mild.'

The study authors point out one possible bias of the study: the nurses providing care knew which treatment the patients were receiving, control or VR, because of the headset. Therefore, there is a chance they could have unknowingly treated the VR patients more gently throughout the treatment.

However, this is the first controlled multi-subject study to demonstrate that virtual reality allows pain reduction for patients undergoing treatment within the hydrotank, which is extremely promising news for burn care. Past pain-reducing options have failed to prove sustainable for many patients undergoing wound treatments, and virtual reality could offer new hope for this group.

• Hoffman, H. (2008). Virtual Reality Pain Control During Burn Wound Debridement in the Hydrotank. Clinical Journal of Pain, 24(4), 299.