Virtual Reality in Rehabilitation

Rehabilitation may be the area in which VR will have the most impact and bring about the greatest transformation in human living. Not only do VR technology promise to make the blind "see" and help the paraplegic "walk," but we have yet to fathom the limits of this technology in related areas (Max and Burke, 1997). In a simulated VE, disabled people can safely engage in all kinds of activities and be relatively free of the limitations imposed by their disabilities. Moreover, there is evidence that skills learned in a VE are transferable to the real world. For example, disabled people can practice navigating their wheelchairs in dangerous situations. Owing to the limitations of current technologies, there is, of course, a trade-off between performance observed within the simulated system and in real life. Even so, research has shown that driving skills of those who may have impairments or are learners and are being trained increase as a function of time spent in VR (Inman, Loge, and Leavens, 1997). Moreover, VR therapy promotes compliance by making the entire rehabilitative process more enjoyable, motivational, and appealing (Bowman, 1997).

DataGlove and WristSystem technologies, which measure human movements, have been discussed and illustrated in Greenleaf (1997). These technologies are being used by occupational and rehabilitation medicine specialists, ergonomists, industrial safety managers, biomechanical researchers, and risk management consultants to study physical movements of patients undergoing rehabilitation. When worn during normal daily tasks, for example, these gloves (and wrist systems attached at the end of the gloves) measure how long the wrist, hand, and arm are positioned at specific angles; they also measure maximum, minimum, and mean wrist angles. Such information can then be usefully applied to study and help patient overcome poor ergonomics such as challenges faced with Carpal Tunnel Syndrome. VR-based rehabilitative workstations simulate occupational tasks as well as tasks of daily living. VR technologies can also help people with vocal impairments communicate. Computer mapping of hand movements in the GloveTalker, for example, can permit one who previously would have been locked inside oneself to convey more complex ideas.

Physical rehabilitation has obvious VR applications, but VR can also reach people with specific attention and movement disorders. Paradoxical walking or the diminished ability to walk voluntarily is a condition suffered by patients with Parkinson's disease. The difficulty of walking can be overcome if only stationary objects can be placed along the walk paths. VEs can be used in presenting the virtual images to the nondominant eye and scrolling the objects toward the subject along a virtual ground plane. Perception of the objects stabilizes appropriately as the subject walks over them. The VE can create images of such stationary objects with the use of special glasses and can superimpose these images onto the real environment, enabling people with paradoxical walking disorder to walk again (Weghorst, 1997). Attention deficit disorder and visual impairments are other domains in which VR rehabilitation is believed to be effective as the VR provides users with visual cues of objects in the surrounding space (Wann, Rushton, Smyth, and Jones, 1997).

Recovery from a stroke is often rapid during the first few weeks but normally plateaus before full functionality is reached. Traditional therapy often helps to prevent an early plateau, but it is hoped that VR therapy can help patients achieve a higher level of functionality as a result of gradual exposure and safe training experimental treatments. VR systems can either be used alone or as a complementary treatment modality alongside traditional treatment. The criteria, of course, should be whether value is added to the rehabilitation process, therefore justifying the required capital investment and technical expertise needed to set up VR therapy.

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