VIRTUAL ENVIRONMENTS FOR REAL TREATMENTS

Abstract Introduction In the era of evidence-based practice, more evidence of the beneficial impact of physical therapy and rehabilitation interventions have emerged. Kwakkel and Wagenaar's meta-analysis, Carr and Shepherd's work relating to the motor learning concept, and Fiatarone's research of strength training, emphasize the influence of rehabilitation in outcome gains by demonstrating that in conjunction with the therapist's expertise, the most influencing factors are therapy frequency and intensity. Aim To show the problem which is the gap between this knowledge and reality. Discusion Recently published observational studies revealed that patients in rehabilitation facilities receive a very small amount of therapy time during rehabilitation. Virtual reality (VR) technology offers assistance, as it enables patients who have difficulties coping in the “real world” to gradually deal with their problems via the “virtual world”. It provides the user with a real time interactive experience, through visual, audible, tactile or any other kind of feedback. Individuals find themselves in a pleasant, challenging, motivating and “inviting” functional environment, thus tending to forget their limitations or disability. In addition, VR encourages them to reach their goals which are difficult to achieve in any other treatment setting. Conclusions VR is a new, innovative technology utilizing virtual and adaptable worlds, created by sophisticated computer systems with improved graphic capability (hardware) and interactive software allowing one to interact “naturally” with the virtual environment, without the risk and cost of moving the patient into the “real world”. The interactive experience is perceived by both, therapist and patient, as very positive, enabling treatment to continue over time without feelings fatigue or boredom. VR can be created through a variety of tools, simple to complex, cheap to expensive. Basic computer systems with different input and output devices, such as different types of monitors or expensive and sophisticated systems using helmets with small video screens head mounted display have been used. Recently, cheap “on the shelf” video game consoles were adopted by clinicians as valuable tools in treating patients suffering from various pathologies and disabilities. Therefore, therapists are required to manoeuvre and plan treatments in systems where the delineation between therapy and fun is not always clear or controlled. The common practice has to be, as always, somewhere in between the most expensive and sophisticated systems and the “non adaptable” video game consoles. We estimate that in the near future, VR technology will be widely used. Meanwhile, today's technology allows us to take more of the VR advantages to the clinical world.