Virtual Reality (VR) is a brand new proposal from the Avalon Foundation for the community they take care of. In the middle of October 2018, as part of the Avalon Active project in cooperation with WalkinVR, we launched a project based on the use of virtual reality in rehabilitation. By January 7, 97 hours of VR classes were conducted.
As part of the subscription, the beneficiaries can participate in individual classes. Each of them is run by a physiotherapist in a room outfitted with VR equipment. Thanks to VR, mentees can have fun playing games and enjoying the newest technology, and at the same time participate in rehabilitation which is cleverly “smuggled” by physiotherapist in the meantime. Participation in games requires the member to perform appropriate moves or achieve particular positions, which are in fact functional activities prepared for him. He overcomes the tasks of the game while overcoming his physical barriers. The person deciding on the type and level of difficulty of the game is physiotherapist. He chooses the patient’s game positions and modificates the surrounding to complicate the task therapeutically as much as it is possible. The person exercising in Virtual Reality actually performs physical training, which complements his standard physiotherapy in the rehabilitation room. This is an additional form of rehabilitation available in the Avalon Active activity pool.
Among the course participants, we observe an interesting phenomenon – a person focusing on the tasks set in the virtual world, boldly and efficiently makes physical progress both during classes in VR and in the rehabilitation room during functional physiotherapy. The scope of supplementing functional physiotherapy with virtual reality classes is diverse. In some cases, classic rehabilitation takes place twice a week, and VR classes – once a week. Some of our patients have one VR classes per four rehabilitations per week, and some of them take a part in VR course every second week. There are no rigid restrictions because it is impossible to standardize VR classes frequency due to the multitude of diseases occurring among our patients. This is also due to one of Avalon Active’s main assumptions which is the individual adjustment of the rehabilitation program to the needs and capabilities of each Beneficiary. With such unconventional behavior, we do not set standards for the “use” of virtual reality in therapy.
Virtual Reality classes are conducted in the 1:1 mode, which means that one therapist individually conducts classes with one Beneficiary per unit of time (one class lasts an hour including the required breaks). Due to different disease entities of our patients, their functional capabilities and needs, we modify the external conditions in which they move. The mentee has not only to play, but above all to practice during classes in VR. Classes take place in a standing position, in a gym (on an active or electric wheelchair, a chair with back support, without support, on a rotating chair without support, on a gym ball, on a rehabilitation roller), in a kneeling on the mattress. A physiotherapist often decides to add 1- 2 kg of weights as loads for upper and / or lower limbs. Sometimes, if he wants to “force” supports on one neglected lower limb, the step to the other is used. In the method of modifying external conditions, there is also no uniform key – each disease manifests itself differently, there are no two identical people with the same disease. Therefore, the creativity of the therapist guarantees the possibility of adjusting the optimal game conditions. The limit is only the imagination.
In addition to the classic use of virtual reality, Avalon Active can also boast of using WalkinVR Driver as part of its therapy. Thanks to it, you can change the technical parameters in the game itself, which makes it possible to use virtual reality by a larger group of people. By modifying the parameters, you can adjust the game’s conditions to the limits of the player, which prevents the classic use of the game. It becomes real to rotate up to 360 degrees without having to do physical rotation. You can move the controllers setting in space, use the assisted controller to help, adjust the motion sensitivity of virtual reality controllers in relation to the reality or orient the position of the controllers.
People using the program are the ones with multiple sclerosis, cerebral palsy, spinal cord injury, stroke, craniocerebral injury, neuropathy, Lyme disease and many other disorders. Virtual reality classes support functional rehabilitation, affecting movement ranges, endurance, neuromuscular coordination, ability to concentrate, receiving stimuli. The most commonly used games by physiotherapists are: Audioshield, BoxVR, BeatSaber, Fruit Ninja, FunHouse, RunAvayVR, Guns’n’Stories.
The world of VR is very rich, although there is still no backroom of interesting games for people with very severe neurological deficits that do not have any and deliberate movements of the upper limbs. In their case, it is worth considering the inclusion of technologies such as “cyber-eye”, so that they can control the vision in the game. The strains of the eye muscles that would be responsible for controlling the virtual world would be an interesting alternative to rehabilitation for these people. The Avalon Foundation’s technology testing physiotherapists points to the need to create simple games with mildly changing images adapted to people struggling with epilepsy and notes the deficit on VR games platforms – BoxVR sports games.
Experience shows that the area of rehabilitation in virtual reality is an endless story, a topic that requires constant exploration of knowledge and carry out many more studies on the impact of VR technology on the human body.
Article created by Avalon Foundation’ therapist Martyna Czarnecka
AVALON Foundation – help for the disabled and the chronically ill.
Since 2009 Avalon Foundation has gained status of Public Benefit Organization (Organizacja Pożytku Publicznego – OPP) and changed name to AVALON Foundation – help for the disabled and the chronically ill. The Founder of our organization is also a disable person.