You can put several examples where virtual reality can be applied, from games to the rehabilitation of cognitive functions. Virtual reality is so useful because with it you can control all the variables of the environment, which is impossible for traditional research and therapies.
With virtual reality, the same environment can be created for all participants, in this way the studies carried out are highly replicable. In addition, in this way, the comparison between patients or between these and the controls, is more reliable because you make sure that all the participants have gone through the same conditions..
The use of virtual reality in rehabilitation allows patients to train from home, and not have to go to the consultation so often, which is an advantage especially for people with reduced mobility.
But not everything is so significant benefits, the use of virtual reality in the clinic and research also has some limitations that will be discussed later in this article.
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Virtual reality software creates an environment, similar to the real one, in which the person enters. This environment is perceived in a way similar to the real one and, often, the person can interact with it.
This virtual environment can be reproduced in different ways, on monitors, projected on walls or other surfaces, on glasses or helmets ... Some types of reproduction, such as projection or glasses, allow the person to move freely through the environment and allow them to act freely since you do not have to hold anything with your hands.
The use of virtual reality in the video game industry is perhaps one of the most popularly known and one of the most progressing thanks to the growing interest of the people.
It can be said that it all started with the Nintendo Wii console (Nintendo Co. Ltd., Kyoto, Japan), which allows you to interact with the game by performing the same movements as if you were in a real situation, for example, moving your arm as if you were playing tennis.
Later another device appeared, the Kinect, from Microsoft (Microsoft Corp., Redmond, Washington) which allows you to control the game with your own body, without the need for any other device..
But the introduction of virtual reality in video games is not only a matter of large companies, some of the best devices have been created by small companies and financed by Kickstater, such as the Oculus Rift glasses or the Razer Hydra sensor..
The development of virtual reality games is not only used for leisure, they can also be used to stimulate or rehabilitate the patient, a process that in psychology is called gamification.
Next, some examples of the use of virtual reality to rehabilitate patients through gamification will be described..
Virtual reality is very useful to treat some psychological disorders that are caused in part by the patient's lack of control of some variables, such as anxiety disorders or phobias.
Thanks to virtual reality, they will be able to train, and gradually decrease their control over the environment, knowing that they are in a safe context..
In research it can also be very useful, since it gives the possibility of controlling all the variables of the environment, which makes the experiment highly replicable. In addition, it allows modifying variables that are not modifiable in the real world or that would be difficult to modify, such as the position of large objects in a room..
Although virtual reality is used in more and more different areas, one of the fields where it has been used the most, and continues to be used, is in the training of professionals, such as airplane pilots or workers at nuclear power plants..
Here, virtual reality is especially beneficial, as it reduces training costs and also guarantees worker safety while training.
Another field where it is being used more and more is in the training of doctors, especially surgeons, so as not to have to use corpses as is done in the usual way. In the future I trust that all universities will have training with virtual reality.
Traditionally, the lack of balance (either due to age or a disorder) has been rehabilitated using a system composed of three pendulums.
The exercise performed is very simple, the balls at the end of the pendulum are slowly thrown towards the patient, who must dodge them and return to their original position. The use of three pendulums prevents the patient from predicting where the next ball will come from.
This system has a series of limitations, firstly, it must adapt to the morphological characteristics of the patient (height and width) and, secondly, it is necessary to control the speed with which the balls are going to be thrown, this aspect depends on how fast the patient is to dodge the ball.
These adjustments must be made manually, which can be tedious and inaccurate.
Other limitations are the high cost of the machinery and the large space necessary to install it, which most doctors or therapists do not have..
Creating a virtual representation of this machine can solve all the problems discussed. Using virtual reality, the size and speed of the balls can be adjusted automatically, and there is no need for such a large space for installation..
In a study by Biedeau et al. (2003) found that there were no significant differences between the scores of the participants in the traditional balance test and the virtual reality test.
Although if it was observed that the movements of the participants were not the same in both conditions, they used to be slower in virtual reality, possibly due to the delay of the virtual reality program.
The main limitation that was found was that the participants did not receive any feedback in the virtual reality program if the ball had touched them or not, but this problem can be solved simply by adding a kind of alarm or sound signal each time this occurs.
Thus, it can be concluded that the use of virtual reality for the evaluation and treatment of patients with balance problems is useful and reliable..
Rehabilitation after suffering a stroke takes place while the person is admitted to the hospital. When he is discharged, this rehabilitation does not continue, although normally the patient is advised to do a series of exercises, from the program called GRASP.
GRASP (Graded repetitive arm supplementary program) is a program that includes physical exercises to improve the mobility of the arms and hands after suffering a stroke.
In a study by Dahlia Kairy et al. (2016) compared the improvements of two groups of participants, one received traditional therapy, rehabilitation in the hospital and GRASP at home, and another with virtual reality and tele-rehabilitation, rehabilitation in the hospital and a virtual reality program at home monitored by a therapist.
The authors concluded that virtual reality and telerehabilitation had been more useful than traditional rehabilitation, increasing patients' adherence to therapy, for two main reasons. The first is that they were monitored by therapists and the second is that the patients found it fun as they saw it as a game.
Multiple sclerosis currently has no cure, but there are several therapies that are applied to improve the functioning, both motor and cognitive, of patients and thus be able to stop future attacks.
These therapies include medications and physical and neuropsychological exercises. Studies carried out so far indicate that there are some symptoms that improve with therapy, but there are no positive results in terms of slowing the development of the disease (Lozano-Quilis, et al., 2014).
These therapies have two important limitations, the first is that motor exercises must be performed with an assistant and many repetitions are required, so sometimes it is not possible to perform them (because there is no assistant) and the patient is not very motivated, which is why their adherence to treatment is quite low.
Second, cognitive exercises must be performed in a specific center, under the direct supervision of a therapist, which can present a high cost both in time and money for the patient (Lozano-Quilis, et al., 2014).
A review carried out on the studies carried out so far in which the use of virtual reality in the rehabilitation of patients with multiple sclerosis was analyzed found quite positive results (Massetti, et al., 2016).
Regarding motor functions, it was found that the interventions in which virtual reality was used increased mobility and control of the arms, balance and the ability to walk.
Improvements were also shown in the processing of sensory information and in the integration of information, which, in turn, increased the anticipation and response mechanisms of postural control..
The authors concluded that the therapies that included a virtual reality program motivated the participants more and were more effective than traditional therapies applied to people with multiple sclerosis, although they consider that more studies need to be carried out on the virtual reality programs of the what we have.
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