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Virtual Reality solutions allow both healthcare professionals and patients to interact with simulated environments tailored for medical education (including simulative surgery training), pain management or rehabilitation. In 2020, the global healthcare VR market was estimated at $336.9 million. It is projected to grow at an average compound average growth rate of 30.7% and reach $2.2 billion by 2024. According to the Goldman Sachs Global Investment Research, healthcare is among the top 3 industries that will remain leading adopters of VR technology up to 2025. 82% of healthcare professionals agree that virtual reality creates a convenient way of accessing and learning information for medical students and practicing healthcare professionals, Accenture says. The agency also reports that 62% of patients would welcome virtual reality healthcare services as an alternative to traditional healthcare.
The key drivers of the growing VR adoption in healthcare are:
In this blog, I will explain the reduction of healthcare costs, due to the increased use of vr technology within healthcare procedures, such as pain management and rehabilitation. Investigators hypothesize that VR acts as a nonpharmacologic form of analgesia by exerting an array of emotional affective, emotion-based cognitive and attentional processes on the body’s intricate pain modulation system. There is substantial research supporting the use of VR for the attenuation of acute pain during medical procedures. Virtual reality pain management apps help lower the level of pain or extreme discomfort by effectively diverting a patient’s attention. This type of VR helps minimize the use of potentially harming painkillers and reduce healthcare costs. After being immersed in the VR simulation, a patient can either become a part of an interactive gamified experience or transferred to a highly realistic environment with a soothing atmosphere that, together with audio stimulation, helps put their mind at ease.
Burn wound treatment
The first example I would like to point out is the use of VR for pain and anxiety attenuation during burn care procedures and rehabilitation of burn survivors. It is one of the most widely researched uses of VR technology. Clearly, burn wound care causes a tremendous amount of pain, anxiety and discomfort to patients. In 2000, Hoffman et al. reported a case study examining the efficacy of VR compared with a standard video game for two adolescents (16 and 17 years old) undergoing burn wound care. VR was found to decrease pain levels, anxiety and time spent thinking about pain. Das et al. conducted a randomized control trial, comparing standard of care (analgesia) with analgesia plus VR for children (5–18 years old) during burn wound care. Analgesia coupled with VR was more effective in reducing pain and distress than analgesia alone. More recently, a water-friendly VR system was investigated during wound debridement for 11 patients (9–40 years), demonstrating that VR lowered pain ratings and increased fun ratings for those who reported feeling engrossed in the VR game.
Virtual reality technology has also been studied with burn patients undergoing physical therapy. Hoffman et al. examined the use of pharmacologic analgesia alone versus VR in addition to analgesia during physical therapy. Patients in the VR group reported lower ratings of pain and an increased range of motion. In another study, Hoffman et al. compared the use of VR to no distraction during physical therapy. After the VR condition, patients reported decreased pain and a greater range of motion. Sharar et al. reported results across three studies and concluded that VR in addition to standard analgesia reduced pain intensity, unpleasantness and time spent thinking about pain. Carrougher et al. found similar results among burn patients undergoing physical therapy/rehabilitation, with nonsignificant clinical improvements in range of motion.
VR for rehabilitation
By moving rehabilitation exercises into the virtual realm, VR turns patients’ therapy sessions into a gamified experience that motivates users to strive for better results via virtual goals and achievements. Software’s built-in AI can provide detailed guidance and inspiring support instead of a real therapist, allowing for cheaper and timewise flexible individual rehabilitation. The VR app guides a patient through their personal training program stored in the software database. A therapist can edit the program anytime as well as control the results – either via the app’s analytics module or by virtually joining the VR session as an instructor.
Researchers at the University of South Carolina (Vourvopoulos et al. 2019) combine the principles of VR and Brain Computer Interface (BCI) to treat chronic stroke survivors with different levels of motor impairment. Their multimodal approach uses virtual reality to show patients avatars of their upper limbs; then, combine brain (electroencephalography, or EEG) and muscle (electromyography or EMG) sensors and signals to visualize their attempted movement to perform the presented task. Over time, this has shown to improve the patients’ motor-imagery (their ability to imagine and plan movements), re-engage the motor circuits, and improve recovery of upper limb motor functions.
VR mediated therapy has also yielded significant improvements in gait rehabilitation following a stroke, according to de Rooij et al (2019). VR interventions to retrain gait frequently comprise treadmill training systems in combination with a screen or a head-mounted device to create an immersive environment. Additional biosensors such as Inertial Measurement Units (IMUs), force sensors, and EMG sensors are also used to track progress in the patients’ kinematics, movement dynamics, and muscle activation. Real-time visualization of these parameters allows therapists to provide patients with timely feedback on the progress and quality of tasks they perform, giving them the opportunity to understand and correct possible mistakes. Furthermore, the adjustable practice and customizable environments enable therapists to design dual tasks and unexpected situations, so that patients can relearn to adapt to environmental changes while walking. Results have shown that VR-trained patients can more effectively increase their gait speed as demanded by the task when compared to patients that underwent traditional rehabilitation. With practice, they can better adapt their gait with respect to the change in the surrounding environment.
Both examples show improvements on the patient’s recovery and rehabilitation process. The digitized creation of these procedures might also cause a shift in the protocols within healthcare institutions, such as hospitals. Procedures and core tasks of personnel can be executed by virtual reality devices, which leads to saving up a tremendous amount of costs, like training and educating new staff, labor expenses for the sector in general and various kinds of rehabilitation equipment.
Sources:
Carrougher GJ, Hoffman HG, Nakamura D, et al. The effect of virtual reality on pain and range of motion in adults with burn injuries. J Burn Care Res. 2009;30(5):785–791.
Das DA, Grimmer KA, Sparon AL, McRae SE, Thomas BH. The efficacy of playing a virtual reality game in modulating pain for children with acute burn injuries: a randomized controlled trial. BMC Pediatr. 2005;5:1–10.
Hoffman HG, Doctor JN, Patterson DR, Carrougher GJ, Furness TA 3rd. Virtual reality as an adjunctive pain control during burn wound care in adolescent patients. Pain. 2000 Mar;85(1-2):305-9.
Hoffman HG, Patterson DR, Carrougher CJ. Use of virtual reality for adjunctive treatment of adult burn pain during physical therapy. Clin J Pain. 2000;16:244–250.
Hoffman HG, Patterson DR, Carrougher CJ, Sharar SR. Effectiveness of virtual reality-based pain control with multiple treatments. Clin J Pain. 2001;17:229–235.
de Rooij I., Port I., Visser-Meily J., Meijer J. (2019). Virtual reality gait training versus non-virtual reality gait training for improving participation in subacute stroke survivors: Study protocol of the ViRTAS randomized controlled trial. Trials. 20.
Sharar SR, Carrougher GJ, Nakamura D, Hoffman HG, Blough DK, Patterson DR. Factors influencing the efficacy of virtual reality distraction analgesia during postburn physical therapy: preliminary results from 3 ongoing studies. Arch Phys Med Rehabil. 2007;88(12 Suppl 2):S43–S49.
Vourvopoulos A, Pardo OM, Lefebvre S, Neureither M, Saldana D, Jahng E and Liew S-L (2019) Effects of a Brain-Computer Interface with Virtual Reality (VR) Neurofeedback: A Pilot Study in Chronic Stroke Patients. Front. Hum. Neurosci. 13:210.
