Introduction To Integrating Virtual Reality Into Physical Therapy

Written by: Arik Yates, PTA

As a Physical Therapist Assistant, it is my goal to not only pursue the best practice but keep an eye open for new and intuitive approaches to achieving functional goals. I never imagined that Virtual Reality (VR) would become as prevalent as a modality within my treatments. Still, as the years go by, my affinity for VR continues to prove its merit. Regardless of the patient population, VR provides a unique approach and method of transforming the mundane into something spectacular. You may be asking yourself, "How does one integrate VR into physical therapy?"

Quite simple, actually. From the perspective of a Physical Therapist Assistant, I must strictly follow the plan of care written for the patients I am treating by the supervising Physical Therapist. Let's take a patient who was recently admitted to therapy and has goals of improving bilateral quad strength along with balance to achieve functional goals, such as reaching independently to the top shelf of their pantry. This would be a perfect candidate for VR. But before we get to integrating exercises into their sessions, we need to ensure the patient does not have seizures secondary to visual stimulus. If this happens to be the case with the patient, VR is a no go due to the sensitivity of visual stimulus, bright lights, etc. If the patient has a history of a seizure but is controlling it with medication, get clearance from their referring physician before administering VR. With approval and contraindications looked at, let's get to the integration of virtual reality into their session.

With VR, I can directly work on both bilateral quad strength and balance simultaneously, saving time due to performing within an immersive, fully simulated environment rather than traveling to different stations in a treatment setting. All VR requires is a head mounted display (HMD) donned by the patient and Neuro Rehab VR’s unique tablet integration allows manipulation of exercises by the therapist. The time saved can be used for extended breaks for the patient, more time spent addressing goals or even documenting your session.

To work towards balance, Neuro Rehab VR has two specific therapeutic applications that come to mind instantly; Fowl Play and Retail Therapy. Fowl Play can be used to perform squats or sit to stands with a metronome backdrop caused by cannonball fire; sounds crazy, right? Well, the good thing about the cannonball fire and cannonballs coming towards the patient, is that it provides a visual stimulus and reason for performing squats or sit to stands; to dodge the cannonballs! By gamifying these exercises, I have seen improved focus, mindfulness, and willingness to push past fatigue just to get a higher score. The speed of cannonballs to the rate at which they fire can be altered in real-time by the therapist via a tablet connected to the headset. 

In Retail Therapy, the patient is tasked with reaching for objects at various heights and outside of the patient’s base of support within the aisles of a grocery store, this can be performed from sitting or standing positions. So not only is the patient tasked with completing their functional goal written within their plan of care, but they are also performing said goal in a very functional environment rather than an unfamiliar therapy gym separated from the environmental norms they are striving to get back to. 

It may seem daunting from the outside, but I hope this intro assists in easing you into understanding the benefits, time efficiency, and unique approach offered by VR when used in physical therapy. In the next blog post, I will address more complex integration utilizing other equipment in tandem with Neuro Rehab VR's list of intuitive exercises. Stay tuned!