Primum non nocere
First, do no harm -Latin proverb
If thinking of virtual reality (VR), we perceive it as only the potential for entertainment, we are definitely right. On the other hand, we are wrong if we associate entertainment only with the game industry. Today, such sectors as retail, education, health care, military, engineering, or real estate use different forms of entertainment for learning purposes.
If we are innovative, we can introduce VR goggles to our professional training plans, and thus, not only improve our employees’ skills but also become more competitive on the market. One may wonder if we could talk about entertainment in the case of the medical industry, especially within the areas of rehabilitation, dealing with mental health problems, and physical disabilities.
To address the above issue, let’s get back to the past.
It occurs that the history of VR dates back to the 60s of the last century and, more or less successfully, has survived to the present time, when technological development allows it to enter the consumer market, providing experiences adequate to customers’ expectations. We should remember that such areas as medical care rather quickly began to benefit from the potential of this technology.
The prospects for VR/AR technologies over the next few years indicate that not counting games, healthcare will be the fastest-growing part of the VR / AR market.
Those who have experienced serious problems with health or the health of their loved ones know how important it is to act quickly. The time of immediate response, and not only in case of emergency, is important. Unfortunately, patients have to wait for weeks and months to get the help they need due to many obstacles that slow down the health care system; whereas, the patient should get medical or therapeutic help as soon as possible. It is important to point out that also motivation and building the right attitude have been recognized as healing factors. However, that part of the recovery appears to be the most difficult one.
The reason why it happens so stems from our way of thinking.
We often associate the rehabilitation process with schematic, dull, daunting, and even degrading programs. The younger the patient, the more difficult it is to get expected results. In that case, we should try some alternatives offered by innovative technologies such as VR. Don’t you think that VR experience will make working with a child easier? Of course, it will.
The possibilities offered by virtual reality in health treatment (of course, we can not consider all cases) are not only effective but also motivating, inspiring, and fun. I am not afraid to say that we are entering a time of entertainment in the service of medicine.
Therefore, we need to change our way of thinking. Dealing with mental health problems does not have to be associated with hard work to earn a reward. Patients can get better through new strategies. This time, we will see that easier means more effective.
Chapter I – THE PAST
In 1994, the New York Times described the case of a 5-year-old boy with cerebral palsy who learned how to drive his electric wheelchair through the VR experience. First, in the virtual world, he walked on the lawns and ice panes to be able to deal with school corridors or street crossings later. Although the application was purely practical, even then, there was a belief that the technology had a future, especially in the entertainment industry.
Nowadays, we know that VR technology has found numerous applications in other areas of industry as well. Therefore, we have to keep discovering its potential and trying its possible applications because virtual skating is not only fun but it has also healing power. Do you believe that it happened over 20 years ago? Nowadays, we can see that the technological capabilities of VR allow creating not only a deep, absorbing, and multi-sensory experience but also use it in many areas of the medical industry. Therefore, I dare conclude that therapy or rehabilitation can effectively be done by addictive gameplay.
What is interesting, also at the discussed time, they had already started to create simulations to treat mental health problems, mainly common phobias. A little later, in 1997, there was an attempt to address a more serious topic – the experience of war. This is one of the biggest challenges not only for human morality and mental health but also for the professionals who help soldiers to recover from post-traumatic stress disorder (PTSD) that develops in some people who have seen or lived through a shocking or dangerous event. An example of a VR simulation in which traumatic war experiences are shown was developed by the Virtual Environments Group at Georgia Tech Graphics, Visualization, and Usability Center. The Group first created a simulation that allows us to face the fear of flying or fear of heights (CC Gatech. edu, 2016, Fear of Fights Image), and right after that, it introduced Virtual Vietnam (CC Gatech. edu., 2016, Virtual Vietnam Image).
In that simulation, veterans suffering from PTSD could take helicopter combat and move in the enemy landing zone. The application was sent to the psychotherapists at Atlanta Veterans Administration hospital, giving them a previously unavailable opportunity to confront the patient with a stressful environment or situation.
Similar simulations, but more complex and realistic, have been created for veterans of the war in Iraq (Rizzo, Pair, et al. n.d.). The described attempts to use VR simulations in the treatment of mental disorders prove that the idea itself, its effectiveness, and a positive influence on the rehabilitation of veterans suffering from PTSD give the reason why VR applications should be developed and improved..
Chapter II – NOW & FUTURE
In the article Effects of conventional neurological treatment and a virtual reality training program on eye-hand coordination in children with cerebral palsy (Ji-won Shin et al., 2015), devoted to the scientific aspects of VR training for children, the authors indicated that a patient’s rehabilitation can take place everywhere, regardless of his presence in a specialized clinic or hospital. This is very important in the context of children’s enrollment in school. The new duties take the time needed for frequent meetings with a specialist. It turns out that the same or even better results young patients can achieve through training based on appropriate VR applications.
What does the notion of ‘appropriate’ mean? It means those applications which help a patient to gain control of his or her body, improve motor skills and perception. The financial aspect of the action is also significant when we compare the time, the costs and results needed in regular clinical circumstances with the requirements set by the VR use – another vote for VR. It is likely that new applications supporting the treatment of specific diseases will be available to those who need them for healing purposes.
Although earlier we could just admire how people tried to use VR to treat traumas and phobias such as claustrophobia, agoraphobia, or acrophobia, the rapid technological progress we are witnessing today makes the experience of VR more realistic and increases our ability to control our avatar (our interaction in a virtual world) – better and more precise.
In addition, immersive VR experiences give the patient a sense of security, everything is done in a fully controlled environment, where he or she can face his or her fears and learn how to deal with them. During a VR session, the patient finds how to face difficult situations instead of avoiding them. A key therapy factor contributing to the success is that the patient stays in a private and secure space for the whole time of a VR simulation, which can be stopped and repeated any time.
Depression vs VR
Recent research conducted by UCL and ICREA-University of Barcelona showed that virtual experience in which we give and get sympathy or compassion reduces critical attitude towards ourselves and helps prevent depression.
The experiment was simple: the subjects were instructed to comfort a troubled child that was sitting in a virtual room. Then, they could see themselves and listen to their own, warm, compassionate words from the child’s perspective. By participating in this simulation, they could offer themselves something they do not experience on a daily basis because of their excessive criticism towards themselves. After the experiment, the clinicians agreed that VR experience allowed improving the mental condition of four patients, and VR simulation interventions may have substantial clinical potential. Therefore, there’s a justified need for the further development of this technology (Falconel et al.,2016).
Another groundbreaking program, possible by the VR experience, is the treatment of pain.
The end of the 90s of the previous century brought us also another application called Virtual Reality Pain Reduction. It was intended to help victims of severe burns by reducing the sensation of pain that accompanied the treatment of wounds and appeared mainly during routine hygiene actions. The fact is that the pharmacological treatment of pain is sufficient only in a situation where patients can rest. During daily dressings change or wound cleaning, it did not work. The younger the patient was the more difficult the problem was. Therefore, during the treatment times, the sufferers could engage their senses (so in broader context attention of the whole brain) in experiencing adventures simulated in the virtual world, which greatly decreased their experience of physical pain (Gromala, 2016).
If VR can help us cope with physical pain and, when properly used, has a positive effect on our psyche, increasing our motion efficiency, it seems just a matter of time to develop more complex devices that will allow patients quicker and more pleasant recovery. An example of such a device is MindMotionPRO, which has been approved for use in European hospitals recently. Dedicated to stroke ridden patients, it enables a systematic and individualized training, without involving additional hospital staff. Moreover, it maintains motivation by gamification and varied levels of difficulty, and, it sends real time messages of the exercise accuracy. All of this for the quickest and most pleasant health regeneration of the patient.
One should be aware that rehabilitation is not the only benefit of using VR technology. It occurs that VR simulations also contribute to the improvement and development of our brain capabilities There are already applications that, by immersing us in the virtual world, have the potential to train and improve the work of our brain: memory, concentration, and multitasking abilities. Such assumptions had the creators of Cerevrum. Certainly, with the passing of time, more specialized training application will appear that will be able to respond to the specific needs or social problems.
One should not forget that there is also a continuously growing group of applications for medical industry that have no therapeutic or rehabilitation purpose, but strictly training.
Let’s not lie to ourselves: everybody knows that corpses are used for surgical practices. Then, there are countless hours of assisting at surgical operations to get sufficient experience. First, the novices have to watch simple surgeries, then more and more complex ones before they are allowed to work independently. Not always “opportunities” are available ad hoc, it is impossible to plan some activities. And now, with the use of VR, they will be able to watch complex treatments from the first person perspective because there are already professionals who make recordings of their operations.
Besides, through a virtual opeating table, they be able to deal with rare problems or situations that may occur during routine operations. And this is not about replacing something, but creating additional opportunities to practice skills, to train your reactions or let the young man face the consequences of wrong decisions.
In recent years we have witnessed great progress in medical science. We create maps of the brain, work out the DNA code, or create advanced prostheses. We really know a lot. When borders become thin, it is easier to find innovative solutions to important problems. More and more we understand how we work and we try to fix things that previously seemed impossible to fix.
We discover that complex problems may often have simple solutions – as in the case of using VR in many areas of medicine. Just a little bit of creativity and expertise is needed. The results of numerous experiments that engage VR, of which we mentioned just a few in our discourse, are convincing and make us believe that it is worth giving virtual reality a try.