Virtual Reality helping patients get better

August 30, 2016

With the price of hardware falling, VR equipment has become a more affordable option for doctors.

Virtual reality isn't just about entertainment. Here are some ways VR is helping in the way medical professionals train, diagnose, and treat.

It’s still a new and experimental approach, but proponents of virtual reality say that it can be an effective treatment for everything from intense pain to Alzheimer’s disease to arachnophobia to depression. And as Facebook Inc., Sony Corp., HTC Corp. and others race to build a dominant VR set, the price of hardware has fallen, making the equipment a more affordable option for hospitals looking for alternatives for pain relief.

When people experience the virtual reality for the first time, a common reaction is to start imagining all the different uses the technology might hold. Even within one industry, healthcare, the potential is open-ended. The good thing is that scientists and medical professionals have been on the drawing board for years now, developing and implementing virtual reality in ways that can help them train, diagnose, and treat in myriad situations.

I was very surprised by it. I didn’t have the expectation of it working.

At Cedars-Sinai in Los Angeles, Ronald Yarbrough is waiting in a room that overlooks the hospital’s landing pad, hoping to see helicopter bring him a donor's heart. He needs a transplant after his artificial one failed and is being kept alive by a machine. He has been trying a Samsung Gear VR headset and specially created software from a startup called AppliedVR. It helped take his mind off the fact that he’s confined to a small hospital room that can feel like a jail cell. When his muscles relaxed, his pain receded, he said.

Proponents of VR are quick to point out that it could have a big benefit over drugs, which can lead to tolerance over prolonged use and sometimes addiction. But VR’s effectiveness still has to be proven, particularly when trying to combat chronic pain. Does the effect last when the headset comes off?

There’s a lot more research needed before VR is going to be widely accepted as a pain relief method. Brennan Spiegel, a gastroenterologist at Cedars-Sinai who’s also director of health services research at the Los Angeles hospital, is about to begin a study on many more patients. So far he’s experienced a range of reactions. Older patients tend to be less open to it than younger ones. One terminal patient refused to even consider it. One woman, who suffered abdominal pain, got such immediate relief that she went home and bought herself a headset.

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The price of a headset and software is small compared to the expense of keeping a patient in the hospital for more days

VR’s potential for use in pain management was discovered by accident. Tom Furness is a professor of industrial engineering at the University of Washington and considered to be the godfather of VR by his peers. He started looking into VR 50 years ago when he was in the Air Force and has spun off more than 20 research projects into companies. One of them was a 1993 consumer headset that relied on a TV tuner and video tapes that sold for $799. It was a commercial flop because of the limited content, but a lot of dentists bought it.

Here are just ten of the use cases that are currently in practice and continually developing, as the technology itself develops too.

Treatment for PTSD

Similar to exposure therapy for phobias and anxieties, virtual reality is being put to use to help soldiers with post-traumatic stress disorder (PTSD). A paper from the University of Southern California Institute for Creative Technologies cited virtual reality's use in PTSD treatment as far back as 1997 when Georgia Tech released something called Virtual Vietnam VR.

Surgical training

Training for surgeons usually involves cadavers and a gradual process of assisting more experienced doctors before taking over tasks and bigger portions of the surgery. Virtual reality could provide another means of practice, without any risk to real patients.

Stanford University, for one, has a surgery simulator that even includes haptic feedback for those doing the training. Stanford's endoscopic sinus surgery simulation uses CT scans from patients to create 3D models for practice, and it's been in use since 2002. While this technology doesn't use a head mounted display, the groundwork that's been done could further the effectiveness of future virtual simulations.

Opportunities for the disabled

It's not a new concept — the New York Times ran a story in 1994 describing multiple uses, like a VR experience that let a 5-year-old boy with cerebral palsy take his wheelchair through a grassy field, or another that let 50 children with cancer spend some time "swimming" around an animated fish tank.

In a more recent example, headset maker Fove, undertook a crowdfunding campaign to create an app called Eye Play the Piano which would allow kids with physical disabilities to play the piano using the headset's eye tracking technology.

Phantom limb pain

For people who lose a limb, a common medical issue is phantom limb pain. For example, someone without an arm might feel as though he is clenching his fist very tightly, unable to relax. Frequently, the pain is sharper than that, even excruciating. Past treatments have included mirror therapy, where the patient would look at a mirror image of the limb they still have, perhaps, and find relief as the brain syncs with the movements of the real and phantom limbs.

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Brain damage assessment and rehabilitation

CyberPsychology & and Behavior published a roundup for virtual reality experiences in use for not only assessing impairments but also in retreating them. One example has to do with executive function, or "impairments in the sequencing and organization of behavior and includes problems with planning," the paper said. Scientists created a virtual reality experience in which users had to reach the exit of a building using doors of different colors. It was supposed to be similar to the Wisconsin Card Sorting Task, a neuropsychological test where participants match cards. They're not told how, only if the match is right or wrong. "The authors concluded that their test measures the same cognitive functions as the WCST and may prove to be more ecologically valid," CyberPsychology & Behavior wrote.

Exposure therapy
One treatment for patients with phobias is exposure therapy. In one instance, psychiatrists at the University of Louisville are using VR to help patients deal with fears of things like flying and claustrophobia.

The VR experiences provide a controlled environment in which patients can face their fears and even practice coping strategies, as well as breaking patterns of avoidance — all while in a setting that's private, safe, and easily stopped or repeated, depending on the circumstances.

Social cognition training for young adults with autism

Professors at the University of Texas, Dallas created a training program to help kids with autism work on social skills. It uses brain imaging and brain wave monitoring, and essentially puts kids in situations like job interviews or blind dates using avatars. They work on reading social cues and expressing socially acceptable behavior. The study found that after completing the program, participants' brain scans showed increased activity in areas of the brain tied to social understanding.

Pain management

For burn victims, pain is an ongoing issue. Doctors are hoping distraction therapy via virtual reality could help them get a handle on that pain. A VR video game from the University of Washington called SnowWorld, which involves throwing snowballs at penguins and listening to Paul Simon, could alleviate pain during tasks that can be excruciating, like wound care or physical therapy, by overwhelming the senses and pain pathways in the brain. A 2011 study the military conducted showed that for soldiers with burn injuries from IED blasts, etc. SnowWorld worked better than morphine.

Opportunities for the homebound

There's a certain amount of fretting which surrounds virtual reality that has to do with what will happen when people can go anywhere and do anything through a VR headset — maybe they won't go anywhere in real life in favor of retreating into an ideal virtual world. The thing is, for those who don't have the ability to get out in the real world, whether they be disabled or elderly, virtual reality could improve their quality of life when they'd otherwise be confined to a single residence, room, or even a bed.

Meditation

One treatment for general anxiety can be meditation. A new app for Oculus Rift called DEEP aims to help users learn how to take deep, meditative breaths by making breathing the only control for the game. The app works with a band worn around the chest that measures breathing. The VR experience is something like being in an underwater world. Breathing is what gets a user from one place to another. The other benefit to the game is that breathing as a controller allows participation from those who might not be otherwise able to use a joystick or controller.

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