Virtual reality - game, treatment, life. VR technology at the service of rehabilitation medicine

    Spending hours playing computer games is not only an activity for professional e-sportsmen or amateur gamers. There are people to whom the immersion in virtual reality is prescribed by the attending physician. Much more depends on their success in the game than reaching a new level or owning a painted artifact. For them, virtual reality is a simulator that provides quality of life, its comfort, and sometimes duration. Welcome to the world of VR rehabilitation.

    Graphic technologies familiar to modern computer games have been used in medicine for a long time. This is not often written and talked about, because the scope of their application is not the most popular for the Russian media. But the significance of such developments from this does not become less.

    Thousands of people in the country need rehabilitation using virtual reality technology. Hundreds of them receive such assistance and, with their own example, confirm its effectiveness. Several domestic start-ups and scientific medical centers are trying to satisfy the market demand for simulators and VR rehabilitation programs. But while such companies are too few to fill a niche that will only grow in the coming years. Although the results achieved already now demonstrate market prospects and, of course, the value for those who need rehabilitation.

    Motorika company develops and manufactures technologies at the intersection of medicine and robotics. The main product is hand prostheses for children and adults. In addition to mechanical traction prostheses, Motorika successfully produces complex and very high-tech bionic devices, the functionality of which actually turns its owner into a cyborg. A person can control such a device almost as well as with a living hand, using the same muscles and nerve endings.

    But in order to fully master the bionic prosthesis and use it confidently, it takes months of training and rehabilitation. In order to facilitate and improve this work qualitatively, the Motory programmers created the ATTILAN digital rehabilitation platform .. At its core, this is a video game for a VR helmet with a consistent plot. Players will visit the orbit of Mars, inside the ATTILAN international space station and prepare for the upcoming colonization of the planet.

    But the tasks and difficulties awaiting them next to the Red Planet are constructed in such a way as to teach how to use bionic prostheses. Players here walk around the station, perform small household tasks, manage cargo and shoot. For various rehabilitation measures, different game characters are provided: engineer, scientist, spaceship pilot.

    Management is carried out using the same muscles that control bionic prostheses. Special sensors detect the tension of the muscle fibers of the forearm and transmit data to the program. The player sees, for example, one “living” hand and one futuristic prosthesis with which he moves, squeezes and unclenches his palm, picks up and carries objects due to the correct work of the muscles of the remaining part of the amputated arm. That is how in the future the player will control his bionic prosthesis in the real world.

    In the ATTILAN game, Motorika implemented one of the most innovative and modern methods of preparing for prosthetics. But in medical rehabilitation, virtual reality technologies, as mentioned above, have long been used in other areas. For example, to restore patients with impaired motor function due to brain damage. Such rehabilitation is often necessary for people who have suffered a stroke or other vascular disease that harms the brain.

    The Istok-Audio group of companies is the Russian leader in the production and distribution of rehabilitation aids and assistive devices for the deaf. But the scope of the enterprise is constantly growing and today applies to people with disabilities of all nosologies. One of Istok-Audio's new developments is the Devirta Delphi virtual rehabilitation program.

    Devirta Delphi is a virtual cyberspace with its own 3D world, for immersion in which, like in ATTILAN, you need a VR helmet and touch sensors that provide biological feedback (BFB). Here the technology is even more interactive - the patient’s computer avatar repeats human movements in the virtual world, which creates the appearance of real interaction with the surrounding space and additionally motivates.

    People who have suffered brain damage are prescribed medical rehabilitation in the form of simple daily exercises. “Devirta Delphi” controls their process and allows the patient to see the result of his efforts, feeling himself the main character of each lesson.

    The Rehabunculus service, provided today by the specialists of the Scientific Center for Neurology and the Intellect and Innovation company, works in a similar way. When creating this simulator, the developers limited themselves to virtual space, without biological feedback. Unlike Devirt Delphi, Rehabunculus does not require touch sensors, it is easier to use, but serves the same purpose - it provides the necessary amount of physical activity for every day.

    “The opportunities that virtual reality provides allow us to use some features of the human body, in particular, brain neuroplasticity,” explains Yegor Tokunov, general director of Intellect and Innovation LLC and project manager of Rehabunculus. “Specially selected technologies and algorithms strengthen recovery mechanisms and make the patient’s body work in the right way. Thus, a virtual reality inspires a person with impaired motor functions that he can do more than actually increase motivation for rehabilitation exercises. ”

    But doctors and developers from the Samara State Medical University went much further, transferring the usual VR-rehabilitation to the plane of neurorehabilitation. Their ReviVR neurotrainer puts on its feet in the literal and figurative sense. In the virtual world created by the Samara State Medical University programmers, people with severe motor impairment walk again, see their legs, hear steps and even feel each one of them. In addition to the image and sound, the simulator provides tactile accompaniment.

    During a rehabilitation session, virtual reality glasses are put on the patient’s head, and special pneumatic cuffs are put on the feet, which simulate the pressure of the ground on the feet when walking. In the VR helmet, the patient sees himself in the first person in an upright position and moves independently. The illusion of movement activates certain muscle groups that stimulate brain activity.

    The experience of medical rehabilitation indicates that neuronal connections are restored during game stimulation of brain activity. Such recovery is possible thanks to the same mechanism of brain neuroplasticity. ReviVR is designed to be the key to launching this mechanism.

    The same team of Samara State Medical University developed another neurotracer with a completely different task, but with the same mission - to help people with disabilities. The ReviMOTION program is designed for children with cerebral palsy or other impaired motor activity.

    Rehabilitation with the ReviMOTION neurotracer is even more like a computer game. With its help, patients perform a course of physical exercises in an easy playful way. Correctly executed movement makes the virtual character move and go through level after level.

    At the same time, the attending physician can use the optical tracking system and movement analytics provided in the simulator to track progress, and the built-in information-analytical system will help him “lead” the patient from session to session throughout the entire rehabilitation course.

    “We proved the effectiveness of the application as a result of the first clinical study on the basis of one of the centers,” said Alexander Zakharov, associate professor at the Samara State Medical University, Department of Neurology and Neurosurgery. “Now we have connected dozens of such medical centers in Russia. No one has yet conducted research on the effectiveness of using technology to restore the movement of the lower extremities of this magnitude in the world. We plan to justify the effectiveness of VR rehabilitation in other pathologies. ”

    The experience of domestic and foreign rehabilitation practice demonstrates that solutions based on virtual reality technologies can help people with health problems recover and adapt, improve their coordination, balance and body control skills. It is reliably known that the characteristics of motion performed in real space do not differ significantly from motion in a virtual environment. Thanks to this, a person, even in an early course of rehabilitation, regains confidence in his actions and strengths, and the skills acquired in the VR world are much easier to then form in the real one.

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