How AR andVR Could Improve Manual Therapies(MTs) Effectiveness

MedTech Outlook | Monday, May 09, 2022

VR and AR applications could help patients overcome their fear of movement by exposing them to painful activities.

FREMONT, CA: VR and AR could benefit MTs in various ways, particularly in the treatment of pain and pain-related disability. For example, appropriate VR designs have been shown to provide analgesic outcomes as they can easily capture the attention of users, shifting their cognitive resources away from their body and toward virtual tasks, effects that may result in pain reduction, Given that the mere thought of a movement can cause pain in some conditions (e.g., complex regional pain syndrome) VR and AR applications could recreate the stimuli that cause pain in the same way that they do for phobias and cravings.

A specific simulated environment depicting various types of postures, movements, or situations could assist therapists and patients in better understanding when and how pain occurs. In addition, this type of simulation could show postures/movements from both first and third-person perspectives: in the former, appropriate kinesthetic and proprioceptive devices could be crucial to elicit the sense of body ownership efficiently; in the latter, observation of another person or avatar would activate the mirror neuron system, an essential mediator for successful sensorimotor rehabilitation using VR.

The same simulated environment could help reduce pain-related experiences in the same way, RHI, mental imagery, and mirror therapy do. Indeed, virtual reality and augmented reality (VR/AR) have the potential to revolutionize these and similar interventions by creating highly realistic immersive environments and reproducing an authentic embodied experience through the induction of visual, auditory, olfactory, tactile, and even interceptive signals.

The triggering stimuli can be tailored to the needs of the patients using VR and AR by varying their intensity, duration, and repetition. So on. Even though this has yet to be tested, the simulated stimuli may even outperform reality (e.g., impossible body postures), favoring better results with greater ease. Indeed, VR and AR reduce pain in phantom limb pain and complex regional pain syndrome (CRPS).

VR and AR could assist therapists in improving the effectiveness of pain neuroscience education and other programs to teach the most recent discoveries about the complexities of pain. Using virtual simulations, patients could see how the nervous system works and understand the difference between simple nociception and complex phenomena like central sensitization, which play an essential role in chronic pain. Because changes in the brain's sensorimotor bodily maps are involved in chronic pain, virtual reality could help patients see those maps. Furthermore, therapists may show patients, 3D interactive models of body anatomy, such as models of the intervertebral discs, removing false beliefs about anatomy (e.g., slipped discs) that may cause pain through fear, nocebo effects, or other neural mechanisms. While patients are distracted by VR applications, therapists could simulate ostensibly painful movements and then inform patients that the movements were carried out with little or no pain.

As therapists may record themselves to better show patients how to perform therapeutic exercises, VR systems could record patients and send their data to therapists—this would be especially useful for patients who cannot reach the therapists' clinic due to a health-related disability or live a long-distance away.

However, careful control and protection of patients' data are required to ensure their privacy, especially if third parties are involved in the applications.