Title: Virtual Reality-Based Assessment and Treatment Interventions for the Combat-Injured Service Member
Name, credentials: Christopher A. Rábago, PT, PhD
Affiliation: 1) DoD-VA Extremity Trauma and Amputation Center of Excellence and 2) Center for the Intrepid, Brooke Army Medical Center, Fort Sam Houston, TX USA
Name, credentials: Alison L. Pruziner, PT, DPT, ATC
Affiliation: 1) DoD-VA Extremity Trauma and Amputation Center of Excellence and 2) Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD USA
This presentation will highlight clinical cases and empirical results from virtual reality (VR)-based rehabilitation programs at two military medical facilities. These programs utilize VR environments to detect and treat functional deficits often difficult to address with standard clinical methods. Injured service members seen at these facilities are often young and highly fit at the time of their injuries. Their injuries include single and multiple limb traumas such as amputation, burns, and limb salvage. Despite the severity of these injuries and associated co-morbidities, these individuals commonly set rehabilitation goals that include a return to competitive sports and/or military duty. Deficits described by these individuals, that can limit the achievement of these goals, can be difficult to detect and quantify with conventional clinical measures. Novel VR-based assessments, developed by our clinical research team, have helped identify functional deficits across multiple domains using ecologically-valid tasks. Further, VR-based treatment applications have been designed to address these deficits and progress patients toward their goals. In general, we have found that service members following traumatic brain injury, amputation, and severe limb trauma demonstrate significant increases in function with VR therapies. These VR interventions are based on well-established therapeutic techniques and can be used to promote functional interactions with challenging environments while maintaining full safeties and controls.
Title: Virtual Reality Technology for the Clinician
Name, credentials: Professor Grigore C. BURDEA PhD
Affiliation: Rutgers University, USA
Virtual reality technology has progressed substantially in recent years, with system costs diminishing. Adoption has been mixed, and sometimes without a strong body of research, which certainly poses safety risks for the patient and professional challenges for the clinician. While building a strong body of data that would lead to “best practices” will take time, this Workshop can assist by giving a broad and unbiased coverage of the technology and predicting trends for the future. Practical issues with adoption will also be discussed, as well as cost considerations.
Title: Developing innovative home-based telerehabilitation strategies for post-stroke rehabilitation
Dahlia Kairy, PT, PhD
Assistant Professor, School of Rehabilitation, Université de Montréal
Philippe Archambault, OT, PhD
Associate Professor, School of Physical and Occupational Therapy, McGill University
The proposed workshop aims to introduce participants to innovative ways in which telerehabilitation can be used to provide rehabilitation services at different stages of the stroke continuum of care, in particular for home care. The evidence regarding the use of telerehabilitation for home-based post-stroke rehabilitation will be introduced. Participants will also consider ways in which services can be optimized by combining telerehabilitation with other technologies, including virtual reality, to provide services in the patient’s home at different stages in the rehabilitation process (functional rehabilitation, community reintegration, chronic stage) and for different rehabilitation professionals, in order to address current gaps in services. Examples of current projects underway will be presented. In addition, participants will be introduced to relevant quantitative and qualitative evaluation strategies for different stages of telerehabilitation development and implementation. Barriers to implementation in clinical practice and strategies to overcome these will be discussed.
Title: Incorporation of motor control and motor learning principles into VR applications
Mindy F. Levin, PT, PhD
Professor, School of Physical and Occupational Therapy, McGill University
Sandeep K. Subramanian, PT, PhD
Post-doctoral fellow, Department of Neuroscience, University of Montreal
Maxime T. Robert, MSc
PhD candidate, Integrated Program in Neuroscience, McGill University
The primary focus of rehabilitation for individuals with motor deficits is the relearning of specific motor skills and daily tasks. Rehabilitation strives to take advantage of neuroplastic processes during recovery, a process that can be addressed by creating enriched training environments using virtual reality (VR) based simulations.
The objectives of this workshop are to review motor control and motor learning principles, to discuss how they can be exploited by VR training environments and to provide examples of how these principles have been incorporated into different VR simulations for improving upper limb motor recovery. The workshop includes a practical component in which participants will design a specific intervention for improving a typical motor problem incorporating motor control and motor learning principles, in both a VR-based and a non-VR-based clinical application. Finally, we will discuss the limitations of the current technologies with respect to their effectiveness and transfer of learning to daily life tasks.