Virtual Reality is an effective technology for the cognitive rehabilitation of patients with brain injury outcomes or disorders associated with neurodegeneration and dementia. In several clinical settings, the importance of Virtual Reality has proved to be the same (or more) of the classic rehabilitation methodologies.
Despite being in circulation since the 50s, it is still poorly represented in the medical and health fields but has a great therapeutic potential. Only recently has Virtual Reality received the right attention, especially thanks to the Oculus Rift.
Applications of Virtual Reality to cognitive rehabilitation
Virtual Reality allows you to experience the sense of presence: the user feels inside the experience and, through specific commands, can interact with the scene in which it is located. The sense of presence depends on the perceptive, emotional and cognitive processes associated with the virtual experience. The immersive virtual environment involves all the senses of the patient and gives the simulation an aspect of reality that can be perceived as authentic.
Virtual Reality increases the patient’s involvement in the environment by providing the clinician with unexplored rehabilitation possibilities. The interactive aspect and the mindset that recalls the “videogame” increases motivation and facilitates the recruitment of cognitive resources.
The virtual situations are able to determine body responses similar to those experienced in the real world variations in heart rate, skin conductance and peripheral temperature. The result is a high degree of ecological validity that brings therapeutic and rehabilitation situations closer to those of the real world. According to various neuropsychological theories, the interaction of the senses with Virtual Reality can generate inputs that, by reaching the neocortex, facilitate the modification of certain cognitive associations. A very early review of the literature indicated already in 2005 as the VR, for its important contribution in the rehabilitation of deficits resulting from brain injury would become an integral part of the therapy.
Parkinson’s disease and Multiple Sclerosis, Virtual Reality for the rehabilitation of the movement
The Michael J. Fox Foundation and the University of Tel Aviv have funded a pilot study to observe the gait of patients with Parkinson’s disease, a chronic and progressive movement disorder that can lead to immobility and falls. After 6 weeks of Virtual Reality treatment, the patients showed:
- greater resistance
- better navigation in a space with obstacles
- greater speed
- increased stride length
Patients also reported improved myocardial quality and fewer persistent falls at 4-6 weeks after treatment. Multiple sclerosis, caused by inflammation and subsequent damage to the insulating tissues of nerve cells in the brain and spinal cord, is another promising area of application. The motor rehabilitation of multiple sclerosis requires repetitive exercises and Virtual Reality has been used both in the evaluation and in the rehabilitation of these patients. The results (good) should be further investigated but Virtual Reality has already been recognized as useful for increasing patient motivation and engagement and as an effective alternative to classical cognitive and motor rehabilitation.
Alzheimer and dementia
Unlike Parkinson’s disease and multiple sclerosis, where we focused on the motor aspects, in the cases of Alzheimer’s the Virtual Reality had the goal of stimulating the interaction of patients with the surrounding environment. Research conducted to date has seen improvements in communication and mood in “non-verbal” patients.
Preliminary studies conducted on Mild Cognitive Impairment have also noted that Virtual Reality is effective in strengthening and training specific skills for the projected user, for example, in a virtual supermarket.