How VR is Helping Doctors Improve

With the launch of large-scale projects like Metaverse, virtual reality (VR) has skyrocketed into the spotlight as a next-generation technology. VR is a simulated experience that uses pose tracking and 3D displays to give the user an immersive feel of a virtual world from anywhere in the world. The VR experience usually involves a headset that fits over one’s head and is worn like goggles. The virtual world one can experience is becoming limitless, and with the right complementary devices, you’re able to walk around and manipulate objects in that world.

While VR typically associated with the gaming and entertainment industries, it continues to be a tool that is revolutionizing the healthcare industry. VR is helping the doctors (and in turn their patients) in a multitude of ways, including patient education and communication; medical training and surgical efficacy; mental health treatment; and pain management and physical therapy.

PATIENT EDUCATION & COMMUNICATION

VR is helping doctors communicate and educate their patients in a variety of ways. A review article published in Patient Education and Counseling found that VR interventions enhance understanding and compliance with treatment plans. VR has helped close knowledge gaps between healthcare provider and patients, deepening patient understanding by simplifying complex scientific information and treatment instructions. In a cross-sectional study published in Annals of Vascular Surgery, 89% of patients agreed or strongly agreed that they felt better informed about their health status after using VR and would like to see VR used more in their health care.

VR has also been associated with accelerating behavior changes and improving adherence to medications and other assorted treatment plans. For example, a study published in Health Communication paired physical pamphlets with immersive virtual environments (IVEs) and VR in an ongoing health promotional campaign to reduce the consumption of soft-drinks in the population. Researchers found that that coupling IVEs with the pamphlet was more effective in accelerating the behavioral change. Nonadherence to HIV medications is an ongoing problem, and in a study published in the Interactive Journal of Medical Research, patients who were shown a 7-minute VR experience that visually explained their illness were found to be significantly more adherent to prescribed treatment plans.

MEDICAL TRAINING

There are devices being developed to increase efficiency and reduce the rate of complications in surgeries every year. While these tools are instrumental in helping patients, surgeons themselves must maintain their skills. Accurate and objective assessments, as well as adequate opportunities to consistently practice skills, can be a challenge for some surgical residency programs. According to a study conducted at the University of Michigan, 30% of surgeons couldn’t operate independently after residency. VR-based training systems offer physicians a solution to these challenges by providing an immersive experience to facilitate hands-on training that mimics the operating room environment. VR offers a portable training environment that can be used on-demand to guide learning, track performance, and analyze procedures.

Researchers at UCLA’S David Geffen School of Medicine that VR is a useful method to strengthen orthopaedic education. Published in the Journal of Surgical Education, they conducted a randomized trial evaluating first and second-year medical students without prior experience of the surgical technique for tibial shaft fracture intramedullary nailing (IMN). The participants were randomly assigned standard guided training or VR training and were observed performing simulated tibia IMN procedure immediately after training. Comparing the two groups, aggregate global assessment scores and the percentage of steps completed correctly were significantly higher in the VR group.

MENTAL HEALTH AND BEHAVIOR THERAPY

It was estimated that around 4.14 million adults in the U.S. were receiving mental health treatment in 2020. With the increasing demand for mental healthcare professionals, VR has offered both patients and providers a potential relief from barriers to access to care. According to chief clinical officer at BehaVR Risa Weisberg Ph.D., “These experiences, because they are fully immersive and processed as though they are actually happening to you, have promise to potentially show clinical effectiveness that may be more comparable to that of some in-person therapy, but with the flexibility of being utilized without a clinician present.”

VR has been applied in conjunction with counseling and cognitive behavior therapy (CBT) for the treatment of addictions, posttraumatic stress disorder (PTSD), agoraphobia, panic disorders, and more. A review of the history and current applications of VR in the mental healthcare sector, published in the Industrial Psychiatry Journal, explained several of the methods used to incorporate VR in modern treatments. For example, PTSD patients have been treated using VR to expose to the source of their disorder in a safe environment with the justification that gradually being exposed to the source of their PTSD linked with relaxation training techniques can enable the patient to adapt to the stress and overcome the negative feelings.

In other study, published in The Lancet Psychiatry¸ researchers at the University of Oxford evaluated the efficacy of an automated VR cognitive therapy (nicknamed gameChange) to treat avoidance and distress in patients with psychosis. The parallel-group, single-blind, randomized, controlled trial assigned patients to either gameChange VR therapy plus usual care or usual care alone. Compared with the standard care alone cohort, the gameChange VR therapy group had significant reductions in agoraphobic avoidance at six weeks of treatment. Researchers also found that patients in the gameChange cohort had reduced anxiety and distress caused by everyday situations. “The mediation analysis indicated that the VR therapy worked in accordance with the cognitive model by reducing anxious thoughts and associated protective behaviors,” researchers noted.

PAIN MANAGEMENT & PHYSICAL THERAPY

Among VR’s many real-world applications, it has also been used to address issues regarding access to supervised in-person rehabilitation, such as pain management services and physical therapy (PT). In-office PT visits can be costly, particularly when they are prescribed at 2-3 day per week intervals.  VR provides a unique mode of delivery for both in-person instruction and/or remote consultations with physical therapists. Using VR, The Johns Hopkins University’s (JHU) School of Medicine’s Brain, Learning, Animation, Movement laboratory created an interactive videogame that could help rehabilitation in stroke victims. In the article published in The New Yorker, researchers detailed how the use of a robotic arm outfitted with a motion-capture camera, allowed patients to control the movement of a dolphin in the water with their arms. “You’re learning the ABCs again—the building blocks of action. You’re not thinking about your arm’s limitations. You’re learning to control a dolphin. In the process, you’re going to experiment with many movements you’d never try in conventional therapy,” professor of neurology and neuroscience and lead research at JHU’s School of Medicine John Krakauer, said.

There is substantial research that supports the use of VR for the management of acute pain during and after procedures. A study published in The Journal of the International Association for the Study of Pain, VR was found to decrease the level of pain, discomfort, and anxiety in patients receiving care for burn wounds. Additionally, the same researchers conducted another study (published in The Clinical Journal of Pain) investigating the use of VR to distract patients at a burn care unit to distract patients from pain during PT sessions. Comparing the use of pharmacologic analgesia alone versus VR in addition to analgesia during PT, patients in the VR group reported lower ratings of pain and an increased range of motion.

More research needs to be done for the efficacy of VR-use in the attenuation of chronic pain; however, several promising studies have offered a promising future for VR. Researchers at the Okayama University Graduate School of Medicine and Dentistry developed a VR mirror visual feedback system and applied it to the treatment of complex regional pain syndrome. “Mirror visual feedback therapy aims to restore normal cortical organization and is applied in the treatment of chronic pain conditions,” the authors explained. Five complex regional pain syndrome patients were included in the study and received VR mirror visual feedback therapy (in addition to previously prescribed medications) once a week for five to eight sessions. Of the five patients included in the study, four patients showed >50% reduction in pain intensity.