Integrating virtual reality into physical therapy

Integrating virtual reality into physical therapy
Dr. Jamie Gehringer, a research assistant professor at UNMC Munroe-Meyer Institute in Omaha, uses one of the many virtual reality games programmed to help children use their arms and improve range of motion during physical therapy. (Nebraska News Service)
October 18th, 2021 | Caitlyn Thomas, Nebraska News Service

OMAHA–Physical therapy can help improve the range of motion and coordination in many children with disabilities. But, when the tasks become too simple or less stimulating, it can be difficult to continue.

Jamie Gehringer, a research assistant professor at UNMC Munroe-Meyer Institute in Omaha, wanted to find a way to incorporate technology into physical therapy in order to make it fun and appealing for children. He came up with the idea of using virtual reality in a medical setting. The Institute offers services like physical therapy, occupational therapy, psychological services, genetic evaluation and more.

With a bachelor’s in computer engineering and a graduate degree in medical sciences, Gehringer studied how the brain responded to various stimuli, specifically physical therapies. 

“My research focused a lot on movement sciences,” Gehringer said. “There was a lot of focus on neuroscience, how the brain controls movement and the associated sensory feedback.”

Gehringer, whose younger brother has Down syndrome, said he saw situations in his everyday life where assistive technologies could be useful.

“I grew up going to therapy appointments with my brother,” Gehringer said. “I would see what the therapist would do just to try to keep different people engaged.”

The physical therapy that Gehringer focuses on is arm and hand movement. He said that in children with autism spectrum disorder (ASD) and cerebral palsy – the two disabilities Gehringer’s program focuses on –  it can be hard for them to use both hands to complete tasks. 

In a regular therapy session, a physical therapist might put a bunch of paper towels in a paper towel tube and have the kid pull them out as fast as they can, which forces the child to move their arms apart and complete different tasks with each arm, one holding the tube still and the other grabbing and removing the paper towel. 

“As you can imagine, that got pretty boring pretty quickly,” Gehringer said. “With VR (virtual reality), we are able to take that task and turn it into a game where you’re pulling plungers out of the back of rockets to activate them to shoot at targets.”

Ryan Thomas, a lab technician at the MMI helps Gehringer design and program these games. For Thomas, being able to work on this is also personal.

“I think my shared experience with Jamie with having a brother who has a disability, it’s really cool what Jamie is working on and developing,” Thomas said. “We both know through personal experience that if our brothers had had something like this earlier on when they were growing up that it would have helped their development.”

Since most children between the ages of 11 and 18 spend an average of two hours a day playing video games, Gehringer said that the appeal of VR and the excitement of playing a video game helps them feel better about physical therapy and helps their motor control while they do it. 

In the VR lab at the Munroe Meyer Institute, Gehringer has tech that uses VR to put the user in an everyday situation, like crossing a street. It also has 3-D motion capture that helps them design the characters for their games and finally an open space in the middle of the room where the user is put into the virtual world and plays games.

A big part of the VR therapy that Gehringer does is called HABIT (Hand Arm Bimanual Intensive Therapy). 

“The difference between normal HABIT, which is using both hands to perform a task, and VR HABIT is that you’re using both hands to perform a task in a game, which makes it more enjoyable,” Thomas said.

The eventual goal for Gehringer and Thomas is to take the VR therapy out of the clinical space and have it available in the homes of those with disabilities, making it more accessible for the families

“It’s a really fun opportunity to use such new technology with VR in a way that hasn’t been done,” Thomas said.” Especially for a group of kids that can really benefit from it.”

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