Alan Frischer, MD, MPH
Many of us have had some exposure to virtual reality; perhaps through gaming, or in an escape room. VR is now finding a home in health care. Virtual reality technology allows us to simulate a situation or experience, and to interact in a computer-generated environment. It might use 3-D goggles with a screen, or gloves that provide sensory feedback, in order to help us learn from experience in a virtual world. Take a look at some of the evolving uses of VR in medicine:
Pain management: VR for pain control is one of the best-studied and most-used areas. VR has been used to reduce suffering from various sources of acute and chronic pain (including labor pain) by allowing patients to be distracted from their symptoms and from the fear related to the pain. For some, VR may offer a drug free alternative for pain control, which is especially relevant during this opioid crisis. It has provided an escape into the digital world for sick and injured children. Cedars Sinai has employed a “virtualist,” who evaluates whether VR might be suitable for a patient, and then tailors a prescription for the technology.
Physical therapy: VR has been effective in the treatment of stroke rehabilitation, Parkinson’s disease, cerebral palsy, and injuries. Using motion enabled programs, VR can reproduce physical movements and provide motivation. Patients can virtually practice real-life skills, like grocery shopping or dishwashing, and receive immediate feedback. A local skilled care facility in Downey has used a virtual bowling game and other virtual sports to get their patients moving.
Physical fitness: VR has been used in a number of fitness apps to encourage physical activity by making it more fun. Apps provide goals and rewards, give feedback on movement, or simply make it more enjoyable by immersing the user in a beautiful environment. I recently ran on a treadmill which allowed me to select my virtual location, and I chose to take that day’s run along the Merced River.
Mental health: VR is used to address anxiety and trauma. Psychologists might, for example, treat someone traumatized by a car crash with virtual exposure therapy to public streets. VR has been used to treat fear of heights and other ailments and phobias, including depression and post-traumatic stress disorder. Some medical centers are using VR to help chemotherapy patients escape from the discomfort, anxiety, or boredom of treatments.
Addiction: VR can be useful in addiction recovery, using gradual exposure techniques alongside coaching. It uses a person’s own environment to practice resisting their own common triggers, prior to encountering those triggers in the real world.
Memory and cognition: Studies show that VR can improve memory, cognitive, and motor function in patients with dementia.
Increasing empathy: Some hospitals use VR simulations to help health care providers better understand what their patients are going through. VR can simulate health conditions for ailments like dementia, Parkinson’s disease, or a migraine.
Surgery prep: Prior to the operation, surgeons have access to 3D renderings of hearts, eyes, knee joints, and other body parts. Surgeons can use feedback gloves to mimic the buzzing of saws and drills.
Medical training: Current medical training has shifted from memorizing facts to imparting real-life skills, and includes problem-oriented learning and communication skills. Virtually any kind of medical situation can be simulated. This is followed by feedback and debriefing. The VR environment is more immersive, interactive, and engaging than many other educational formats, and it has the potential to profoundly change medical education.
The medical applications of VR continue to expand, as the technology is advancing quickly, costs are dropping, and devices are smaller, faster, more reliable, and more affordable. I will be paying close attention to see where this field takes us.