Advantages and limitations of virtual reality for balance assessment and rehabilitation

Abstract

Virtual reality (VR) is now commonly used in many domains because of its ability to provide a standardized, reproducible and controllable environment. In balance assessment, it can be used to control stimuli presented to patients and thus accurately evaluate their progression or compare them to different populations in standardized situations. In balance rehabilitation, VR allows the creation of new generation tools and at the same time the means to assess the efficiency of each parameter of these tools in order to optimize them. Moreover, with the development of low-cost devices, this rehabilitation can be continued at home, making access to these tools much easier, in addition to their entertaining and thus motivating properties. Nevertheless, and even more with low-cost systems, VR has limits that can alter the results of the studies that use it: the latency of the system (the delay cumulated on each step of the process from data acquisition on the patients to multimodal outputs); and distance perception, which tends to be underestimated in VR. After having described why VR is an essential tool for balance assessment and rehabilitation and illustrated this statement with a case study, this review discusses the previous works in the domain with regards to the technological limits of VR.

The effect of viewing a virtual environment through a head-mounted display on balance

“…In this condition, the only difference between the virtual and the physical environment is the added weight of the HMD, all other sensory information being the same. Wearing the HMD did not increase CoP displacements suggesting that the added weight of the HMD does not seem to affect balance (see Morel et al, [34] for similar results).…”

“…Large head movement are not well considered by HMD which could lead to conflict between vision and sensory information associated with the movement of the head. Latency of the HMD could also contribute to this sensory conflict and affect postural control, especially in dynamic tasks [34].…”

Exploring the Influence of Simulated Road Environments on Cyclist Behavior

“…Legrand et al (Legrand et al 2011) applied a stationary bike to study the capability of VR to enhance exercise performance, enjoyment, and dissociations. Morel, M.s team (Morel et al 2015) let patients ride a bicycle to follow a central line on a virtual road while keeping their centre of pressure stable. In these studies, the bike is used as an essential tool in VR for balance assessment or rehabilitation, but can be replaced by other forms of moderate-to-intense physical activity (e.g.…”

A method for creating interactive, user-resembling avatars

“…To mention but a few examples beyond the gaming scene, VR is now widely used in medical applications for physical rehabilitation (Paolini et al, 2013;Baldominos, Saez & Del Pozo, 2015;Draganov & Boumbarov, 2015;Morel et al, 2015;Donati et al, 2016;Shokur et al, 2016), exposure therapy for phobias and post-traumatic stress (Notzon et al, 2015;Cuperus et al, 2016), treatment for addiction (Park et al, 2016) and even autism (Didehbani et al, 2016). Other fields such as architecture and urban planning (Portman, Natapov & Fisher-Gewirtzman, 2015;Luigi et al, 2015) and education (Abulrub, Attridge & Williams, 2011) also benefit from the technology.…”