Virtual Reality = Precise Measurements = Increased Efficiency

Modern medicine relies on ever more efficient technologies. It is compiling more and more data and using it to improve care prognoses for patients. Robotic surgery is a good example. It translates imaging information and a compilation of other data to help the surgeon perform the best possible procedure. However, he remains the decision-maker on the technique he will use. In physiotherapy, few technologies record data, the transcription of which allows the practitioner to offer a better quality of care to his patients. Virtual reality integrates this possibility. A lot of data is recorded: measurements of angle, distance, speed, precision, etc.

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It remains to be seen how this can change the outcome of rehabilitation?

Although not subject to the obligation of results, the physiotherapist is increasingly subject to activity control and an obligation of means. We are asked to do better with fewer sessions: a utopia some will say, not so sure others will say.

No rehabilitation is perfectly linear. Progress may be slow, in increments. The more data the practitioner knows how to compile, the more they will be able to transcribe these developments. VR records session data so data transcription is no longer the responsibility of the practitioner.

He can devote himself to other tasks while having objective and precise data at his disposal. Quantifying changes is no longer subjective. A recent meta-analysis published on the Pedro database[1] highlights the interest in virtual reality rehabilitation in several therapeutic areas. I

mmersive VR emerges as the most relevant technology. To boost results it requires customizing environments. In other words, it is up to the VR to adapt to the patient, not the patient to adapt to the VR. But in practice what does this mean and what are the benefits for the patient and the practitioner?

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Being able to use VR technology and modifying environments allows the practitioner to systematically offer the exercise best suited to the patient's abilities. A patient who tires during a session needs to have a revised objective so as not to expose him to failure which would hinder the positive impact on brain plasticity of a successful exercise. The patient will carry out precise and targeted sessions. He will spend less time in an office and this time will nevertheless be optimized.

Thus a patient treated for a shoulder pathology will be able to carry out active care in a joint sector with a precision of the order of mm or degree. From one session to the next, the practitioner will be able to offer extremely accurate treatments based on objective data dissociating joint and muscular skills.

At the same amplitude of flexion, does the patient gain in speed of movement? is the gesture more stable? after how long does the movement become slower? When does fatigability become predominant? Is it the speed of execution of the movement which does not progress despite an increase in amplitude. Each criterion can be considered independently and adjusted in real time during the session, without the patient even realizing that the practitioner has modulated the objective of the session.

The same will apply to conditions of the spine or lower limbs. In addition to being a versatile tool for the physiotherapist, VR could become the ally of performance: more targeted, more precise sessions with superior results and faster.

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Bibliography :

_{[1] Virtual Reality in Neurorehabilitation: An Umbrella Review of Meta-Analyses Alexandra Voinescu, Jie Sui, Danaë Stanton Fraser. J Clin Med. 2021 Apr; 10(7):1478. doi: 10.3390/jcm10071478}