Treatment Areas

Virtual reality (VR) and other advanced technologies are improving the treatment available for a range of medical disorders by leaps and bounds such as

• Anxiety Disorders
• Posttraumatic Stress Disorder
• Addiction
• Autism
• Pain Management for Acute and Chronic Pain
• Rehabilitation

People suffering from conditions ranging from mental disorders, to brain injury to physical disability can benefit from VR and similar systems. Technology is enhancing the lives of people around the world by increasing the efficacy, efficiency, and availability of quality healthcare.

Anxiety Disorders

- Specific Phobias
- Social Phobia
- Panic Disorder
- Obsessive Compulsive Disorder

Anxiety disorders, as a group, are the most common mental illnesses in the world. According to a 2007 study by the Anxiety Disorder Resource Center, anxiety disorders affect approximately 1 in 4 people worldwide at some point in their lives. Not only adults, but also children and adolescents can also develop anxiety disorders, including phobias (specific phobias, social phobia, or agoraphobia) panic disorder, obsessive-compulsive disorder, posttraumatic stress disorder, and generalized anxiety disorder.

Most people experience feelings of anxiety before an important event such as a big exam, business presentation, or first date. Anxiety disorders, however, are illnesses that fill people's lives with overwhelming anxiety and fear that are chronic, unremitting, and can grow progressively worse. Tormented by panic attacks, obsessive thoughts, flashbacks of traumatic events, nightmares, or countless frightening physical symptoms, some people with anxiety disorders even become housebound. IMI-E advances the treatment of these conditions through the use of virtual reality therapy.

Virtual reality exposure therapy places clients in a computer-generated world where they "experience" the various stimuli related to their phobia. The client wears a head-mounted display with small TV monitors and stereo earphones to receive both visual and auditory cues. In careful, controlled stages, the client is exposed to experiences that elicit higher levels of anxiety. Each stage can be repeated until the client is comfortable with the experience and satisfied with the response.

Future areas of research in anxiety disorders for IMI-E include the use of virtual reality to treat anxiety that develops with diagnosis of chronic and serious physical illness to improve overall quality of life for this population.

• Specific Phobias

  Phobias are the most common psychiatric disorder, more common than major depression, alcohol abuse, or alcohol dependence. A specific phobia is defined as an intense and persistent fear that is considered excessive or unreasonable in response to a situation. Specific phobias include fears of flying, heights, animals, thunderstorms, blood, etc. Exposure to the phobic stimulus consistently provokes an anxious reaction, which may take the form of a situationally predisposed panic attack. Adults with phobias recognize that their fear is excessive and unreasonable, but they are unable to control it. Children may not have any insight into the fact that their fear is excessive. In both adults and children, the feared object or situation is usually avoided or anticipated with dread. The disorder is diagnosed when one’s fear, or more often the evasive actions to avoid the feared situation, interferes with daily routine, employment, or social life.
  
  Although over 200 phobias have been identified and named, there are five subtypes of specific phobias. These are:

• Animal Type, which generally has a childhood onset and includes fear of insects or other animals.

• Natural Environment Type, which includes fear of heights, water, and storms and generally has a childhood onset.

• Blood-Injection-Injury Type, including fear of invasive medical or dental procedures such as receiving an injection, giving blood or seeing blood or an injury. This phobia subtype is often characterized by fainting.

• Situational Type, which includes fear of flying, bridges, elevators, driving, or enclosed places. The age of onset is either during childhood or in the mid-20s. This is the most frequent subtype seen in adults.

• Other Type, which includes fear of falling down when away from walls, fear of vomiting or choking, fear of contracting an illness, fear of loud sounds, and fear of costumed characters.

  The most common traditional treatment for specific phobias is exposure therapy. This exposure is typically either real-life or imaginal. However, real-life exposure to feared stimuli is not always convenient, safe, or cost-effective (e.g., fear of flying, fear of driving), and 85% of the population is not able to imagine the feared situation vividly enough to evoke the anxiety response necessary for successful treatment. That’s where virtual reality (VR) comes in. VR provides all of the stimuli needed for successful treatment while at the same time allowing therapy to take place in a secure, controlled environment. Studies by IMI-E and partner companies have shown that VR exposure therapy for specific phobias has a 92% success rate in just 8-12 one-hour sessions. Specific phobias treated at VRMC include fear of flying, fear of driving, fear of heights, fear of public speaking, fear of thunderstorms, fear of enclosed spaces, fear of open spaces, and fear of spiders.

• Social Phobia

  Social phobia, also called social anxiety, is a disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. People with social phobia have a persistent, intense, and chronic fear of being watched and judged by others and of being embarrassed or humiliated by their own actions. Their fear may be so severe that it interferes with work, school, and other ordinary activities. While many people with social phobia recognize that their fear of being around people may be excessive or unreasonable, they are unable to overcome it. They often worry for days or weeks in advance of a dreaded situation.
  
  Social phobia can be limited to only one type of situation¾such as a fear of speaking in formal or informal situations, or eating or drinking in front of others¾or, in its most severe form, may be so broad that a person experiences symptoms almost any time they are around other people. Social phobia can be very debilitating¾it may even keep people from going to work or school on some days. Many people with this illness have a hard time making and keeping friends.
  
  Physical symptoms often accompany the intense anxiety of social phobia and include blushing, profuse sweating, trembling, and other symptoms of anxiety, including difficulty talking and nausea or other stomach discomfort. These visible symptoms heighten the fear of disapproval and the symptoms themselves can become an additional focus of fear. Fear of symptoms can create a vicious cycle: As people with social phobia worry about experiencing the symptoms, the greater their chances of developing the symptoms. Social phobia often runs in families and may be accompanied by depression or alcohol dependence.
  
  Research has shown that there are two effective forms of treatment available for social phobia: certain medications and a specific form of short-term psychotherapy called cognitive-behavioral therapy (CBT). The central component of CBT is exposure therapy, which involves helping patients gradually become more comfortable with situations that frighten them. The exposure process often involves three stages. The first is introducing people to the feared situation. The second level is to increase the risk for disapproval in that situation so people build confidence that they can handle rejection or criticism. The third stage involves teaching people techniques to cope with disapproval. In this stage, people imagine their worst fear and are encouraged to develop constructive responses to their fear and perceived disapproval.
  
  All three of the stages of exposure therapy can be accomplished in vivo (real life) or virtual reality (VR). However, using VR provides certain advantages. First, therapy is carried out in the privacy of the therapist’s office. Second, the therapist can control the reactions of the people with which the patient is interacting. More importantly, treatment can progress at the user’s own pace. It allows each session to be catered to the individual receiving treatment.

• Panic Disorder

  Panic disorder is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress. These sensations often mimic symptoms of a heart attack or other life-threatening medical conditions. As a result, the diagnosis of panic disorder is frequently not made until extensive and costly medical procedures fail to provide a correct diagnosis or relief.
  
  Many people with panic disorder develop intense anxiety between episodes. It is not unusual for a person with panic disorder to develop phobias about places or situations where panic attacks have occurred, such as in supermarkets or other everyday situations. As the frequency of panic attacks increases, the person often begins to avoid situations where they fear another attack may occur or where help would not be immediately available. This avoidance may eventually develop into agoraphobia, an inability to go beyond known and safe surroundings because of intense fear and anxiety.
  
  Appropriate treatment by an experienced professional can reduce or prevent panic attacks in 70% to 90% of people with panic disorder. Treatment for panic disorder includes medications and a type of psychotherapy known as cognitive-behavioral therapy (CBT). CBT teaches people how to view panic attacks differently and demonstrates ways to reduce anxiety. IMI-E and partner company The Virtual Reality Medical Center (VRMC) have explored using virtual reality (VR) to enhance CBT for panic disorders. VR environments used to treat panic disorder involve exposing patients to feared situations (similar to those where they have experienced panic attacks) or to reproductions of the physical symptoms of panic attacks (e.g., shortness of breath, vertigo, and tunnel vision). The latter can be accomplished in virtual environments with sound (pounding heart, fast breathing) or with visual effects (blurred or stretched images). Each of these exposures is accompanied by therapist-facilitated cognitive restructuring and coping skills.
  
  Most patients show significant progress after a few weeks of therapy. Relapses may occur, but they can often be effectively treated just like the initial episode.

• Obsessive-Compulsive Disorder

  There are two sides to obsessive-compulsive disorder (OCD): obsessions and compulsions. Obsessions are thoughts, and compulsions are actions. The obsessions in OCD are repetitive and persistent, inappropriate and intrusive, and are impossible to suppress, causing the sufferer significant distress and anxiety. Compulsions are repetitive behaviors or mental acts that the person applies based on rigid rules that they follow. The goal of these actions is to prevent a dreaded event or to lessen distress, but they are not really connected in a logical way to these events. Once the person completes a compulsive behavior, they feel a sense of relief. It is easy to imagine how these unwanted thoughts and disruptive behaviors cause disturbances and impair the sufferer from living everyday life. Not only are these rituals time consuming, but it is quite difficult to function socially while experiencing them.
  
  OCD is most often treated with a combination of medication and exposure therapy with ritual prevention. Some SSRIs have been found to have a significant effect on the symptoms associated with OCD, but relapse rates upon medication cessation are extremely high if coping skills are not also learned prior to discontinuing medication. At The Virtual Reality Medical Center (a partner company of IMI-E) research has delved into using virtual reality (VR) for the exposure piece of OCD treatment. Research has revealed that VR is effective at inducing the anxiety response necessary for effective treatment to take place. The benefit of conducting exposure therapy with VR is that situations that trigger obsessions and compulsions can be experienced repeatedly, a necessary element of overcoming the repetition of OCD. In addition, this treatment can take place in the privacy of a therapist’s office, ensuring patient confidentiality. Though VR exposure therapy for OCD can take longer than for specific phobias, many patients experience some relief within the first few sessions.

Posttraumatic Stress Disorder

Many have heard the term “shell shock” in the context of soldiers returning from war. The condition’s technical name is Posttraumatic Stress Disorder (PTSD). PTSD can affect anyone who has experienced a traumatic event such as a motor vehicle accident Christian, can we make this a live link to http://www.vrphobia.com/driving.htm), an assault, or anything that threatens a person’s life or physical integrity. Symptoms can include increased anxiety or arousal, dissociation, and flashbacks of the event, though the disorder manifests differently in each individual.

Because PTSD has such varied symptoms, a combination of treatments is often necessary. Anxiety-reducing medications, antidepressants, support from friends and family, and cognitive-behavioral therapy involving exposure can help with recovery. Exposure seems to be included in almost all treatment regimens. One type of exposure therapy that has been proven effective for PTSD is imaginal exposure therapy, in which patients are asked to repeatedly imagine and retell their traumatic experience to their therapist. However, because one of the hallmarks of PTSD is an avoidance of reminders of the trauma, this is often difficult for some patients. Those who are unable to engage with their memories do not evoke an anxiety response during exposure, and these patients fail to improve. It is generally thought that this is due to lack of activation of the brain’s fear structure, where the trauma memories are stored. Since the structure is not activated, it is thought that the information stored is therefore not available to receiving “disconfirming” information (e.g., “there is no longer danger here”)

Virtual reality (VR) can solve the problem of avoidance and lack of good imagery abilities that plague some patients and prohibit satisfactory treatment. By providing the patient with stimuli that engage multiple senses (audio, visual, tactile, and olfactory), the therapist does not have to rely on the imagination and willingness of the patient to create anxiety, but rather can provide stimuli directly to the patient at the touch of a button. In addition, because the virtual environment allows the therapist and patient complete control over the pace and duration of treatment sessions, the danger of overwhelming the patient with anxiety can be avoided, alleviating the patient’s anxiety at beginning treatment. In addition, many clinicians combine physiological monitoring and feedback with VR exposure. This has the added advantage of providing continuous monitoring of the patient’s heart rate and other physiological signals, allowing for an objective, real-time measurement of the patient’s condition to occur. With this addition, the therapy is further individualized and can progress according to each individual patient’s needs.

VR exposure treatment has been performed for those suffering PTSD symptoms following an earthquake, a motor vehicle accident, and other various traumatic events. One of the most recent developments has been to use this treatment for those returning from Iraq and Afghanistan who are diagnosed with PTSD. IMI-E’s U.S.-based affiliates, Virtual Reality Medical Center and Interactive Media Institute, have been funded to provide treatment to both U.S.-based troops as well as Polish troops. Currently in use at several military and veterans hospitals in the U.S., the system was most recently installed in Warsaw, Poland at the Military Institute of the Health Services. Psychologists were trained on clinical protocols and patients are now undergoing this innovative treatment. 

The current rate of PTSD among U.S. Army and Marine Corps combatants returning from duty in Iraq is approximately 19 percent, and research suggests that the rate of PTSD among Polish troops may be similar or even higher. Currently, Poland has the second largest number of troops in Iraq of all of the strategic allies. The VR program recently established in Poland will help these soldiers, as well as lend itself to the clinical investigation of determining if the system must be reconfigured to allow for cultural differences, or if it can be effectively used cross-culturally. 

Addiction

- Teen Smoking Cessation
- fMRI Research

• Teen Smoking Cessation

  The Virtual Reality Medical Center, a partner of IMI-E, has created an Internet-based virtual reality game that helps adolescents quit smoking. The interactive program uses cue-exposure therapy to treat addictive behaviors involved with smoking. The program identifies various triggers (ashtrays, packs of cigarettes, coffee, beer, and peer pressure) that cause a smoker to continue smoking, while providing teens with ways to avoid these triggers (exercising, playing games, cooking, taking naps, or calling a friend).
  
  The program consists of two major environments: home and school. Upon beginning the game, the first thing the user must do is choose a quit date, which is a successful strategy to quit smoking. The users are then faced with triggers that can cause cravings, which they must navigate through and avoid in order to succeed.
  
  In the school environment, users are exposed to the trigger of peer pressure. When a user chooses not to smoke, the user is faced with a randomly selected game. If the user wins the game, he or she is successful in denying the craving, whereas if the user loses, he or she has given into the craving and smokes. This resets the smoke-free day counter in the top of the screen, which demonstrates the importance of overcoming peer pressure to quit smoking. In addition, users are exposed to the repercussions of smoking through a lung icon in the corner of the screen. Every time a player smokes, the lungs darken and the user’s stamina decreases. The ultimate goal of the program is for the user to remain smoke-free in both environments for as long as possible.
  
  Findings from a recent research study with the program suggest that it helps adolescents gain knowledge and understanding about quitting techniques, such as setting a quit date, staying busy, and performing activities. Participants in the study agreed that the virtual reality setting is a realistic environment and brings about no negative side effects.
  
  The Virtual Reality Medical Center and its affiliates in Brussels, The Virtual Reality Medical Institute and IMI-E, have initiated conversations with European partners who are committed to bringing the Teen Smoking Cessation project to their countries. There is currently an agreement with a foundation in Romania to place the system in 10 schools throughout the country. Future enhancements include multiplayer capability and coordination of an online “common” such as a forum or message board. The goal of this program is to provide a safe environment for citizens to learn about smoking cessation.  

• fMRI Research

  Basic research conducted with our colleagues at Hanyang University in Seoul, Korea has shown that when smokers are exposed to smoking-related triggers (e.g., ashtrays, alcohol, cigarettes) their cardiovascular reactivity is higher than when they are shown neutral cues. It is thought that the higher a person’s cue reactivity, the lower their chance is of quitting successfully. As such, the goal of treatment is to lessen a patient’s cue reactivity, often through exposure therapy.
  
  One way to measure this reactivity is with functional magnetic resonance imaging (fMRI). In our pilot study with Hanyang University, it was found that virtual environments were more immersive and evoked smoking craving more effectively than traditionally used methods. It is thought, then, that VR will help patients decrease their cue reactivity more quickly. In a later study, we sought to test whether smokers could experience cue-induced smoking craving inside of an MRI scanner using the VR system. Findings suggest that 3D stimulus evoked more attention than the 2D condition.
  
  Though fMRI research with VR is still in its early stages, it is thought that VR will be an effective tool to elicit the cravings necessary to help people learn to control their urges and quit smoking successfully.
  
  

Autism

Autism is an especially difficult disorder to treat because of its main symptoms: attention and communication deficits. VR can be utilized in many ways to attempt to improve the prognosis of those diagnosed with autism. The Institute is particularly interested in focusing on teaching children with autism social skills and activities of daily living.

By creating virtual worlds including classrooms, bathrooms, and homes, IMI-E hopes to develop protocols for improving the quality of life for these children. Another advantage of virtual reality is that it can also be used to filter out stimuli, which aids in focusing attention in patients with autism. The therapist can adjust the level of stimuli in the environment according to each individual user, adding in more distractions as their performance improves.

Pain Management for Acute and Chronic Pain

- Acute Pain
- Chronic Pain
- Basic Research Studies

IMI-E is studying the effects of advanced technology on pain perception. Research shows that virtual reality and similar technologies are effective in distracting patients from pain during medical and dental procedures. Procedures studied have included dental procedures, wound treatment, chemotherapy, venipuncture, spinal tap, and even certain types of surgery.  In addition, it also appears these same technologies can offer relief to those with chronic pain conditions

• Acute Pain

- Burn Wound Treatment
- Dental Pain
- Ambulatory Surgical Procedures

•      Burn Wound Treatment

  When patients are resting, medication is often adequate for controlling burn pain. However, during wound care such as daily bandage changes, wound cleaning, staple removal, etc., medication ceases to be effective in controlling the excruciating pain. Traditional pain management techniques are not sufficient, particularly in children.
  
  Since pain perception has a strong psychological component, incoming pain signals can be interpreted as painful or not depending on what the patient is thinking. IMI, IMI-E’s U.S. counterpart, has begun research on the use of virtual reality to distract patients during wound care. Virtual reality immerses the patient in an environment, causing their attention to be distracted, and in turn, their pain levels to be attenuated. 

• Dental Pain

  The Virtual Realty Medical Center, a partner of IMI-E, uses a custom-designed VR environment to distract patients from the pain of dental procedures. Since no VR pain distraction product customized to dental practice currently exists, the company plans to produce a fully integrated VR and physiological monitoring device for use in general dental practice. The system will consist of virtual environment software, compatible computer hardware, a head-mounted display, physiological sensors, a physiological sensor interface module, and a wireless peripheral device used to interact with and explore the virtual world. The system is designed to be inexpensive, easy to use, upgradeable, and reliable.
  
  It is IMI-E’s goal to disseminate this product throughout Europe, taking into account possible cultural adaptations that must be made in order to achieve the same pain relieving effect for patients.

• Ambulatory Surgical Procedures

  VR has been used to successfully reduce pain or discomfort during simple medical procedures such as intravenous cannulation in pediatric patients, wound dressing, and teeth extractions in dentistry, but use of VR in invasive procedures for pain distraction had not been documented before this year. However, IMI-E and partner countries are working with several public health hospitals in Mexico City to decrease pain during and after invasive surgical procedures.
  
  Displaying a variety of virtual environments in head-mounted displays, IMI-E and partners were able to test pain reduction effects in more than 300 participants ranging from 2 days to 70 years of age, male and female. Invasive procedures have included upper gastrointestinal endoscope, infectious surgery, colonoscopy, labor and delivery, caesarean surgery, neonatology critical care unit (CCU), post surgical care, CCU of heart, kidney transplant CCU, epidural block, and ambulatory surgery.
  
  The distress was found to be different with each procedure, but the three groups who benefitted most from VR exposure were patients in post surgical critical care unit of the heart, colonoscopy, and ambulatory surgery. The degree of pain relief depends on disease, sex, age, and anatomical region manipulated during the procedure. VR was found to work best for patients who accept and can concentrate during hospitalization or manipulation in medical or surgical procedures.
  
  One impressive benefit of VR is that the necessary dosage of medication was greatly reduced in patients who used VR. Patients did not have to be put under general anesthesia, which allows a significant decrease in the risk and costs of the procedure.
  
  IMI-E plans to continue this research in other countries, working to reduce the cost, distress, and risk that may accompany traditional invasive and non-invasive medical procedures.
  
  
  

• Chronic Pain  

  Though many virtual reality (VR) applications for pain distraction have been for use in patients with acute, temporary pain, IMI-E is also conscious of those patients suffering from chronic pain. A pain distraction VR system was used at Naval Medical Center San Diego (NMCSD) where a culturally diverse population suffers chronic pain from disorders such as fibromyalgia, lower back injury, migraine, and temporomandibular joint dysfunction. In this study, we found that this virtual environment, navigated using a head-mounted display and joystick, dramatically reduced pain ratings by over 75 percent. Physiological data collected from this same population corroborated this discovery and confirms that participants experienced reduced physiological arousal and reduced subjective pain ratings while engaged in the virtual world.

• Basic Research Studies

  In 2004, a study completed at IMI-E’s affiliate, The Virtual Reality Medical Center indicated that VR could effectively reduce levels of pain in participants suffering from a variety of painful stimuli. In the study, participants were placed inside a virtual environment featuring a snowscape called Icy Cool World. First, participants were asked to focus on their pain with their eyes closed. They were then asked to rate their pain during this focus period. Participants then opened their eyes and began exploring Icy Cool World. All participants reported a drop in pain while in the VR environment, and the magnitude of pain reduction from the VR compared to the pain focus condition was large (75.8%) and significant. The results indicate that because VR absorbs attention and pain is based on perception, immersive VR can be a magnificent tool for distracting users, and thus decreasing their pain.
  
  Beyond that study, we are working in collaboration with our colleagues in the Psychology Department at University of Wuerzburg, Wuerzburg, Germany to study basic pain mechanisms. One study examines whether pain triggered by warm or cold stimuli is modulated by “warm” or “cold” virtual worlds. For example, does having burn patients in a snow-related environment help relieve their pain, or would a warm fiery environment alleviate their symptoms just as well? It was found that the content of the environment did not really affect the efficacy of the environment. As long as the VR was immersive and engaging, patients with all types of pain could experience relief regardless of VR content.
   

Quality of Life

- In Cancer Patients
- In People with Chronic Illness

• In Cancer Patients

  Many clinical studies have been completed that involve using guided imagery as a form of distraction and relaxation during painful or unpleasant procedures. Though guided imagery has proven to have immensely positive effects in the quality of life during cancer treatment, only 15% of the population can visualize effectively. Therefore, 85% of people are not able to picture images vividly or realistically enough to reap the benefits of guided imagery therapy.
  
  This is where virtual reality can help. In virtual environments, images are provided in a realistic manner, allowing the user to become fully immersed in the virtual environment. This, in turn, elicits the appropriate physiological and emotional responses.
  
  Following this line of research, IMI-E plans to use virtual reality as a means to lessen anxiety about illness and to improve overall quality of life for those suffering from this disease.
  

• In People with Chronic Illness

  Studies are also being developed to increase quality of life in those with other chronic illnesses, such as multiple sclerosis, cerebral palsy, and other illnesses that may cause anxiety or a decrease in quality of life. Virtual reality distraction can help lessen anxiety and increase the ability to cope with pain. It can also provide leisure activities for those not able to participate in typical leisure activities (e.g., those confined to a wheelchair, those with breathing difficulties). IMI-E is dedicated to providing solutions to those suffering from many types of chronic illness.

Rehabilitation

- Cognitive Rehabilitation
- Neurorehabilitation
- Physical Rehabilitation

As the available technology has advanced, so has the ability of doctors to assess and treat both physical and cognitive injuries. Whether the impairment is caused by stroke, head injury, neurological disease, or traumatic injury, technologies such as the Internet, virtual reality, video games, and robots have allowed for a great variety of improvements in the quality of life of patients with cognitive, neurological, and physical disorders.
 

• Cognitive Rehabilitation

  IMI-E is interested in applying VR and other advanced technologies to improve cognitive function in a variety of people. One rapidly growing area of the population with the need for cognitive rehabilitation includes veterans who have suffered traumatic brain injury (TBI) during active duty.  
     
  TBI is the most common combat-related injury and results in disturbances of attention, memory, and executive function. Sixty percent of troops who survive external injuries from bomb blasts may have TBI. A TBI survivor faces 5 to 10 years of intensive rehabilitation costing an estimated $4 million. It is thus imperative to develop new ways to diagnose and treat TBI.
  
  The Virtual Reality Medical Center (VRMC), an affiliate of IMI-E, is partnering with the Media Convergence Lab (MCL) at the University of Central Florida’s Institute for Simulation and Training (UCF/IST), to develop a mixed reality rehabilitation system for TBI patients. Animal studies have shown that animals raised in enriched environments have improved cognitive functioning/responses. The goal of this project is to use mixed reality (MR) to create an enriched virtual environment designed to stimulate and improve cognitive functions in service men and women who have TBI. This MR tool will thus provide troops suffering from blast-induced TBI an effective form of cognitive rehabilitation with the goal of allowing them to return to a normal life.

• Neurorehabilitation

  In addition to TBI, stroke is a leading cause of serious, long-term disability around the world, often resulting in paralysis on one side of the body affecting the whole side or just an arm or leg.
  
  The VRMC/MCL team is working to develop a MR rehabilitation system for stroke patients. In MR, virtual enhancements, overlays, and contexts rendered through a head-mounted display convert the real world into an altered reality without losing the properties of a physical setting. This MR system includes both hardware and software designed to increase upper-arm movement and result in positive brain changes through use.
  
  It is our hope that these systems will help citizens around the world overcome cognitive injury and disorders.
  
  

• Physical Rehabilitation

  Advanced technologies are being used more and more to help improve physical therapy. Often dreaded by patients, traditional physical therapy can be painful, tiring, and extremely boring. Because of this, many patients avoid their treatment, or experience great anxiety before and during therapy, significantly inhibiting their ability to recover.
  
  With virtual reality, video games, and robots, physical therapy can become more bearable. Graphics and game-like goals can motivate and entertain patients. The Internet and inexpensive computers can allow patients to practice their therapy at home, between sessions. The immersion inherent in virtual reality can distract patients from their pain. The regularity and exact repetition of technology can objectively measure patients’ progress, further encouraging both therapist and patient.
  
  IMI-E aims to continue research in this field, improving the accessibility of this type of physical rehabilitation for European citizens.

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