How is VR is Changing Medicine?

The ER VR system developed by Immersive Education in Partnership with The Royal College of Surgeons in Ireland.

Emerging Virtual Reality technologies like the Occulus Rift, Samsung Gear and Google Cardboard are changing how we interact with other humans, the reality around us and in particular how we learn about that reality. One of the most interesting aspects to these technologies is their ability to recreate real life scenarios in a non-consequential manner. This is why I propose the question “How is VR Changing Medicine?” If we can create a non-consequential reality, our ability to understand consequential actions becomes more impactful. For example the ER VR created in Ireland creates a scenario in which surgeons can effectively go through a trauma exercise without a real patient or cadaver.

An additional example of an advanced Medical VR experience and how it can better train doctors and surgeons is the Salisbury Surgical Simulation, created at Stanford. While the visual aspects of surgery are important, the thing that is most interesting part of Salisbury is the inclusion of Haptic response in the VR experience.

Surgical Simulation concentrates on how to allow surgeons to practice surgery on a virtual patient and experience realistic sights, sounds, and forces like they were actually in the operating room. http://web.stanford.edu/group/sailsbury_robotx/cgi-bin/salisbury_lab/?page_id=205

By including haptic response, we are creating a real response to our actions within the experience. This is incredibly important in learning a physical action. Salisbury has created an advanced system of rendered haptic responses that behave like a normal reality… without the consequence.

“We have developed an approach for haptic rendering of deformable isosurfaces within volumetric medical image data. Our experiments have shown that the method is effective for a variety of anatomical structures. A physically-based deformation model coupled to high-resolution volume data allows for detailed visual and haptic display with realistic tissue behavior.” http://www.stanford.edu/group/sailsbury_robotx/cgi-bin/salisbury_lab/?page_id=2213

While VR is changing how we understand physical things like surgery, it is also changing how we understand more ephemeral things like mental illness. In my research I found some surprising applications of VR in therapy situations. One of those applications is the use of VR in War Veteran PTSD cases.

More recently, clinics and hospitals are using virtual reality simulations of warfare akin to Iraq and Afghanistan to help veterans who are, in many ways, continually reliving the traumatic events they experienced. In a safe and controlled environment, they can learn how to deal with instances that might otherwise be triggers to behavior that could be destructive to themselves and others.” See Article Below.

Again creating a non-consequential environment is key to the technology’s success.

Another common medical problem with no clear solution is helping children with high level autism engage socially with other humans. As the video below depicts being autistic in public is challenging in ways normal people cannot imagine.

On a personal note, I found this video incredibly disturbing and informative. I had no idea this is what people with Autism experience everyday.

In particular VR is helping kids with autism learn social cues and skills. From the Autism Speaks website “Twice a week, each of the young adults in Daniel Yang’s study spends an hour inside a virtual world. A webcam projects his or her facial expressions onto a digital avatar that interacts with the avatar of an autism therapist.

https://www.autismspeaks.org/science/science-news/virtual-reality-training-improves-social-skills-and-brain-activity

One or more virtual characters join in as the therapist presents the day’s situation. It may be a job interview, a new neighbor or a blind date. The counselor also describes the social skills they’ll be practicing. The task may involve recognizing the unspoken intentions behind a behavior or sharing an opinion in a socially acceptable way.”

Daniel Yang’s work is showing promise within the Autism community, from children to adults. “Our early results are beginning to reveal a remarkable degree of malleability in the neural systems involved in social cognition in adults with ASD,” he says. Lay translation: On brain scans performed after the training, the researchers are seeing brain regions associated with social understanding literally light up in ways they hadn’t before. (See image below.)

This is living proof that VR can better connect us as humans, not create barriers between us. By creating a non-consequential environment for people with Autism to explore social situations, they can better understand other actual humans without fear of repercussions.

On an additional note for those who suffer from social anxiety, Dr. Yang has also used the same program on non-autistic people. “So far, two men and two women have completed the testing.”

Pre- and post-training test results

To gauge changes in social awareness and understanding, the participants watch an animation of two “dancing” triangles. In some cases, the triangles move randomly. In others, their movements suggest an interaction.

After virtual reality training, young adults with autism performed better at discerning random movement versus interaction in an animation of two “dancing” triangles.

“While the participants perform the task, the researchers monitor their brain activity with functional magnetic resonance imaging (fMRI). The fMRI reveals the location and degree of brain activity. Importantly, Dr. Yang says, the increased brain activity and connections seen after the virtual-reality training more-closely resemble the brain activity seen in the four “neurotypical” adults serving as controls.

In addition, the researchers will use electroencephalography (EEG) to track whether different areas of the brain respond more quickly, or efficiently, to social cues. Dr. Yang and his team are still analyzing the results of their first EEGs.”

As VR evolves we can treat a number of mental disorders in ways that were previously impossible

As VR evolves we can treat a number of mental disorders in ways that were previously impossible. Another common mental issue that can be addressed through a VR experience is anxiety. Again speaking from a personal point of view, I suffer from several forms of anxiety and I’ve never found a system that can truly alleviate the symptoms. This is why I’m particularly interested in VR Meditation experiences that help with forms of anxiety.

Enter the DEEP app. “Breathe in. The lights around you glow and intensify. Breathe out. The glow diminishes. Take a deep breath. You rise up and glide across the seascape.

DEEP is a meditative and psychoactive VR game that is controlled by breathing. Players don the Oculus Rift and the custom DEEP controller to explore a beautiful and mysterious undersea world. Allow the game to sweep you into its relaxing embrace as it teaches you yogic breathing techniques that can relieve stress, anxiety and mild depression. Take a DEEP breath and soar beneath the waves to meet ancient gods and strange lifeforms.”

http://www.exploredeep.com/#about-deep

DEEP provides the tools for a meditative experience with no experience necessary. Most people feel they can’t meditate because it’s too hard to let go of their daily life. DEEP helps people leave the baggage behind because they are getting a visual stimuli to correlate to their breathing. This is where traditional meditation can fall short for westerners. We’re told to think of our mind as an empty sky and our thoughts are some clouds floating through. It can be very difficult to focus on your breathing while trying to create this visual space in our minds. DEEP creates the space so you can use your breathing to control the game progression. This is a grand departure from traditional meditation as well as gaming experiences.

Compounding on the immersive VR experience, companies are now developing experiences for homebound people such as senior citizens. For example people with mobility issues can now ride a bike through Bali as if they were actually there, without being there. The ability to see and feel an experience greatly enhances a person’s life.

“Bill Frye, 96, may be in a wheelchair, but on April 22, he was still rotating his bike pedals through the Balinese forest. As he pedaled faster, chickens darted from the underbrush across his path, and he felt the wind against his face.” (See below)

This small story illustrates how we can safely enhance the life of a person with limited mobility. Bill Frye can now go for a bike ride in Bali, without leaving the senior home in Palo Alto. There is also no chance of a fatality or injury. This only makes Bill’s life better. "It was magnificent, said Frye, who has not been able to ride a bike for some time. Depression affects nearly 15 percent of the elderly population," said Kelly Lowens, a Stanford mechanical engineering graduate student who is on the SUSIE team. "In many cases, depression is not recognized or treated, so this number is likely much greater. This seemingly subtle issue has significant impact. It has been linked by the Geriatric Mental Health Foundation to dementia, stroke, cancer and other illness."

VR has long been feared as the end of human interaction. People genuinely feared that once we got a taste of the Virtual world that we would never leave. The presented evidence proves that VR is not a black and white experience. We can use VR to teach surgery, treat PTSD or walk down an Australian beach to relax. While the future holds a lot of uncertainty, we can be certain that VR is here to stay. It now becomes a matter of ethics. How will we use this technology? My hope and drive is to create a more ethical and connected world through more robust visual and user centered designs.

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