The possibilities provided by virtual reality (VR) technology in the rehabilitation of neurological diseases, especially stroke rehabilitation, arouse excitement. One of the important challenges in rehabilitation is to design therapies that motivate patients, make sense, and stimulate their senses. Ample repetitions and exercise are key to recovery after stroke. However, the exercises should not bore the person, be neither too easy nor impossible to do according to their current situation, and should be aimed at a specific purpose rather than mechanical movements. Virtual reality offers unique possibilities to meet these requirements for everyone.
In rehabilitation with virtual reality, the movements of the patient are perceived by sensors, these movements are transferred to the virtual environment, virtual reality changes according to the movements of the patient, changes in virtual reality are transferred to the patient with visual, auditory and tactile stimuli. Rehabilitation with virtual reality can be done with commercial game consoles such as Xbox Kinect, Nintendo Wii or with systems specially designed for this job.
One of the prominent initiatives in neurorehabilitation with virtual reality is MindMaze, which was founded in 2012 by Tej Tadi. The methods the company has developed can also be effective in amputees suffering from phantom pain, apart from stroke rehabilitation.
Early initiation of rehabilitation after stroke is one of the prerequisites for the best results. With the MindMotion Pro device, developed by MindMaze for use in hospitals, the therapy of stroke patients can be started from the fourth day. Similar to Microsoft Kinect in this device, motion-detecting optical sensors allow the person to interact with the virtual environment. According to the company’s website, with MindMotion Pro, it is possible to achieve a double increase in therapy intensity in the early period. MindMotion Go device has been developed so that patients can use it at home after discharge. With this tool, it is aimed to prevent the decrease in the treatment motivation of patients after discharge. It has been observed that patients exercise more at home with MindMotion Go compared to the traditional approach.
Another tool used in rehabilitation with virtual reality is the Elements system. Virtual reality therapy can improve cognitive skills as well as movement skills in stroke patients. Cognitive and motor (movement) systems coincide structurally and functionally in the brain. The functioning of cognition and movement in a way that reinforces each other in stroke rehabilitation is explained by the perception-action cycle. For this reason, positive effects on cognitive properties such as memory and attention have been reported even in motion-focused VR systems. The Elements system is designed to improve both movement and cognitive functions together.
The Elements system offers a large desktop screen, tangible user interface, and targeted and engaging virtual environment.
Features known to facilitate the neuroplastic healing process can be easily integrated into virtual reality treatments. These are enriched environment, receiving simultaneous feedback on performance, scaling exercise difficulty according to current cognitive and motor level.
According to a Cochrane review published in 2017, virtual reality has not been shown to be superior to traditional treatment on arm and hand functions. However, when used in addition to traditional treatment, it can be beneficial in terms of arm and hand function and activities of daily living. Data are insufficient to comment on the effect on gait, balance, participation and quality of life. Studies on this subject in the literature have generally been conducted with a small number of patients, and the treatment targets and the devices used vary considerably.