Virtual reality (VR) is defined as a program that immerses the user in a virtual environment with the use of a headset. This requires audio and video components, head tracking to simulate head movement, and a 360-degree view of the virtual world. The imagery must be an entirely fictional reality with actions and images controlled by the system. Virtual reality can sometimes be confused with augmented reality. Virtual reality creates a computer-generated world, while augmented reality layers a digital image on the real world through a device screen like a smart phone. For example, virtual reality would allow you to feel like you are swimming in an underwater environment, while augmented reality would display a fish swimming on the wall in front of you.
Currently, virtual reality is used in healthcare in pain treatment, anxiety treatment, phobia exposure, surgical training, education, and physical fitness. However, more studies are available to support the use of virtual reality in treating pain and anxiety. Virtual reality treats anxiety by two mechanisms: exposure and distraction. Exposure refers to the virtual confrontation of a problematic situation like public speaking, and distraction simply provides some calming event in the virtual world to take focus away from an anxious event. One anxiety study looked at virtual reality exposure to treat social anxiety disorder.1 The patients self-reported anxiety levels pretreatment, posttreatment, and 12 months after treatment. There was significant improvement in anxiety 12 months after treatment without any notable side effects observed. This is encouraging, because this long-lasting effect could justify the costs associated with virtual reality treatment if it eliminates chronic medication use. Virtual reality’s place in therapy could also be justified by eliminating the use of benzodiazepines in anxiety treatment, which are a potentially addictive substance that we would like to limit in healthcare.
When looking at pain treatment, virtual reality works via three mechanisms: distraction, focus shifting, and skill building. Distraction tries to divert the patient’s attention with a passive virtual experience. Focus shifting guides user interaction and creates virtual tasks for the user to complete, which tries to use an active program to shift focus from painful stimuli. Skill building uses the virtual world to learn techniques that could help in the real world, which includes controlled breathing exercises. Studies looking at these pain treatments have shown significant improvement in pain scale ratings with nausea as the only side effect. One potential place in therapy is the replacement of opioids in some patients; eliminating the use of addictive substances could provide motivation to push virtual reality into the mainstream.
In other fields, virtual reality is being used for education in medical, nursing, and pharmacy schools. It is used for patient counseling practice and clinical examination practice. The potential benefit of these uses is eliminating the need for patient actors or simulation mannequins, which may allow universities to save money in the long run. The future goal is to have multiplayer virtual reality, which would allow people from around the world to interact in the same virtual space for teaching or clinical practice. In a related field, virtual reality is being used for surgical training, which allows surgeons to practice their technique without the real-life risks of surgical procedures. Lastly, phobias are another common use for virtual reality where exposure therapy is used to alleviate fears, such as public speaking or spiders.
Two companies currently providing virtual reality therapy are Behavr and XR Health. Behavr is $599 for a 22-week program focusing on mental health or pain treatment. The headset with the pre-loaded programs is sent directly to the patient. The other, XR Health, is $69 for a week for self-use or $89 a week for sessions with a therapist. This site advertised it is covered by many insurances, but it is unclear exactly what the final pricing would look like with a large variance expected between plans. This system is also used for pain or anxiety treatment, and it comes with individualized patient programs pre-loaded on the device. Similarly, Osso VR is a current program offered for use in surgical training, but pricing information is not available. This program rates the success of virtual procedures and tracks improvement and time spent training.
Overall, virtual reality in healthcare is still in the beginning stages of use. There are many encouraging advancements, but it still has a lot of room for growth in the market. Recent advances in virtual reality were driven by the increasing availability and affordability of headsets. With more remote learning and work-from-home opportunities due to COVID, the virtual reality market is poised for expansion. In the future, access to headsets will continue to increase, and virtual reality will continue to grow in use and programming. How do you think virtual reality can continue to expand its use in healthcare?
Reference
- Anderson PL, Price M, Edwards S et al.. Virtual reality exposure therapy for social anxiety disorder: a randomized controlled trial. J Consult Clin Psychol. 2013 Oct;81(5):751-60.
Posted: February 2022