In Ostrava on 28 November 2023

Patient

The patient who used therapeutic programs in virtual reality is a 10-year-old girl with SMA (spinal muscular atrophy). The patient has been in therapy with us for about three years, her main problem is deteriorating performance and stability, manifested mainly in the lower limbs and pelvic girdle.

The patient is mobile without aids and attends therapy regularly almost throughout the year, with the exception of spa stays. Spinraza is applied several times a year, and the application is always followed by intensive rehabilitation. Since it is a child, the therapy must not only be effective, but also interesting, variable and motivating.

Progress

We apply therapeutic techniques on a neurophysiological basis suitable for this type of disease, to which the girl responds well and have a positive effect on maintaining the coordination and strength abilities necessary for high-quality verticalization and walking on both level and uneven variable terrain.

The girl also wants to carry out regular activities with her classmates and friends, such as leisure activities of a sporting nature - walks and hikes, cycling where she uses an adult tricycle, dancing, etc. For all this, she needs to be stable and efficient.

For motivational training of mainly stabilizing functions in various positions, we have started to add exercises in virtual reality to the therapy, where we cooperate with the company VR LIFE and their product VR Vitalis. For the girl, it was a welcome change from routine physiotherapy and she always looks forward to virtual reality exercises. We now use the "eights" and "puzzle" programs. We also tried a 3D painting program before.

Since the girl is able to stand independently without help and aids, we chose to perform these exercises not only while standing on a flat mat, but we also tried a foam labile surface, which slightly changed the input parameters of perception. During another exercise in virtual reality, we made the exercise more difficult for the patient with a differentiated position of the lower limbs, where one DK stood on a flat mat and the other DK on a small step, which somewhat imitated standing on one leg, which the girl manages with great difficulty. It was also possible to use other developmental positions, such as high knee or knight positions, which are also more difficult for the patient in terms of stability.

Exercise in virtual reality complemented standard therapeutic procedures and was always included at the end of the therapeutic unit as a suitable addition lasting about 10-15 minutes. In the form of a game, which is very motivating for her, the child includes training elements aimed at coordination and stability into movement stereotypes.

It is also advantageous that the therapist can control the exact execution of the movements in virtual reality in the application on his mobile and also manually correct the patient during the exercise. This is how correct, coordinated and qualitatively correctly executed movement is achieved.

Conclusion

Including exercises in virtual reality has a very positive effect on a child with this diagnosis. Coordination and postural stability have improved, and I also see a big benefit in the fact that the child can exercise for longer with greater commitment. He does not consider training in virtual reality as exercise, but as a game.

Author

PhDr. Jarmila Kristiníková, Ph.D.

Physiotherapy Pohoda

The use of this case report is not possible without the permission of the author and the company VR LIFE s.r.o. The website https://vrvitalis.cz/ (hereinafter referred to as the "Web") and case reports may contain copyrighted works, trademarks, databases and other assets protected by law. The website visitor may not copy any content of the website and case studies or use the content of the website and case studies for commercial or non-commercial purposes without the prior consent of VR LIFE s.r.o.

The visitor may not, without the prior consent of VR LIFE s.r.o. scrape or otherwise extract data from the Web and case studies for any purpose, including automated analysis of text or data (e.g. for AI training).

Complete study for download