Virtual World Training

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CDRS Kimberly Briggs scientific research paper on VXP driving simulator:


Rehabilitation of patients with neurological and physical disorders poses a significant challenge to the medical community.   Current methodologies are reclusive in nature and require a significant time commitment for effective neurorehabilitation to occur.  These treatment modalities are repetitious and tedious, making it difficult for the patient to sustain interest over long periods of time.  This frequently leads to decreased motivation and participation with therapeutic treatments and limited compliance with home therapy regimens, which may adversely affect the potential functional outcome and level of functional independence that can be achieved.   


The effective use of Virtual Reality and Simulation tools, offer a long term cutting edge alternative to prevalent treatment.  Initial research studies in gross motor gesture analysis demonstrate a high correlation between virtual simulated tasks and functional daily life skill.   For example, components of Wii™ boxing have been matched specifically to self feeding.  These studies reveal that improvement in skill in the simulated task, although technically different, translates to improvement in the daily life task.   This research also indicates a significant increase in active participation, motivation, and compliance with virtual reality and therapeutic simulation tasks leading to increased rate of recovery and return to independent living.  


The Certified Driver Rehabilitation Specialist faces similar challenges.   A client afflicted with Cerebral Palsy, for example, often requires 40 or more hours of one to one clinical and behind the wheel training and instruction.   It is difficult to recruit family to assist with this extensive training due to a need for a dual braking system in the vehicle.  Lengthy one to one training at an hourly rate is not cost effective for the private pay client and is often not reimbursed by Medicare or most insurance companies.   The VXP™ partnered with Accessible Racing offers a low cost off the shelf solution to deliver "State of the Art" evaluation and treatment that can maximize resource utilization, decrease cost, increase revenue, and improve driving skill and function in a decreased length of time.  It is a perfect adjunct to any Drivers Education or Rehabilitation Program.  


The VXP™ utilizes an inexpensive off the shelf MOMO Force Feedback Racing Wheel that has been modified to allow adaptability and versatility during evaluation and training for individualized client needs and goals.  It has capability to be equipped with a variety of hand control and steering devices to allow independent use for those with limited or impaired upper and lower extremity function.  Various software programs are available that offer therapeutic simulation exercises to address a wide range of functional pre-driving skills including:  reaction timing, visual processing time, eye hand coordination, proprioception/kinesthesia, dynamic sitting balance, gross and fine motor coordination/dexterity,  multistep direction following, accident avoidance and other significant executive functioning skills. 


As indicated in current research, simulation devices and activities like the VXP™ are engaging and fun.  Clients display increased motivation and participation in the treatment and have significantly increased sustained attention to the task as opposed to conventional therapeutic methods.  There is opportunity for the client to perform part of the training independently and for family and friends to participate.  SD card technology allows the therapist or CDRS to track time, monitor progress and upgrade the home rehab program.  


Virtual Reality and Therapeutic simulation modalities such as VXP™ are:


· Engaging and fun

· Improve client and clinician satisfaction

· Increase motivation and compliance with home programs

· Improve functional performance in daily life skills

· Improve pre driving skills

· Increase family, caregiver, friend involvement and participation in rehabilitation process

· Increase patient to therapist ratios

· Decrease length of recovery time, increase revenue, decrease cost

· Offer opportunity to utilize versatile, low cost, off the shelf technology

· Offer opportunity for ambient monitoring and SD card tracking 

 

References


Advani, S., & Hosman, R. (2001) Integrated motion cueing algorithm and motion based design for effective road vehicle simulation.  Paper presented at the Driving Simulation Conference 2001, Sophia Atipolis, France 


Barnett, J., Bowen, S. A., & Oakley, B. P., (2006) Effects of Motion Skill Acquisition in Future Simulators.  Study report 2006-2007.  US Army Research Institute for the Behavioral and Social Sciences.


Briggs K, Kappenman W, Kahol K, Greenlee J, Johnson, K, Smith ML, "Scientific      Framework for Selecting Simulation Games for Rehabilitation and Assistance:  A case Study with the Wii™" , accepted for publication at Medicine Meets Virtual Reality 17, 2009.


Diaper, D., Stanton, N. (2004) Handbook of Task Analysis, Lawrence Eribaum Associates, New