Virtual Reality and Exergaming in Rehabilitation: Scientific Evidence and Practical Impact on Adapted Physical Activity (APA)

Abstract

Virtual reality (VR) is a spatio-temporal environment thatmixes the sensation of real body structures with artificialobjects. VR is often combined with gaming principles, suchas rewarding for successful actions and providing sensoryfeedback. In many cases it is comprised of physical activ- ity components, taken from recreational or competitivesports such as boxing, tennis, volleyball, surfing, etc. Thismodality of VR has been labeled Exergaming. The scien- tific interest in VR and Exergaming has rapidly increasedin the last two decades. When entering the terms VR andrehabilitation within the PUBMED database in mid Febru- ary 2013, 608 records were retrieved, and for the termExergaming, 35 records. The most common populationsattending VR studies were the elderly (192 records) andstroke survivors (191 records). Other common populationsattracting VR research were children (70 records) andpersons with cerebral palsy (30 records). Specific bodyfunctions that have been reported to be targeted throughVR and Exergaming include balance, motor strength, up- per limb and hand function, gait, motor control (e.g., bodysegment coupling), and cognitive functions. Participationin social play and cognitive activity is another domain ofinterest, particularly for children with autism spectrumdisorders. Recent systematic reviews on the impact ofVR and Exergaming compared to conservative types oftherapy and exercise have addressed evidence suggest- ing that VR and Exergaming are effective in developingstrength and endurance, in improving upper limb functionanad activities of daily living, and in facilitating walkingpatterns and balance. However, VR has also shown a cer- tain limitation after continuous practice, called cybersick- ness. This presentation will outline the current evidenceon VR technology and outcomes, and will describe recentactivity programs developed for using VR within a hybridrehabilitation framework utilizing VR and a treadmill, aswell as other exercise and balancing modalities for pro- moting motor control and rehabilitation outcomes, whichcould be utilized by APA practitioners.