Virtual Reality's Potential to Change Medicine

Join us as we explore, Medical Frontiers.

Wow, look at these dinosaurs are so incredibly realistic.

Virtual reality, which is used in games and also entertainment which immerse users in a simulated environment is now being implemented in the field of rehabilitation.

The results so far have surprised the doctors and incredibly encouraging, and also offer promising new treatments, for example, in people who previously couldn't walk.

In Japan, virtual reality is being used to rehabilitate patients who have difficulty moving their limbs due to stroke, spinal conditions or other diseases.

This footage shows a man in his 30s undergoing rehabilitation.

The right side of his body was paralyzed after a stroke.

His right hand has difficulty receiving commands from his brain.

As a result, he has a hard time picking up balls and moving them from one side to the other.

But after 20 minutes of rehabilitation using virtual reality, he can hold balls firmly with his right hand and move them at a faster pace.

The difference is clear when they are compared side by side.

This rehabilitation using virtual reality enabled the patient to more easily get dressed and do daily chores such as folding clothes.

To understand what happened to the patient's body, Erica tried out the latest VR rehabilitation therapy.

Cardiologist Hara Masahiko developed the system, tapping his experience examining patients who require rehabilitation.

Just give it a try.

Oh, my gosh.

This is so strange and very new.

New sensation.

Completely.

First all, I'm going to start with your right hand.

And you can see a fixed object.

The center is a white and circle is red, right?

And please touch softly.

Oh, okay. I see. I see. Okay, great. Got it.

Well, this is fun.

Oh, my gosh. This is fun.

It's like popping bubbles.

In this game, targets appear one after another.

The player touches them with controllers held in both hands.

You reach like this with a smooth movements of your elbow.

When using VR in rehabilitation, it should be done in the right form.

A specialist stays by the patient's side and gives advice on arm and other movements.

And keep this position.

Keeping the position is very difficult.

It's very difficult for many people to do like this.

I think the reaching out in the stretching and it was such a new experience for me, but it was also quite active movements.

So you really have to kind of stabilize and use your core and be aware of your movements.

Seventy-year-old Nakano Yasuo has been in a wheelchair for eight years.

He developed difficulty walking due to damage in his spinal nerves.

If someone touches me like this below
the knee, I can't tell where they're touching.

But if they hit me, I feel a tingling sensation.

Nakano used to serve locally as a baseball umpire for 40 years.

He would dedicate his weekends to his favorite sport.

But now, he is unable to stand on the baseball field.

The biggest fear wheelchair users have is falling over.

Nakano lives by himself.

If he falls, he may not be able to call for help, and that could put him in danger.

I know my legs can't support my body.
I'm scared to lean forward because I could fall.

Nakano was so afraid of falling, he kept his movements to a minimum.

That left his muscles stiff.

Conventional rehabilitation didn't have much effect on Nakano.

But one day, he discovered VR-based therapy.

He has VR rehabilitation sessions twice a week, for an hour each.

Lean forward with your upper body,
not just your shoulders.

This is what Nakano sees in front of him.

Targets appear in various directions, and he tries to touch them.

It's just like a virtual-reality game.

The major difference is that a physical therapist is standing right beside him and giving advice while watching his movements.

The therapist adjusts the game's settings to apply an appropriate load to Nakano's core and legs, based on his physical capabilities.

Here, Nakano is trying to capture the target in front of him.

A closer look at his lower back and legs shows he is spontaneously using both legs to support his upper body.

Firmly plant your left buttock. Putting your
weight on your side is the most difficult.

When Nakano reaches out to the left or right, he tightens his buttocks to balance his body.

By using the right muscles properly, he can avoid falling out of the wheelchair when moving his upper body.

Put your weight on your buttocks.
You can do it. Yes, that's it.

Not too quickly. Move your weight slowly.
Lean gradually, and return slowly.

Do it just like you did now.
It's hard, but let's do it slowly.

VR rehabilitation also gives an accurate, numeric evaluation of the patient's performance.

This chart shows how far Nakano has been able to extend his arms when leaning forward.

The green lines reflect data from when he first started rehabilitation.

The orange lines indicate his performance three months later, and the blue lines, 14 months after starting.

The lines for his right arm show that after three months of rehabilitation, his reach was 20 centimeters longer, and after 14 months, it was 35 centimeters longer.

VR rehabilitation has also made it easy for Nakano to pick things up off the floor.

He's no longer worried about falling when he leans forward to close the curtains.

His physical therapist believes that once patients can balance their bodies, they're ready for the next step.

Next, he can lean on his hands to lift
his buttocks off the chair, as if to stand up.

The arm exercise lets him practice standing up.

I have fun doing rehabilitation.
I can tell that it has made my legs stronger.

You have better control of your legs now.

I'd like to walk to the baseball field,
using a cane if necessary.

I want to walk to the umpire's room.
That's my current goal.

Nakano's doctor, Asami Toyoko, is a pioneer who was the first to introduce robotic technology into rehabilitation at Saga university hospital.

Why is it so effective for rehabilitation?

Why is virtual reality so effective?

In VR rehabilitation, patients see and recognize
the target and move their bodies toward it.

This means that the VR rehabilitation challenges
both their cognitive and physical functions.

It stimulates their brains,
generating new, beneficial outcomes.

This therapy forces patients to use both
hands as they move their bodies.

It's fun and immersive, and it
boosts their motivation.

It makes patients want to continue.
That's how it's different from regular VR games.

The developer, Hara, believes that doing physical activity while looking at virtual reality rebuilds the pathways between the brain and body.

The brain has two pathways. One issues commands
to move the body, and the other receives them.

All diseases result from abnormalities
in one or both of these pathways.

I think you can cure any disease
by doing traffic control in the brain.

I guess not wiring properly or just not the signal between the brake and the accelerator or the signal going out to the signal coming in is confused.

That's right, that's right.

Including Parkinson's disease.

Cerebral palsy after stroke or Sarcopenia or even aging have the same problem.

So it's very simple.

For me in my viewpoint, all diseases have a single mechanism.

That's why mediVR KAGURA can approach and can be applicable to all kinds of diseases and we can succeed in curing them.

There are high hopes that VR rehabilitation will also help children with cerebral palsy.

Thirteen-year-old Kamagome Haruto suffered paralysis in his limbs soon after birth.

He has difficulty walking.

He cannot go from one place to another without the help of people around him.

Conventional rehabilitation did not help.

His mother gave up on trying to get him to walk.

Then, a year ago, she discovered VR rehabilitation after learning about it on the internet.

Nervous? Your legs are tense.

I'll tell you when to stretch and loosen
your body so that you can relax.

Haruto does three rehabilitation sessions using VR a week, for about one hour each.

His physical therapist takes part remotely.

Relax your left hand.

You're tense today.

The VR rehabilitation helps to loosen his tense muscles.

It also stimulates the muscles in the lower part of his body.

This footage was taken a year ago, when Haruto first began his VR rehabilitation.

At the time, it was difficult for him to maintain his posture without a backrest.

Three weeks later, he was able to sit in a backless chair, using his core muscles to support his upper body.

His legs also appeared to be more firmly planted to the floor.

Heels on the floor. Look straight ahead.
That's it, Haruto.

He even became able to walk using a walker.

Just three weeks of VR rehabilitation took him from crawling on the floor to walking with a walker.

And only one month after he started rehabilitation.

Good!

Yes, that's good.

Look ahead.

You're doing fine.

Use your body weight.

Haruto became able to walk using crutches.

In this session, he was able to take more than 10 steps.

At the time, I thought I was dreaming.
It was a very moving experience.

Sorry.

He had been undergoing
rehabilitation for a long time.

Sorry.

Our goal was for Haruto to walk.

But to be honest, back then,
I couldn't imagine him walking.

Then, he suddenly started walking.
I thought I was dreaming.

I thought VR rehabilitation was amazing.

I was astonished.

It made me think, "Wow!"

I was really surprised at the time.

In the spring of 2022, Haruto and his family had an unforgettable moment, six months after beginning VR rehabilitation.

It was at the graduation ceremony of Haruto's elementary school.

He was able to walk across the stage unaided, and receive his diploma.

Now, one year has passed since Haruto started VR rehabilitation.

That's good.

You're doing well!

He can now walk longer distances.

He's also become more accustomed to using his crutches, and his steps are steadier.

You are walking nicely.

Can you turn around?

Walking is very beneficial for Haruto.

It moves his muscles and keeps him healthy.

It also makes him more confident about becoming independent.

That's good.

Haruto has been working hard to achieve his dream.

My goal, at minimum, is to
walk like other people.

I want to go out and walk around
outside for long periods.

Right now, I can't go anywhere alone, and
need someone to drive or take me around.

I want to be able to walk and
play with my friends.

It was incredible to watch the footage of that thirteen-year-old boy who couldn't walk and how far his progressed.

And at the moment, I mean, he's assisted, but he's walking.

What are your thoughts on the applications, particularly for this technology for children?

I think rehabilitation therapy is
very important for children too.

They take part in more activities at school
and have more options after graduation.

They can have a brighter future.

Going forward, what sort of I guess clues or hints do you think that the virtual reality rehabilitation can give to, I guess, to improve regular rehabilitation?

The major differences between the
VR system and other rehabilitation robots are that the VR system has few risks, and it's
easy to implement, user-friendly and satisfying.

VR therapy is fun, so patients
want to keep doing it.

If they continue, it will benefit them more.

Thank you so much.

Virtual reality is now being used to treat depression as well.

This woman in her 30s gave birth during the coronavirus pandemic.

She developed postpartum depression.

I don't think there's a right answer
when it comes to raising a child.

But I would keep looking for it
and blaming myself.

I'd feel down and anxious about little things.

In Japan, the pandemic led to a larger number of new mothers being unable to share their worries.

A 2020 survey by a Japanese university says almost one in every four mothers likely had postpartum depression.

This woman lost her will to do anything and became convinced that she was a bad mother.

Her adoration for her newborn baby began to fade.

Japan's National Center of Neurology and Psychiatry is studying the effects of virtual reality on depression.

In 2020, clinical psychologist Ito Masaya conducted a clinical trial using virtual reality.

I think depression therapy using VR has
excellent, if not limitless, potential.

Many people can get better.
I believe that's a possibility.

Ito and his colleagues conduct VR therapy using an unconventional approach.

Standard therapy involves having patients recall negative feelings and discussing with their therapists ways to ease their stress.

However, remembering negative feelings is painful for patients.

The new therapy focuses on positive feelings.

Before patients wear a VR device, they first recall memories of fun times.

If your child was asleep and you had time
to yourself, what would you like to do?

I'm imagining what I would like to do
if I had one hour of free time.

I'd make myself chamomile tea
and enjoy its warmth.

After about 30 minutes of conversation, patients rediscover what makes them happy.

Then, the VR device simulates experiences that help the patient feel positive.

I see a fluffy, very cute panda.

The woman chose a video of giant pandas.

It shows a panda cub sleeping peacefully on its mother's belly.

Whether animal or human,
babies don't stay small for long.

Babies are so cute, I could watch them forever.

How were the VR images?

The panda cub was really cute.
It reminded me of when my son was small.

He would make cute, clumsy
movements, just like the little panda.

How did you feel when you recalled
the time your son was a newborn?

He was just like the panda cub.
It made me smile.

The VR content includes various videos, such as those of the sea and sunset.

Patients can choose the one that matches their mood on a particular day.

In the clinical trial, participants had a 50-minute session of the VR therapy once a week for eight weeks.

Seven of the eight patients saw improvement in their depressive symptoms.

The 360-degree VR experience is effective
because it brings up past, positive feelings.

It provides rich experiences that remind
patients of long-forgotten events and sensations in a favorable way.

Patients will think to themselves,
"Yes, I used to enjoy this."

Memories of things such as delicious food
are revived along with the sensations.

The woman's moderate depressive symptoms have improved to a mild level.

And now, she feels happy about the time she spends with her child.

I remembered things about the past,
such as what I used to enjoy.

I tried to involve myself in such things,
and that brought me positive feelings.

This encouraged me to be
kinder toward my child.

I feel like the weight has been
lifted off my shoulders.

Virtual reality has the potential to change the field of rehabilitation, and also help with depression.

The technology could dramatically improve the quality of life of sufferers and enable them to fully enjoy life once again.

The exact mechanism of how it works, isn't yet fully understood.

But uncovering that would allow VR to be used in even more effective ways, giving hope to a larger number of patients.