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Virtual reality added to soldiers' rehab


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Virtual reality helps GIs deal with PTSD

By MELANTHIA MITCHELL, Associated Press WriterSat Aug 4, 1:05 PM ET

TACOMA, Wash. - Staff Sgt. Jeff Ebert's entire body flinches as a roadside bomb explodes near his vehicle. Smoke obscures his view. Gunfire rattles around him.

This isn't on a road in Iraq but inside a room at Madigan Army Medical Center, where psychologists plan to begin using virtual reality — think immersive video games — to treat post-traumatic stress disorder by recreating the conditions of war.

Virtual-reality therapy provides doctors with a tool that uses visual, auditory and thermal cues to set the stage for treatment of veterans with the disorder, which causes nightmares and flashbacks. It can be so severe that some victims withdraw from society.

At Madigan, clinical psychologist Greg Reger hopes to begin offering the treatment later this summer.

"Just about everybody is affected by their deployment experience," said Reger, a former Army captain who recently came off active duty after spending a year in Iraq with the 62nd Medical Brigade. "The vast majority come home and there's a natural recovery that occurs, but for the significant minority that does need additional help, we do see a number of those individuals here in the clinic."

The research is being funded by the Office of Naval Research, which in 2005 provided $4 million to several groups to examine how virtual reality can help treat PTSD. The disorder affects an estimated 15 percent to 30 percent of Iraq war veterans.

Other research is being conducted in California, Hawaii, and Georgia. The Madigan program, Reger said, received a $200,000 grant for its work.

In clinical studies at San Diego's Naval Medical Center and Atlanta's Emory University, eight Iraq veterans with PTSD underwent virtual reality treatment and six showed a reduction of symptoms, said Dr. Albert Rizzo, a University of Southern California psychologist developing a virtual reality system.

"We're very enthusiastic that this is really going to start to make a difference," Rizzo said.

During a demonstration at Madigan, Ebert appears visibly jolted when a concussion from a bomb rocks his mock Humvee as he drives it in a military convoy. Ebert, who doesn't suffer from PTSD, sits in a chair atop a low platform that rumbles and shakes to simulate the vehicle's motion. He wears a headset that displays the scene.

The experience is "very realistic," he said, noting his palms became sweaty during the demonstration.

"I had my fair share of convoys," said the 28-year-old behavioral health specialist from Toledo, Ohio, who returned from a yearlong tour in Iraq in November 2004.

Next Ebert walks through a simulated Iraqi village and scans the area, his right hand instinctively moving to his hip where he would normally be carrying a sidearm while on patrol.

"Being through it before, it's just automatic reactions ... staying ready," Ebert said. "Just a sense of security."

At Madigan, treatment will involve interviewing the soldier to learn what may have triggered the PTSD symptoms, Reger said. He'll then tailor a virtual reality scenario for that person.

"What this technology does is it gives us an environment to help facilitate soldiers telling of their own story," Reger said.

Clinicians can also incorporate a slew of smells — body odor, gun fire or burning rubber, for example — to enhance the therapy sessions.

"You really can do a lot of things ... to heighten the level of realism of the experience," said Mark Wiederhold, president and director of Virtual Reality Medical Center in San Diego.

The company uses cognitive behavioral therapy along with virtual reality to treat people with a range of phobias, including fear of flying, heights and spiders. Its clinicians also have worked with patients involved in motor vehicle accidents who were later diagnosed with post-traumatic stress disorder.

Virtual-reality systems are also being used in the rehabilitation of disabled patients at Israel's Chaim Sheba Rehabilitation Hospital near Tel Aviv.

Previously, options for treating PTSD involved group or individual psychotherapy, or having a person imagine their experience, Wiederhold said.

"The issue is you want to access the fear hierarchy in patients," Wiederhold said. "Only about 15 percent of people are good imaginers. They have difficulty maintaining that state of imagining a scenario. Virtual reality is a much more vivid experience."

Veterans advocates, while not endorsing any specific treatment, welcome the technology for improving mental health.

"Being able to treat these people ... is very important," said Patrick Campbell, legislative director for Iraq and Afghanistan Veterans of America. "It's not just about the drugs."

On the Net:
Madigan Army Medical Center: http://www.mamc.amedd.army.mil/wrmc/wrmcfront.htm
Virtual Reality Medical Center: http://www.vrphobia.com/



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Wounded soldiers and injured civilians will soon be using technology reminiscent of the holodeck in old Star Trek movies to help regain their physical and mental confidence.

"In this case, reality is reflecting art," said Commodore Hans Jung, surgeon general for the Canadian Forces.

Jung was speaking at a funding announcement Sunday to bring a $1.5-million virtual reality simulator to Edmonton's Glenrose Rehabilitation Hospital.

People learning to use an artificial limb or recovering from a stroke will be able to walk, drive or even swim through a variety of virtual environments without leaving the safety of the hospital — almost like on the holodeck of the fictional Starship Enterprise.

CAREN — the Computer-Assisted Rehabilitation Environment — consists of a mobile platform, and a variety of video projectors and cameras.

Patients will stand on the platform, which moves according to what they're doing and what terrain they're moving through. Meanwhile, they are surrounded by images of whatever environment they've chosen.

Heals mental injuries
"It's very much like a 3-D game scenario, where you get into the environment," said Jung.

"The patient actually feels like they're in that environment. You can actually get completely immersed in your virtual environment to really push yourself."

Because the treatment takes place in hospital and not the outside world, it's much safer for patients still in recovery. It's also much easier for hospital staff to take someone to CAREN instead of the park.

Jung said the system will also help heal mental injuries as well.

"With [post-traumatic stress disorder], the therapy is often on reintroduction of the scenarios that caused it in the first place," he said.

"With this, you can virtually create the scenario that caused it in the first place — whether it's on the battlefield, a car accident — and gently re-introduce the individual. That's what allows a person to get back into their real life without the fear of constant flashbacks."

The simulator should greatly speed up recovery times, said Jung, who called it a "transformational" technology.

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This is definitely really cool, amazing the technological advancements we have nowadays.  It'd be interesting to see how this actually works in a video!


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I'm really interested in how this can be used for exposure therapy. If it is realistic enough to be able to do that, it could be an excellent tool for rehab/treatment.


The Bread Guy

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Bump with the latest from the Government of Canada's public tendering site:
.... The Department of National Defence has a requirement for the supply of six (6) Virtual Reality Exposure Therapy System for delivery to Ottawa, Ontario.  The delivery is required by 31st July 2014.  The requirement also includes an irrevocable option to purchase up to two (2) additional units within one year after contract award.

The Canadian Forces (CF), Health Services sector as a requirement to augment its current inventory of virtual reality exposure treatment (VRET) systems for the purpose of expanding treatment capability to CF members presenting with post traumatic stress syndrome (PTSD).  Virtually Better Inc.'s VRET system is used extensively by the USA DoD and has proven effective in treating PTSD.  The CF Health Services experience using Virtually Better Inc.'s VRET has been identical to the USA DoD experience.  The intellectual property (IP) rights associated with the VRET system are owned by the USA DoD. The USA DoD in conjunction with Virtually Better Inc and the University of Southern California have partnered to develop the VRET. Virtual Better Inc is the only known vendor offering a complete VRET system (hardware and necessary software programs) to effectively treat,  in a medical office setting, military personnel presenting with PTSD.  To facilitate inter-site and CF/DoD consultation and, for reasons related to IP, and
interchangeability of methodologies, protocols and parts and components, it is proposed to negotiate directly with Virtual Better Inc., of Georgia, USA,  for this requirement.

For reasons of exclusive rights, it is proposed to negotiate directly with the manufacturer, Virtually Better, Decatur, Georgia ....
More on the company here, and on the product here (brochure via dropbox.com).