What Is VR Therapy and How Can It Benefit Patients?

In the world of rehabilitative and behavioral therapy, virtual reality (VR) & extended reality (XR) is emerging as a powerful tool in breaking down barriers to healthcare treatment.

Patients with limited mobility face a significant obstacle when it comes to traveling to and from medical clinics. However, VR/XR presents a solution by allowing patients to engage in immersive therapeutic experiences, guided by a therapist, within the convenience of their own homes using a telemedicine platform. But what is VR/XR therapy exactly?

To understand the various aspects of VR/XR therapy and how it can benefit patients, HTC VIVE spoke with some of the top leading minds in the healthcare field to gain insight into VR/XR therapy and where it’s heading.

This article was developed in partnership with the following subject-matter experts. HTC VIVE VIVE would like to thank them for their contributions.

Dave Rawlins
COO
MyndVR

Erica Kaitz
VP of Behavioral Health
Amelia Virtual Care

Patrick Murta
Chief Technology Officer
BehaVR

What Is VR Therapy?

Virtual reality and extended reality therapy is an innovative approach to therapeutic treatment that harnesses the power of VR/XR technology to guide patients through rehabilitative exercises. While the definition of VR/XR therapy is multifaceted, its applications are tailored to the specific therapeutic needs of each patient. This versatile form of therapy finds utility across occupational, physical, and behavioral therapies, and can be customized to cater to diverse populations, including children, older adults, and veterans.

• Occupational Therapy (OT): Occupational therapists focus on improving patients’ capacity to perform activities of daily living. A VR/XR program for OT sessions may include simulated walking exercises in a safe virtual environment or re-learning basic motor skills.
• Physical Therapy (PT): Physical therapists help patients regain or maintain mobility. Virtual reality PT sessions may include interactive games that involve a wide range of motion. For example, a patient recovering from shoulder surgery may engage in an immersive tennis session to improve motor rehabilitation of the shoulder. Similarly, a senior aiming to safely relearn the skill of standing up after a hip fracture could benefit from tailored VR/XR exercises.
• Behavioral Therapy: Mental health professionals can use VR/XR to treat a range of mental health disorders ^[1] , including post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), depression, anxiety, and various phobias, through immersive eye movement desensitization and reprocessing (EMDR), exposure therapy, and coping and relaxation exercises.

Virtual reality therapy is also being used to manage cognitive disorders that tend to affect older populations, such as Alzheimer's and dementia. Dave Rawlins, Chief Operating Officer at MyndVR , says that VR treatments have been particularly efficient as a distraction during sundowning episodes ^[2] , “Sundowning is a neurological phenomenon that is common in people with dementia and refers to increased confusion or agitation at nightfall. Typical treatment for this usually involves antipsychotic drugs, which is obviously not something we want to see. There is a big overuse of antipsychotics exactly for this reason. What we found is that using VR/XR is a very helpful way to distract, meditate and calm a patient down potentially even before sundown,” he explains. Therefore, there’s a possibility that replacing antipsychotics with VR/XR therapy, at least to prevent sundowning episodes, can mitigate some of the negative side effects associated with this class of drugs.”

Another use case of VR/XR therapy is the treatment of neurological developmental disorders ^[3] in children and young adults, such as autism and ADHD, where interactive play can be used to expand and build social skills with peers in a way that would be hard to replicate in real life. The therapeutic potential of VR/XR is virtually boundless, limited only by the imagination of clinicians and developers.

How Does VR Therapy Differ from Traditional Therapy?

By its definition, VR/XR is more immersive and flexible compared to traditional therapy methods. Sessions can be conducted in both in-patient and out-patient facilities, as well as remotely, and can be guided by a therapist or assigned to patients for independent completion between sessions. Patrick Murta, Chief Technology Officer at BehaVR , says that VR/XR is uniquely positioned to resolve many challenges that traditional therapy struggles to overcome. “The current healthcare system can’t scale to the needs that we have for behavioral and mental health. There are more people who need treatment than there are therapists. VR allows us to take the same science and therapeutic approach in an asynchronous model, enabling us to scale therapy to the necessary extent,” he explains.

VR/XR therapy also provides the clinician and their patients options that would be impossible to recreate in real life. For instance, VR/XR can simulate a plane take-off for individuals undergoing exposure therapy to overcome aviophobia, the fear of flying. To make these experiences as efficient as possible, clinicians need to receive training in using VR/XR solutions. Fortunately, more training programs are allocating resources to equip future clinicians with the necessary skills to work with VR/XR as its adoption becomes more widespread. To learn more about the state of VR/XR training in the healthcare industry, take a look at our latest report .

Benefits of VR Therapy

Increased Accessibility

The COVID-19 pandemic changed the world of therapy by making remote sessions commonplace, and in many cases, the only way patients could access services for years. This trend, according to Erica Kaitz, licensed clinical social worker and Vice President of Behavioral Health at Amelia Virtual Care , helped speed up the adoption of VR/XR treatments. Lower costs of headsets and software had a similar effect, “It's become far more accessible. Back in the day, it was super expensive. Now, it's much more affordable so that mom-and-pop clinicians can really start using it within their practice,” she says.

Virtual reality’s potential for remote therapy creates opportunities for patients that otherwise would not be able to receive treatment because of logistics or transportation difficulties. One example Kaitz gives is that of patients with phobias undergoing exposure therapy ^[4] , like that for aviophobia (fear of flying). “With a VR headset, I can transport you anywhere. I can put you on a plane, taking off 15 times in a single session” — a scenario that would be impossible, and incredibly costly, to achieve in real life. Similarly, patients living in remote areas or those without access to reliable transportation can receive some therapeutic services without leaving their homes.

More Realistic, Immersive Experiences

"The power of immersion is really important in the therapeutic process because it intentionally slows down the pace so that patients can really consider what they've just experienced,” says Kaitz, who regularly conducts exposure therapy exercises with her patients. “VR therapy allows for this immersive process to occur faster because the experience feels much more realistic.” When asked how that immersive experience compares to traditional therapeutic exercises, she explains, “The main problem is that you're asking your patients to create distress for themselves and that just runs against our default system. With the power of VR/XR, patients don’t need to recreate the situation for themselves, leading to more engaging, effective experiences.”

Enhanced Engagement and Motivation

Patients who use VR/XR tend to be more engaged and motivated. A recent study of multiple-sclerosis patients undergoing occupational therapy showed that the dropout rate from the program for VR/XR therapy was almost half that of the control group ^[5] in traditional therapy. “People like it," Kaitz says, noting that her own patients seem more engaged and excited to participate in sessions when VR is used.

“This enthusiasm also has larger implications — the better adherence a patient has, the more likely they are to experience positive results,” Kaitz explains. “Patients who are motivated to continue with their treatment also tend to stick with the program for a longer period of time, leading to even more improvement.”

Better Progress Tracking

One of the benefits of VR/XR rehabilitation is that it makes tracking patient progress a less subjective process. As Rawlins of MyndVR points out, "Not only can therapists simulate the exact same range of movement, they can measure that range of motion as well.” In other words, occupational and physical therapists can tell exactly how much improvement a patient is seeing in their range of motion from one session to the next and can create exercises that challenge the patient appropriately as they move through their treatment plan.

Are There Any Limitations or Challenges to VR/XR Therapy?

Although VR/XR may change how patients receive care, experts are quick to point out that it is a tool, not a replacement or a substitute for a trained medical professional. “At the end of the day, you’re still a therapist, you’re still driving this train,” says Kaitz. “But VR can help most patients get to where they need to go faster due to greater immersion.” That being said, some patients may not feel comfortable with strapping on a headset, while those with photosensitivity are advised not to use VR/XR at all (though research is being conducted ^[6] into whether that restriction actually has merit).

All three experts HTC VIVE interviewed for this article agree that some of the greatest challenges to VR/XR adoption in therapy come from a lack of operational standards and difficulties with insurance companies. Regulations tend to move slower than technology which makes clinics and practitioners who are new to VR/XR wary of setting up a new treatment program without codified guidance. Similarly, getting software certified as durable medical equipment (which would allow it to be covered by Medicare) is a long road. However, progress is being made, with AppliedVR being the first VR/XR provider to be approved by the FDA ^[7] for its therapeutic chronic back pain program.

Yet another limitation is connectivity. Patients or therapy clinics without reliable access to the internet will need to depend on VR/XR headsets that come with preloaded content. Though as access to broadband is improving in rural areas ^[8] connectivity will at some point no longer be an issue.

VR/XR technology is changing quickly. As immersive experiences become more advanced, patients will likely also see greater customization options and ways to tailor treatment to their unique needs. HTC VIVE is at the forefront of this innovation. By partnering with leading figures in VR medical training solutions ^[9] , we’re hoping to expand access to all types of care.

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^[1] Smithsonian Magazine, https://www.smithsonianmag.com/science-nature/inside-the-effort-to-expand-virtual-reality-treatments-for-mental-health-180979995/

^[2] Alzheimer’s Association, https://www.alz.org/help-support/caregiving/stages-behaviors/sleep-issues-sundowning

^[3] Children on the Autism Spectrum and the Use of Virtual Reality for Supporting Social Skills, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870236/

^[4] American Psychological Association, https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapy

^[5] Multiple Sclerosis News Today, https://multiplesclerosisnewstoday.com/news-posts/2023/01/16/virtual-reality-uses-physical-therapy-ms-may-aid-adherence/

^[6] US National Library of Medicine, https://classic.clinicaltrials.gov/ct2/show/NCT05296057

^[7] Cision PR Newswire, https://www.prnewswire.com/news-releases/fda-grants-appliedvr-approval-for-first-virtual-reality-therapeutic-to-treat-chronic-low-back-pain-301426221.html

^[8] FCC, https://www.fcc.gov/document/new-fcc-report-shows-digital-divide-continuing-close-0

^[9] HTC VIVE, https://business.vive.com/us/stories/best-practices-vr-healthcare-ebook/