Using virtual reality to reduce pain and aid rehabilitation

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Ivan Phelan

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05 January 2022

Using virtual reality to reduce pain and aid rehabilitation

Principal Research Fellow

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REF 2021

This case study was included as part of the Research Excellence Framework for 2021:

Thursday 16 December 2021 • Viewing time: 1 minute

Our researchers are making life-changing links between virtual reality (VR) and healthcare to help patients recover from serious injuries.

Virtual reality (VR) is not a new technology. Consumer VR headsets have been in development since the late 1960s, but only in the last few years has VR really begun to take off.

VR can be defined as an artificial environment where the user feels just as immersed as they usually feel in everyday life. It has the power to fundamentally change the way we think, do and feel.

As a keen gamer, I was fascinated by the growth of VR and the endless opportunities to use this technology within the healthcare sector.

I lead the Impact VR team at Sheffield Hallam, and together we’ve developed a suite of innovative VR rehabilitation systems for patients living with orthopaedic trauma, chronic pain and neurological and musculoskeletal conditions.

Here are three of our standout projects.

Exploring prosthetics training

According to NHS England, up to 20% of adults with upper limb amputations choose not to be fitted for a prosthesis. And out of those who do, as many as 26% are dissatisfied with their device and decide not to use it.

The reasons for this often include expense, a lack of sensory or fine motor control, the device being too heavy or simply failing to meet functional needs. High rejection rates are not only costly for the NHS, they prevent amputees from regaining their independence.

Working closely with healthcare consultants, we developed an interactive virtual experience that allows amputees to practise using a prosthetic limb.

It works by transporting the user to a kitchen where they undertake basic interactions with different objects. This experience-based training gives amputees a way to ‘try before they buy’, allowing them to practice using the device before they are fitted for one.

This means patients are much more likely to stick with their device, giving them the freedom to carry out everyday tasks and do more of the things they enjoy.

Working with the Department of Physical Medicine and Rehabilitation at the Loma Linda University Medical Centre in California, we’ve also been able to repurpose the interactive virtual environment as a way to relieve phantom limb pain in amputees.

It works by using the traditional principles of ‘mirror therapy’ whereby the amputee views their native limb in a mirror, thus appearing to be their amputated limb.

Using VR, amputees were able to visualise virtual hands as if they were their own and perform everyday kitchen activities. The patient noted they felt the virtual hand was actually their own, and in comparison to traditional mirror therapy, pain was significantly improved and had a long-lasting effect.

Reducing pain for burns survivors

Burns injuries can cause intense and prolonged pain, which is often worse while dressings are being changed to prevent infection and aid healing. This painful procedure can also lead to severe anxiety and distress for patients, both in the run up to and throughout their treatment.

Working with burns survivors at Sheffield Teaching Hospital, we explored how VR can reduce pain and anxiety during treatment.

Through clinical trials, we found active VR scenarios that required patients to engage in their virtual surroundings were highly effective in helping patients cope with pain.

One participant said: ‘It took my mind off the pain and made me concentrate on VR, this is a good fall-back. I would like to always have this even if I had to pay for it’.

The immersive nature of VR does more than just distract patients — it captures the mind’s attention and helps to block pain signals from reaching the brain. This reduces pain perception as patients become absorbed in an alternative, more engaging world.

The benefits of using VR to treat burns patients are huge. While patients experience less pain, discomfort and anxiety, medical practitioners are able to spend more time changing dressings and removing surgical staples, all of which helps to speed up the healing process.

Supporting upper limb rehabilitation

For certain hand and arm injuries, particularly fractures, muscles and joints can go unused and become weakened. In some cases, physiotherapy is required to help limbs recover.

However, it can be difficult to motivate children to stick to these vital exercises.

Working with physiotherapists and play specialists at Sheffield Children's NHS Foundation Trust, we created Luna's Light, a VR archery and climbing game, that encourages children to complete their rehabilitation exercises in a fun and engaging way.

It’s designed to help children regain their mobility by carrying out movements such as reaching behind their back to grab arrows or stretching upwards to climb a castle wall.

Through game-play, children are encouraged to actively engage in their physio sessions and no longer see their appointments as a medical procedure or chore.

One patient said ‘I was doing something I enjoy. It was much easier to do, I didn’t notice any pain’. Their family member commented: ‘She didn’t look as though she was in pain at all. She looked as though she could’ve done a lot more than she realises is possible.’

The exercises are designed by a therapist, and the user can obtain in-game rewards to progress to the next level when they perform the exercises correctly.

The system is also a vital tool for physiotherapists to monitor how patients cope with certain exercises and track the progress they make — helping to motivate and aid recovery.

In 2023, Luna’s Light won Best Health Game at the 2023 Games for Change awards. The system is also being used at Sheffield Children's Hospital and Stanford University Children's Hospital, with plans to have this available for widespread adoption in the NHS and internationally. 

Supporting lower limb rehabilitation

Following the success of upper limb rehabilitation, we have further collaborated with Sheffield Children’s Hospital to provide rehabilitation for children after lower limb surgery. 

 

Alongside physiotherapists, we developed bespoke VR play scenarios for in-patients in the immediate post-surgery period to encourage them to perform the required physiotherapy exercises. 

 

Engaging in these scenarios helped distract patients from the pain and assist with weight-bearing, which is essential for healing and recovery. 

 

Patient anxiety was assessed before and after each session with patients reporting significantly lower levels of anxiety at their second appointment. Pain levels were also reported to be considerably lower at the second session. 

 

One patient said ‘It made it more accessible and a lot easier. Because it’s when I was trying to walk with it, I was like on my tiptoes. But when I was doing it with VR, I could put my whole foot down and not be scared.’

 

We look forward to working with Sheffield Children’s Hospital to further develop this system and get it into the hands of patients.


Beyond entertainment

Our work has shown how VR can go beyond pure gaming and entertainment to transform quality of life for people facing serious health challenges.

From giving amputees their independence, to reducing pain for burn patients and helping children recover from injury, VR can transform people’s health, wellbeing and lifestyle.

We’re continuing to build on our work by developing new ways to treat people with different health problems and disabilities using VR. These include games to tackle dysphasia in stroke victims and help children with muscular dystrophy stay healthy for longer.

The opportunities to use VR in healthcare are endless. I’m proud to be part of an amazing team committed to using this technology to make a real difference to people’s lives.

Staff

Ivan Phelan

Ivan Phelan

Senior Research Fellow


Infographic reading 'are you an academic leader with ambition?' and 'join our team' image also features a pink arrow.

REF 2021 Research Excellence Framework logo

About this project

Explore the people and organisations behind this research, and find related publications by the research team.

Research team

Ivan Phelan

Related courses

Our teaching is informed by research. Browse undergraduate and postgraduate courses with links to this research project, topic or team.

Get in touch

Find key contacts for enquiries about funding, partnerships, collaborations and doctoral degrees.