Virtual Reality Physical Therapy and Trunk Restraint

Recently, interest in virtual-reality technology as used in physical rehabilitation has risen drastically. The applications in this field are varied. They range from simulations that address various phobias, to physical interfaces that help to improve and analyze   fine motor control. In  Physical Therapy, the majority of virtual-reality applications focus on hand and arm movements. This is because of the variety of available hand interfaces developed by the gaming industry. However, when used within the context of VR therapy, these hand interfaces only provide limited sensory information, which often yields unreliable results. For example, if an application requires the patient to move their arm in a certain manner, and the patient is unable to do this satisfactorily, he may compensate for  the action by adjusting his posture or his shoulders. In that case,  the patient fails in accomplishing the intended therapeutic objectives but the application  may still register the action as a ‘success’.

Researchers note that typically, the patient compensates for a reach task mostly through moving the trunk forward  and to a lesser extent, shoulder flexion. This movement compensation is used instead of the natural reach pattern, which involves interjoint co-ordination of shoulder, elbow and hand.  Technologies that  are available do  address shoulder and posture control with the precision required by researchers but   are cost-prohibitive and  bulky. These include camera based motion-capture systems, which require high  setup and maintenance costs. However physical and occupational therapists can now use the HANDTUTOR, ARMTUTOR and 3DTUTOR to allow their patients to practice intensive reaching and gripping exercises and receive feedback on the position of the trunk as they are performing the reaching task.  The software also shows the patient how to reposition the trunk in the correct way. Being aware of the trunk position during reaching exercises  using the ARMTUTOR and or HANDTUTOR will allow the patient to practice active trunk constraint.

The TUTOR system (which also includes a LEGTUTOR) was originally designed to assist patients recovering from stroke, brain/spinal cord injuries and other upper and lower limb disabilities. The TUTOR system consists of ergonomically designed gloves and braces which include sensors connected to dedicated exercise software. The patient uses his own power to move objects on the screen. Physical and occupational therapists record and evaluate the patient’s progress and then design a customized exercise program for the patient.

Operating now in leading U.S. and European hospitals and clinics the TUTORs are fully certified by the FDA and CE. They are also available at the patient’s home through the use of telerehabilitation.

See WWW.MEDITOUCH.CO.IL for further information.


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