Recent advances in virtual rehabilitation system design

Wendy Powell (Editor), Albert Rizzo (Editor), Paul Sharkey (Editor), Joav Merrick (Editor)

Research output: Contribution to journalSpecial issuepeer-review


With a rapidly increasing global population and a widening gap between demand for high quality healthcare and the resources available to support this, there is a pressing need for additional tools to support the delivery of clinical excellence.
In recent years we have seen a trend towards the use of virtual reality (VR) technologies for rehabilitation and disability support. This is partly driven by the decreasing cost and improved accessibility to the technology, but also by the growth in expertise of virtual rehabilitation researchers and practitioners.
The benefits of virtual reality are becoming well established in a number of areas such as pain management, physical rehabilitation and cognitive interventions, and research studies have demonstrated benefits across a range of conditions including Parkinson's disease, cerebral palsy, autism and anxiety disorders.
However, the diversity of hardware and software available currently has little standardisation, and patients with disabilities or health conditions often have unique interaction needs which differ from the general population, and this presents challenges to practitioners developing virtual rehabilitation systems, and there is a need to understand the broader implications of how we design virtual rehabilitation systems and their interactions.
The context of use is an important consideration. For example, in a clinical setting it may be appropriate to use wide area tracking and full body motion capture, but this is likely to be impractical for home use, where low-cost mobile VR may be the technology of choice. This in turn will have implications for way in which users interact with the system, and hence influence application design.
Another key factor is the particular needs of different user groups, where disability or impairment may impede performance and make certain systems or interactions difficult to use. For example, pointing techniques can be difficult for patients with tremor or spasm, but software can be designed to predict user intentions using gaze recognition or movement analysis and facilitating interactions for those with physical or cognitive impairments.
Where there is motor impairment or injury, interaction techniques which would present little challenge to unimpaired users can exacerbate problems during rehabilitation. For example, many mobile VR devices have switches or buttons on the headset itself, but prolonged or repeated elevation of the arms during interaction can rapidly cause discomfort, pain or fatigue, and alternative techniques such as gaze-directed selection should be considered when designing interventions for these populations. Alternatively, gestural interaction can be used via a camera-based sensor such as Leap Motion, but individual gestures should be evaluated for their likelihood to have negative impacts on individual users.
Furthermore, even when the hardware selection and interaction design is appropriate for the needs of the target population, the design of the software itself is an integral part of good virtual rehabilitation design. Visual content, sound design, and even the way the input device is represented within the virtual environment, all have an impact on the way in which the rehabilitation application is experienced, and consequently has an effect on clinical outcomes.
This special issues explores a number of these issues, presenting recent research findings and technical developments which help us to understand the unique challenges of virtual rehabilitation design and guide future VR system development.
Original languageEnglish
JournalJournal of Alternative Medicine Research
Issue number4
Publication statusPublished - 31 Dec 2018


  • virtual reality
  • virtual rehabilitation
  • system design


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