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Prescribing
Lora Appel, PhD
TechnoMTL
Oct 10, 2017
Can Virtual Reality offer an alternative therapy
for people living with Dementia/ Alzheimer’s?
What is Virtual Reality, Really?
Technologies that use
specialized software & hardware
to generate realistic sensations
(visual, auditory, tactile, proprioceptive and/or vestibular)
that replicate the real world.
Source: New Yorker
Source: Intel
Mobile VR
• Samsung Gear VR (Oculus)
• Google Cardboard
• Google Daydream
PC VR (GPU, CPU)
• Oculus Rift
• HTC Vive
• Microsoft Hololens
http://pulseonvr.ca/
2025 AR/VR use-case assumptions
Source: Goldman Sachs Global Investment Research 2016
VR in Healthcare
• Teaching/Education (e.g. anatomy, emergency procedures)
• Training (e.g. surgical skills)
• Rehabilitation (e.g. mobility training, upper limb movement)
• Phobia treatment/ PTSD (e.g. systematic desensitization)
• Pain Management (e.g. in burn units)
• Wayfinding/Navigation
• Empathy building (patient, provider experiences)
• Symptom management (anxiety, depression, isolation)
https://www.youtube.com/watch?v=MIhtFp9AcMo&feature=youtu.be&t=44m4s
Dementia/ Alzheimer’s facts
• 47.5 million people currently have dementia, 7.7 million new cases
every year (World Health Organization).
• > 500,000 Canadians live with dementia, 1.1 million are affected;
annual cost to society $10.4 billion (Alzheimer’s Society Canada)
• results in loss of function &
independence, tendency to wander
• safety risks to patients, challenges to
personal/professional caregivers
resulting in institutionalization
• feelings of isolation and loneliness
trigger depression and cognitive
decline Source: World Alzheimer Report 2015
Objectives
• Usability
• Safety (adverse events)
• Optimal characteristics
• volume/ light,
• multimodality,
• length,
• content
• Impact symptoms
• depression,
• anxiety,
• aggression,
• wandering
Study Methods
• Prospective, non-randomized intervention pilot study
• 56 seniors, various degrees of D/CI (MoCA/MMSE)
• Three healthcare sites:
• Intervention: Participants seated in swivel chair
• Exposed to 5-15 minutes of 360° VR footage
• Natural settings displayed using Samsung GearVR
• Pre-intervention survey,
• Standardized observation session,
• post-intervention interview
Demographics
(N=56)
• Mean Age: 80
• 61% f; 39% m
• 80% need glasses
• 20% trouble hearing
• 22% limited/ no
head mobility
• 59% limited/ no
body mobility
• 40% wheel-chair
• 38% walker
• 6% cane
• 2% scooter
Preliminary Findings
• 85% HMD found easy to get used to
• Only 9% found HMD too heavy
• 25% image resolution (not fidelity)
reported a challenge
• 96% did not experience nausea
• 50% tried to interact by moving/
looking around
• ~40% were very vocal
(giggling/wowing/initiated
conversations)
• >50% reported the virtual world
seemed very real
• 40% indicated experience helped
relax & get relief from unwanted
feelings or thoughts
• 74% would recommend experience
to a friend; 80% would want to try it
again
Conclusions
• D/CI population can tolerate VR
HMD (hardware)
• Experiences (the 360° VR films)
were not disorienting
• VR has potential as therapy for
people with D/CI
• Multimodal experiences (e.g. seeing
and hearing waves) & experiences
showing people or animals were
preferred
Next Steps:
• Conduct RCT with updated VR
experiences, displayed on higher-
end GPU-VR devices, and collect
objective bio-physiological outcome
measures
PrescribingVR.com
lora.appel@uhn.ca

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How Virtual Reality could Change Alzheimer Care

  • 1. Prescribing Lora Appel, PhD TechnoMTL Oct 10, 2017 Can Virtual Reality offer an alternative therapy for people living with Dementia/ Alzheimer’s?
  • 2.
  • 3. What is Virtual Reality, Really? Technologies that use specialized software & hardware to generate realistic sensations (visual, auditory, tactile, proprioceptive and/or vestibular) that replicate the real world. Source: New Yorker
  • 5. Mobile VR • Samsung Gear VR (Oculus) • Google Cardboard • Google Daydream PC VR (GPU, CPU) • Oculus Rift • HTC Vive • Microsoft Hololens http://pulseonvr.ca/
  • 6. 2025 AR/VR use-case assumptions Source: Goldman Sachs Global Investment Research 2016
  • 7. VR in Healthcare • Teaching/Education (e.g. anatomy, emergency procedures) • Training (e.g. surgical skills) • Rehabilitation (e.g. mobility training, upper limb movement) • Phobia treatment/ PTSD (e.g. systematic desensitization) • Pain Management (e.g. in burn units) • Wayfinding/Navigation • Empathy building (patient, provider experiences) • Symptom management (anxiety, depression, isolation)
  • 9. Dementia/ Alzheimer’s facts • 47.5 million people currently have dementia, 7.7 million new cases every year (World Health Organization). • > 500,000 Canadians live with dementia, 1.1 million are affected; annual cost to society $10.4 billion (Alzheimer’s Society Canada) • results in loss of function & independence, tendency to wander • safety risks to patients, challenges to personal/professional caregivers resulting in institutionalization • feelings of isolation and loneliness trigger depression and cognitive decline Source: World Alzheimer Report 2015
  • 10. Objectives • Usability • Safety (adverse events) • Optimal characteristics • volume/ light, • multimodality, • length, • content • Impact symptoms • depression, • anxiety, • aggression, • wandering
  • 11. Study Methods • Prospective, non-randomized intervention pilot study • 56 seniors, various degrees of D/CI (MoCA/MMSE) • Three healthcare sites: • Intervention: Participants seated in swivel chair • Exposed to 5-15 minutes of 360° VR footage • Natural settings displayed using Samsung GearVR • Pre-intervention survey, • Standardized observation session, • post-intervention interview
  • 12. Demographics (N=56) • Mean Age: 80 • 61% f; 39% m • 80% need glasses • 20% trouble hearing • 22% limited/ no head mobility • 59% limited/ no body mobility • 40% wheel-chair • 38% walker • 6% cane • 2% scooter
  • 13. Preliminary Findings • 85% HMD found easy to get used to • Only 9% found HMD too heavy • 25% image resolution (not fidelity) reported a challenge • 96% did not experience nausea • 50% tried to interact by moving/ looking around • ~40% were very vocal (giggling/wowing/initiated conversations) • >50% reported the virtual world seemed very real • 40% indicated experience helped relax & get relief from unwanted feelings or thoughts • 74% would recommend experience to a friend; 80% would want to try it again
  • 14. Conclusions • D/CI population can tolerate VR HMD (hardware) • Experiences (the 360° VR films) were not disorienting • VR has potential as therapy for people with D/CI • Multimodal experiences (e.g. seeing and hearing waves) & experiences showing people or animals were preferred Next Steps: • Conduct RCT with updated VR experiences, displayed on higher- end GPU-VR devices, and collect objective bio-physiological outcome measures