Virtual Reality in Cognitive and Perceptual Rehabilitation - A Promising Approach

Abstract

Opinion In modern medical era, the paradigm of rehabilitation bench upon functional outcomes. The conventional approaches primarily dealing with physical issues in terms of sensory-motor deficits of patients with neurological disorders seem insufficient. Cognitive and perceptual rehabilitation is the one which enables the individual to utilize various sensory cues from environment together with its understanding, judgement and memory for achieving meaningful gains. It is important that the rehabilitation approaches do not underestimate the importance of this area of rehabilitation because cognitive and perceptual skills are, in a way, considered prerequisite skills to even physical performances. Virtual reality (VR) is one, amongst other modalities, with immense potential to be used in comprehensive neurological rehabilitation, though most of its utilization has been done in terms of physical training. Its concept and techniques has been used in the field of rehabilitation since years. However its potential in terms of cognitive and perceptual rehabilitation has been under-explored. VR typically refers to the use of interactive simulations created with computer hardware and software to present users with opportunities to engage in environments that appear to be and feel similar to real-world objects and events [1]. VR follows the theories of mental imagery not only for physical gains but also for cognitive and perceptual improvement. Our recent review on mental imagery focused on the use of mental imagery in physical gains [2]. Virtual reality, unlike that, follows the theories of mental imagery not only for physical gains but also for cognitive and perceptual improvement. It is based on the concept of neuro-plasticity which states that structural and functional reorganization follows any damage to central nervous system. Various researches have shown that this re-organization can be enhanced by exposing the individual to stimulation situations with the use of virtual reality. The technique of virtual reality training could be immersive or non-immersive type. Immersive type means the client is basically immersed in a virtual environment. The advantage of immersive systems is the user's sense of being a part of the virtual world. In non-immersive systems, the VR system consists of a display device, mouse, keyboard and possibly joysticks, tactile and force sensors. The multi-sensory illusion is created via visual, tactile and auditory feedback. Visual feedback is traditionally given by computer screens, large screen projection, wall projectors and head-mounted displays. Acoustic feedback in mono or stereo sound can be provided by speakers, headphones or other sophisticated surround sound systems. Tactile feedback provided by robotic actuators or haptic (tactile) gloves that