VIRTUAL REALITY IN THERAPY CONTEXT: A BLINDSPOT WITH A LOT OF POTENTIAL

Introduction

The use of Virtual Reality (VR) by physiotherapists is not yet widespread in the Netherlands and Belgium. Currently, a small 20% of Dutch physiotherapists apply VR in their treatments. In Belgium, that percentage is even lower, at 10%.

But that does not change the fact that a majority of physiotherapists do see the potential of VR for their treatments. And it is not an unrealistic expectation that this percentage will increase further in the coming years. For example, 36% of Dutch and 40% of Belgian physical therapists now think more positively about VR than they did a year ago.

So what is the reason that there is a large group of physiotherapists who see the benefits of VR, while only a small group is actually actively using the technology in their treatments?

In this concise research report, compiled from a quantitative and qualitative survey of over 150 physiotherapists in the Netherlands and Belgium, Corpus VR explains where the pain points are and what solutions might be available for them.

The report starts with a brief account of the state of the art regarding the application of VR in the therapy context. Then, the second chapter will list the major concerns that therapists have when it comes to VR and that have emerged from the survey. This chapter will also reveal that there are some misunderstandings surrounding VR in the therapy context, offering suggestions on how this ambiguity can be resolved. The final chapters will feature a physical therapist and a manager in a large hospital who are already using VR. What can we learn from their experiences?

VIRTUAL REALITY IN THERAPY CONTEXT: THE STATE OF THINGS

Looking at the physical therapists who already use VR in their treatments, it is noticeable that in the Netherlands VR is used as often for physical complaints as for pain relief and relaxation.

In Belgium, VR is used slightly more often for pain relief, but again the percentages are almost the same for the three focus areas.

But even among the group of physiotherapists who are not currently using VR, the enthusiasm to start using this technology seems high. For example, less than 4% of Belgian physical therapists say they do not want to use VR at all. The remaining 96% see enough potential.

Among the Dutch respondents, we see the same picture. Here, 10% do not see any application for which they would consider deploying VR. The other focus areas score between over 40% and 65%.

One would expect that with such enthusiasm, the percentage of therapists who are already using VR should be much higher than it is now. Especially considering that the vast majority of them think more positively or equally positively about VR compared to a year ago. Over a third of therapists think more positively about VR applications in therapy context, only 5% are more negative.

Yet, the group of therapists who currently already apply VR in their treatments is even relatively small. In the Netherlands this concerns 17.5% of physiotherapists, in Belgium 10%. Why is this? In the next chapter we will explore the causes and answer the question of whether it is realistic to expect this percentage to increase in the coming years.

VR IN THERAPY CONTEXT: THE PAIN POINTS

We can be brief about the biggest obstacles to large-scale implementation: three-quarters of Dutch physical therapists consider cost to be the biggest drawback to deploying VR solutions. Moreover, half of the Dutch respondents indicate that it is unclear to them what the added value of VR can be.

Looking at the situation in Belgium, it is striking that the cost aspect plays an even greater role proportionally. A significantly smaller percentage (25%) is not yet clear what the added value of Virtual Reality can be.

The solution seems simple: ensure lower costs and implementation will skyrocket. But that is too short of the mark – in fact, the survey also shows that there is still a lot of ignorance about the application of VR in a therapy context. For example, about a quarter of the respondents think that VR does not increase therapy adherence, even though this technology has been shown to have a positive impact on this.

Simply lowering prices is not going to remove this ignorance; education seems more appropriate here. A thought that is supported by the answers given to the question of what should be improved around VR in a therapy context.

The top five answers (both countries combined) are:

Admittedly, lowering the price as an improvement stands out considerably. Nevertheless, experience expert Bart Segers, who is business manager of Kinesitherapy and Nephrology at ZNA, said, “But let’s start by noting that the cost of a good VR application was very manageable for us.”

But at least as striking is the need for good information and clear communication. In addition, improving ease of use for both practitioners and patients also plays a significant role. It is therefore not surprising that a large proportion of the respondents in the study indicated that they would first like to see a VR solution in action before deciding to introduce VR in their treatments. In the Netherlands the percentage is 40%, in Belgium it is 35%.

VR IN THERAPY CONTEXT: THE PRACTICE

Geert van Baggem is co-owner of “de fysioo” Physical Therapists and a board member of the national quality network of physical therapy practices Fys’Optima. In his treatments, he already applies VR. In his own words, he gains from this in every area: “Time, treatment effect, patient experience, you name it. If you use these techniques intelligently and organize your organization accordingly, you can direct more as a practitioner and leave the treatment more to the patient and the technology.”

Indeed, by incorporating VR into his therapy, Van Baggem turns “traditional manual labor” into science. The patient follows his therapy in the VR world prepared specifically for his exercise goals, and the practitioner sees the feedback from the exercises immediately in the dashboard, via the sensors on that patient. To optimize the treatment, based on that real-time feedback, the practitioner adjusts the difficulty of the exercise very easily. Moreover, the use of such new technologies significantly improves clinical reasoning.

Moreover, every physical therapist knows that symptoms could be masked by, for example, aging symptoms, the presence of another pathology or the effect of medication. The use of VR helps the therapist move from subjective perception to real evidence. Indeed, technology allows for more, better and more accurate insights, giving the practitioner a more realistic understanding of their patient’s progress.

According to Van Baggem, Virtual Reality can provide a solution to several serious challenges facing physical therapy today. He envisions the following future scenario: “Let’s make sure that we keep developing the technology, and that the need for that development continues to be emphasized by students learning to work in the new way as early as their training. Let’s make sure we use the early adopters as ambassadors to get the early and late majority on board more quickly. And then we will get the desired flywheel effect, so that health insurers reimburse such innovations appropriately and governments really start thinking seriously about their preventive and long-term effects.”

Read the full interview with Geert van Baggem here.

VR IN THERAPY CONTEXT: THE HOSPITAL

Bart Segers is business manager of Physiotherapy and Nephrology at Ziekenhuis Netwerk Antwerpen (ZNA) and umbrella coordinator of physiotherapy GasthuisZusters Antwerpen (GZA). When the forthcoming merger is officially completed, ZNA and GZA will together be among the largest hospital groups in Europe.

ZNA has been deploying virtual reality since 2021, at several sites. Segers, whose job involves a structural search for innovations that make the work of his colleagues smarter, faster and better, is responsible for this; he saw the potential of using VR to facilitate the diagnosis and rehabilitation of disorders of the locomotor system and nerves and arranged for a tender to be issued.

After the tender process – which also included an agreed upon trial period – supplier Corpus VR was allowed to install a device at every ZNA site. Segers still experiences the enthusiasm of his colleagues and patients on a daily basis. The only downside is organizational: “The current structure and workload in various departments of a hospital mean that an implementation in terms of IT, nomenclature, and organization within the departments could be significantly better.”

Apart from that, both patients and practitioners are quite satisfied. Segers: “Patients experience more variety in the treatments and much more freedom in their exercises. After all, they can do the exercises from home while the practitioner in the hospital gets all the data on his dashboard. And especially our colleagues who really use the application on a daily basis see a structural improvement in therapy compliance and the effectiveness of their treatment.”

Read the full interview with Bart Segers here.