By Aleisha Theisen, PTA and NBC-HWC
In 2024, we’ve highlighted several ways we can help bring balance back into your life through our services at FYZICAL-Forest Grove. And who says improving your balance has to be all work and no play?
Our virtual reality Virtualis system uses high tech “games” that retrain your visual, vestibular and somatosensory systems. As we discussed in last month’s blog post, these systems all work together to help you balance.
Could you benefit?
The VR program in our clinic is a safe, fun and effective way to get your balance systems back on track if:
- You are unsteady or falling
- You suffer from motion sickness
- You have a vestibular disorder
- You’ve had a concussion
- Your coordination needs a tune-up
- Your position sense in your joints has been altered by an injury or a joint replacement
How it works
The PT will evaluate you and create a balance treatment plan in line with your goals. It may include various tools and systems in our clinic, including the Solo Step Overhead Track System and the Virtualis VR system.
Gabe Camilli, a physical therapist at FYZICAL-Forest Grove, uses the Virtualis system in our clinic for many types of treatments. However, sometimes he’ll start patients with real-world training first. The patient may need to face a plain background while moving their head and eyes for various exercises, then they will progress to facing the room as their tolerance for visual stimuli improves. When they are comfortable with these activities, he may then incorporate virtual reality.
If you use our Virtualis system, you’ll wear a headset with goggles, and you will stand on a platform that can move. You are completely safe, surrounded by the frame of the system, with your PT next to you. Your PT also can use a harness for you if needed.
The PT will adjust the challenge level to meet your needs, so it isn’t too easy or too difficult but rather in that perfect “Goldilocks zone.” This uses the principle of neuroplasticity, retraining the communication pathways between the brain and body to improve balance.
Game time
The virtual reality system works through game-like training that immerses you in a scene such as skiing in snow or other realistic
environments. You may shift your weight in your feet, ankles, knees and hips, or you might move your head or arms in various directions. Meanwhile the platform you stand on may be stable, or it could move, depending on the level of challenge you need.
Some of the programs include:
- The relaxation program: This simulates standing in woods with butterflies and deer moving nearby.
- The kinetic program: You’ll feel as if you are in a tunnel with asteroids floating around you. The PT controls how much movement is happening and at what intervals.
- Optokinetic programs: This can include dots spinning around you, or you may have a view of a forest moving past you.
- The sea program makes you feel like you are on the water with waves coming toward you.
- The car simulation lets you simulate driving through mountain vistas with various visual challenges.
- The grocery store simulation incorporates multitasking and memory.
Customized for you
A key feature of our virtual reality system is how highly customizable it is.
Gabe says this is especially helpful for folks with motion sickness. The Virtualis system allows patients to be exposed to a challenging environment “in a more gradual way than real life would allow.” Based on the patient’s tolerance, Gabe will choose how many items are in the line of sight and how fast things are moving. He can also adjust the brightness of the visual stimuli.
Customizations also can be made for someone with balance difficulties. Gabe likes to use the moving platform for balance reaction training. If you feel very unsteady, you can start with a stable platform and a safety harness. As your balance improves and you need a bigger challenge, your PT can increase the difficulty level in the system, so the platform moves forward and backward or side to side at faster speeds. Gabe sometimes will incorporate head movements to increase the challenge.
Because the system allows for a graded approach, and it has many variables that can be gradually adjusted for each patient, “we can push them to that challenge line without overwhelming them,” Gabe says.
Measuring progress
The Virtualis system is rich in data, so your PT can use it to test you for a balance problem and to assess you throughout to make sure you are on track toward your goals. Using what’s known as a sensory organization test, the system measures how well you are using your vestibular, visual and somatosensory systems. If you are overly reliant on one, and another area is weaker, your physical therapy program will be adjusted to improve this. You’ll be able to see graphs that show how your balance systems are improving over time, which can be very satisfying.
Ultimately, this will correspond with you feeling better in everyday-life scenarios, so the drive over the bridge will feel less bothersome, or that walk on uneven terrain will feel more stable.
If you or someone you know is having balance difficulties, call us for an evaluation at 503-357-1706. You can also read more about our virtual reality system here.
Aleisha Theisen is a physical therapist assistant and a board-certified health and wellness coach.
Disclaimer: This blog is provided for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition.