Therapy and Assessment in Embodied Virtual Reality: Accessible realism for exercising cognitive functions

The practice and observation of daily living activities in real world settings is fundamental in the achievement of long-term rehabilitation objectives. Numerous factors may prevent clinicians from taking service users out into the community, frustrating attempts to perform relevant practice and to further service user progression goals. Virtual reality can be used to create settings akin to those encountered in the real world, particularly those that are difficult to repeatedly produce for training or assessment purposes. The embodied component of virtual reality induces a feeling of ‘being there’ such that service users can meaningfully plan and carry out activities to expose and exercise their higher cognitive functions in realistic settings. If designed in collaboration with clinical professionals, virtual environments can offer a controlled means of exposing service users to daily living activities in a safe and observable manner. Professionals from BIRT have directly contributed to the design of our environment, Z-world, as a mechanism for researching the potential of virtual reality for assessment and training for people living with a brain injury. We have found that an effective design should directly involve the clinician by allowing cognitive load on service users to be continually monitored and adjusted as they attempt each therapeutic activity. Clinical feedback suggests that behavioural recordings of activities carried out by service users in Z-world have the potential to support clinical decision making around assessment and training. The compelling nature of virtual reality might encourage service users to engage in therapeutically meaningful activities, enriching the experiences available to them. Virtual reality environments offer new opportunities to carry out activities of therapeutic and service user interest, extending the range of goals achievable in current rehabilitation settings.