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For a long time, health has been defined as the absence of disease. This concept led to an approach to medicine and care that focused solely on symptom suppression.
Since 1946, the WHO has considered health to be “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. According to this principle, medical practices today are evolving towards comprehensive patient care, integrating the notions of well-being and quality of life.
Brain lesions, whatever their causes (trauma, stroke, inflammation, tumors, toxins, etc.) often lead to serious and disabling sequelae. Cerebrovascular accidents are the leading cause of acquired disability among adults in France, while head injuries are the leading cause of severe disability in adults under 45 years of age. Also, multiple sclerosis is the leading cause of non-traumatic disability in young adults.
The consequences of brain injuries vary greatly from case to case, including the following:
- Physical disorders: motor, practical, balance, sensory, etc.
- Cognitive disorders: deficits in executive functions, language, memory, attention, etc.
- Behavioral disorders: apathy, disinhibition, etc.
- Psycho-affective disorders: anxiety and depressive symptoms, anhedonia, etc.
Since 2015, C2Care’s vocation is to harness the possibilities offered by Virtual Reality for health and well-being. After having developed virtual reality therapeutic software for mental health, in particular for Virtual Reality Exposure Therapy (VRET), we now offer solutions for rehabilitation and reintegration as part of comprehensive care.
The therapeutic software has been designed to meet the needs of health institutions working with people with brain damage or cognitive disorders. Our tools are intended for all rehabilitation professionals (neuropsychologists, occupational therapists, physiotherapists, psychomotor therapists, etc.) to help them promote the autonomy and reintegration of their stroke patients.
COGNITIVE AND MOTOR REHABILITATION
C2Neuro is a virtual environment allowing a realistic simulation of shopping in a supermarket. Assessment and rehabilitation of Instrumental Activities of Daily Living (IADL) is a crucial element for the reintegration of people with cerebral palsy.
Shopping in a supermarket involves many functions such as executive functions, working memory, orientation, and spatial navigation. Also, it is an indispensable skill for living independently. Unfortunately, it is often complicated to assess and train because it requires the professional to physically move around to accompany the patient. The use of C2neuro provides an environmentally friendly method of assessment and remediation, which is inexpensive in terms of time and personnel while guaranteeing the patient’s total safety (Schultheis & Rizzo, 2001).
C2neuro can be used for cognitive functions as well as motor and practical functions.
motor disorders care
C2physio can be used for the evaluation and rehabilitation of functional mobility. The software allows a quick and accurate quantitative assessment of joint amplitudes.
The proposed exercises allow working on the gain of amplitude in the search for articular mobility, the follow-up, and the precision of the gesture to improve the fine control of the movement and the maintenance in a position to increase the strength and the endurance of the patients. In orthopedics, it is possible to begin rehabilitation of an immobilized limb as soon as possible or to relieve pain in a phantom limb.
Brain injuries frequently lead to disturbances in body schema and proprioception. C2physio enables the patient’s positional sense to be assessed through a fast and precise quantification of positional error.
ASSESS THE RETURN TO DRIVING
For many people, the use of a car is a sign of autonomy, freedom, and quality of life. Nevertheless, driving is a complex activity, involving many cognitive and sensorimotor functions. As a result, driving skills become impaired following a brain injury (Lundqvist and al., 1997, 2000). However, many patients return to the road without having been tested, which may endanger not only the patients themselves but also other road users (Fisk and al., 1998). While it is the responsibility of health and rehabilitation specialists to estimate the level of risk and the ability to drive safely, this task is particularly challenging because neuropsychological tests do not allow for a satisfactory assessment of driving ability (Gagnon, 2010). Ortoleva and al. showed in 2012 that in the absence of a valid neuropsychological predictor, assessment in a driving simulator was useful. Used with a steering wheel and pedals, C2drive can realistically simulate driving, thus allowing an ecological assessment of driving recovery capacities.
For patients suffering from stress syndrome following a car accident, it can also be used for exposure therapy or alternating bilateral stimulation. In 2010, a meta-analysis by Wiederhold et al. showed that virtual reality exposure helps to reduce symptoms in patients suffering from post-traumatic stress disorder after a car accident.
C2memory is a cognitive stimulation software, controlled solely by head movements. The proposed exercise is similar to physical exercises (Memory card games) or presented on a computer but accessible to people with motor or praxis disorders.
C2memory is also useful for leisure or occupation during care.
C2companion allows your patients to take care of a small virtual dog. Animal therapy improves the healing process and quality of life for patients (Yeh, 2005). Libin and Cohen-Mansfield showed in 2004 that the use of robotic and stuffed cats generated interest and pleasure among residents of a retirement home. When the presence of a real animal is not possible, C2companion allows the management of anxiety and depressive symptoms through the benefits of pet therapy.
Controlled by head movements, the environment is accessible to patients with motor or praxis disorders and can be used as a leisure activity or as an occupation during care. The social aspect of animal care makes C2companion an ideal tool for creating a link between patient and caregiver or for group mediation (Siriaraya and al., 2014).
HYPNOSIS AND RELAXATION
Designed in collaboration with specialists in relaxation and hypnosis (psychologists, hypnotherapists, sophrologists), C2hypno allows the management of anxiety and depressive symptoms as well as pain. The different environments adapt to all relaxation techniques (Cardiac Coherence, Autogenic Training, Jacobson Technique, Full Consciousness, Hypnosis, etc.) and can also be complemented by other methods such as aromatherapy or massage therapy.
A literature review by Zeng and collaborators published in 2018 showed that virtual reality has beneficial effects on depressive and anxiety symptoms without any adverse effects. In 2007, a study by Hoffman et al. showed that the use of virtual reality significantly reduced pain (reduction of physiological and subjective markers of pain).
C2hypno can be used as an ad hoc treatment for pain care or as a background treatment for the management of chronic pain. For patients who can no longer travel, C2hypno offers the prospect of escape.
virtual reality services
HOW TO START A RELAXATION SESSION?
The VR sessions for relaxation are recommended to last 20-30 minutes, in combination with a desired relaxation method (for example cardiac coherence, mindfulness, autogenic training)
- Possibility of group sessions
- Possibility of autonomous (wireless) use
20-30 minutes cognitive stimulation sessions with the therapist.
WHAT SCIENTIFIC STUDIES ARE THE APPLICATIONS BASED ON?
In 2008, Tribet underlined the interest of the animal in a population in cognitive decline, as a vector favoring the emergence of emotions and the revival of psychic activity. Libin and Cohen-Mansfield in 2004 showed that this beneficial effect could be obtained with robotic and stuffed cats when the use of a real animal was not possible.
A review of D’Cunha in 2019 showed that virtual reality relaxation offered an immersive experience leading to deep relaxation, allowing people with reduced mobility to escape and get away from everyday life.
A meta-analysis by Coyle, Traynor & Solowij (2015) on the use of cognitive training with computers and virtual reality showed an improvement in cognitive performance in different cognitive domains such as attention, working memory, executive functions, global functioning, memory, processing speed, visuospatial abilities, and verbal fluency.
Working on everyday tasks increases autonomy (Giovannetti and al., 2007; Dechamps and al., 2011).
The use of virtual reality in day hospitals makes it possible to recreate tasks of daily life in complete safety (Yamaguchi, Foloppe, Richard, Richard & Allain, 2012).
For the medical teams working in the FRC (Follow-up and Rehabilitation Care) clinic and the rehabilitation structure. In hospitals and clinics for all rehabilitation professionals: neuropsychologists, occupational therapists, physiotherapists, psychomotor therapists, pediatric neurologist, etc.
WHAT ARE THE CONTRAINDICATIONS?
Virtual Reality is not recommended for:
- Photosensitive epileptic patients
- Pregnant women
- Psychotic patients in crisis
A literature review by D’Cunha and al, 2019, as well as clinical trials with leading institutions showed that virtual reality was well accepted and appreciated by patients.