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Using VR and AR for Pain Management

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Immersive technologies have been used for the past 30 years to treat pain, PTSD, phobia, anxiety, and phantom limb syndrome, said Deepa Mann-Kler at Women in Tech Dublin. She explained that the human brain processes images 60,000 times faster than text, and 90% of information transmitted to the brain is visual. Since we are visual by nature, we can use VR and AR in pain management, she argued.

Mann-Kler mentioned that deep breathing is one of nature’s most powerful medicines. Neon has developed BreatheVR, which combines the visual power of distraction with deep breathing to create a state of "immersive distraction." It’s a virtual reality application for Gear VR and Oculus Go that uses the breath, and rewards the user visually to help them reach a relaxed state of deep breathing.

Mann-Kler explained how BreatheVR combines the power of virtual reality and deep breathing to create an immersive experience for the user:

Once the headset is on, the user is in a bright, colourful, animated meadow, listening to calming music and birds. The user is asked to inhale deeply through the nose and then to exhale deeply through the mouth, at which point this breath is detected by the mic, which in turn causes the leaves in the virtual reality environment to rise up. This sequence is then repeated, encouraging the user to get into a pattern of diaphragmatic breathing.

The second game Neon has developed is called "Whack A Mo," an augmented reality game, based on the familiar "whack a mole" game at funfairs. AR is the overlaying of a digital image onto the real world when viewed through a phone or iPad.

Mann-Kler said that AR equally offers the same opportunities to be effective in immersive distraction as VR:

The play element of Whack A Mo maximises the child’s attention and by adding three difficulty levels - it ensures that it caters for a range of ages from 8-12 years of age and that children will play the game repeatedly.

We need clinically led and randomised control trials to really provide evidence of the therapeutic benefits that immersive technologies and virtual reality give, said Mann-Kler. In the short term, if they can minimise the amount of drugs/pain medication that a person has to take, then that has to be a good thing, she said.

Deepa Mann-Kler, visiting professor in Immersive Futures at Ulster University, spoke at Women in Tech Dublin 2019. InfoQ did an interview with her.

InfoQ: You were part of the Belfast pain hackathon attended by chronic pain sufferers and health professionals. What results came out of it?

Deepa Mann-Kler: On 3rd June 2017, the Innovation Lab, Department Of Finance and the Public Health Agency held a Pain Hackathon at Queens University Belfast. The morning session was attended by chronic pain sufferers and health professionals. People suffering from chronic pain said that they needed access to a range of tools to help them de-escalate their pain.

Health professionals said that the single biggest benefit their patients reported was being taught to breathe mindfully. It was from this that the idea for BreatheVR was developed.

InfoQ: How do you use augmented reality to support children who are undergoing medical treatment?

Mann-Kler: We were approached by play therapists at the Belfast children’s hospital who were really keen on using technology with children undergoing chemotherapy treatment, and in particular routine cannula procedures. VR was not a suitable solution, as the play therapists wanted children to be able to see their family and procedure at the same time. Undergoing any kind of medical procedure can be frightening and stressful for a child, and if procedures fail to go ahead this can result in the delay of treatment of the child, and stress and costs for the NHS.

To further enhance childrens’ attention, this game is only available in the hospital setting. Co-design and co-production are central values of this process and at the heart of everything Neon does. Whack A Mo is on a six-month pilot at the Belfast children’s Hospital. The reason we wanted to make a game is that play allows children to use their creativity while developing their imagination, dexterity, and physical, cognitive, and emotional strength. And play is so important to healthy brain development. It is through play that children at a very early age engage and interact in the world around them. And play is important for us adults too, often leading to laughter as a de-stresser. So it seems only natural to combine the magic of AR, unlimited imagination, and the creativity of play.

InfoQ: What ethical aspects should we consider when using immersive technology?

Mann-Kler: The more I have researched the capabilities of technology the more important one question becomes: what is it to be human, and what is the role of technology in our humanity?

I spoke about the ethical aspects in my TEDx Talk on "Being Human" where I said:

"We have to future proof what we create. We have to anticipate all the intended and unintended consequences. We have to imagine the worst and most successful outcomes. We have to examine ethics at every level. We have to involve and empower the people we are trying to benefit. We have to limit bias and discrimination in the design of solutions that aim to meet people’s needs. So many changes are speeding towards us at breakneck speed, artificial intelligence, machine learning, avatars, that the lines between reality and not reality will blur to the point of obsolescence. But through this all, if we do not keep our eye firmly fixed on what it is to be human, we are doomed."

InfoQ: What do you expect the future to bring in immersive technologies for health and wellbeing?

Mann-Kler: Tech will become wearable, fully personalised and responsive to individual needs and biodata. VR will only have a certain life span as the capabilities of AR, mixed reality and wearables are realised.

Wouldn’t it be great if we had such a joint approach that our physiology was so well-monitored and personalised, that we ate the right things for us in terms of preventative healthcare; our fridge freezers ordered directly from supermarkets - knowing what we need before we do?

We will no longer talk about tech in the same way that we no longer talk about electricity; it will simply be a means to an end.

My fear is that our health data will be used for profit and commoditised.

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