Different types of Virtual Reality environments for gait analysis, monitoring and training are present with the CAREN and V-gait systems. One example is about teaching the patient how to walk (and eventually run) with a prosthetic limb after an amputation. In addition, using output data of the system, prosthetic limbs can be fine-tuned and aligned. 

Forest path 

The patient finds himself walking on a winding forest path. His target is to walk this path to reach it’s end. Walking on the treadmill in a self paced mode, the path andulates to all directions, ascending and decending, turning left and right.

The motion platform follows the path accurately so the patient actually feels the ground in the same way as if it was in the real world.

A secondary task in this environment deals with dual tasking and cognitive load. While walking, there are objects that fly by. Dual tasking mode causes the attention of the subject to be on the additional task, forcing the walking to go more unconscious.

All parameters inside this application are under operator control. Many parameters are recorded for progress monitoring and the patient can also receive a performance score while clinical reports can be generated for the therapists.

Gait analysis

This application analyzes patient’s Gait using an instrumented treadmill that can run at fixed speed or at a self-paced mode. Therapists can instantly look at an analyze Gait parameters that are grouped to spatial-temporal (step length, step width, walking speed, cycle time) and kinematic (joint rotation of the hip, knee and ankle, mean joint angles of the hip/knee/ankle, and thigh/trunk/foot angles) classes .

These parameters can also be compared to gait data from healthy people. Deviations are immediately apparent. Based on feedback from the application, the training through treadmill perturbations can be applied in order to adjust the patient’s gait pattern. Real-time feedback immediately shows the effects on the Gait patterns.

Motek Medical systems present powerful and flexible solutions for people with balance problems and postural disorders. Treatment programs and training exercise can be precisely controlled so that patients are never overstressed. By applying serious gaming, patients achieve higher levels and scores when they perform well.

Therapists control a variety of input parameters for challenging balance and postural stability conditions. For example, controlling the reaction amplitude of the motion platform to specific patient's sway or presenting virtual targets to stimulate the patient balance control. 

Body posture

This application illustrates well how immersion and motivation can enhance performance, specifically for patients with balance and postural disorders who are afraid of incurring pain during a movement. The aim of the training is to increase weight bearing on the affected or "guarded" limb.

In the Body posture application, the patient needs to mimic postures of a hollow avatar that advances towards him on screen. Positive feedback is given when he performs correctly. The therapist can increase difficulty. The therapist can also input how accurately the patient must move into the posture in order to receive positive feedback.  

Boat

The boat application offers the subject a Virtual Reality environment where a small boat needs to be steered through a course in an Island landscape. The subject only partly controls the motions of the support surface since the support surface moves according to both waves as well as to the subject’s ‘rocking of the boat’.

The subject sees islands in the water and is standing on a small wooden boat. The operator can control the level of the application by altering the height, direction and velocity of the waves. In addition, the minimum and maximum speed of the boat can be controlled. 

Our systems offer a broad range of training programs to meet different conditions. Those training programs cater for patients with skeletal and bone injuries, amputees, joint replacements, multi trauma and diabetes-associated pain, neck and lower back disorders and other orthopedic complications.

Further we can assist in the diagnosis and categorization of several orthopedics related conditions such as: back pain, whiplash, lumbar and cervical disc disease, foot, ankle and knee injuries, frozen shoulder, arthritis, and osteoporosis. Also in cases of Diabetic foot conditions the systems can measure the severity of the situation, register and record performance related feedback to specific balance perturbations and classify conditions.

Hit!

Hit is a serious gaming application in which the patient must touch moving targets as quickly as possible by bending his knees. Both speed and strength are needed for the exercises. Reaction times are tracked enabling both therapist and patient to see improvements over time. This application is designed to train recovery from hamstring injuries, meniscus injuries and also for stability training. The application is also used to increase muscle strength and movement range for the elderly, thereby decreasing chances of falling.

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With the help of our systems, patients can recover a wide range of conditions, appropriate for any person who has problems from a neurological condition. Treatment for head injury, stroke, multiple sclerosis, motor neuron disease, cerebral palsy and muscular dystrophy are opportunities with CAREN and V-Gait systems.

Our systems offer true multi sensory stimulation that may enhance the plasticity of the central nervous system. Article - Stroke journal

Some of Motek Neurology - rehab clients also facilitate provision of individualized assessment, foundational retraining in behavior, physical functioning, communication and transfer from working in Virtual reality to daily living.

Goblin’s post office

Motek Medical designed a specialised intervention delivered in the form of computer games leading to an enjoyable experience resulting in better compliance with treatment and therefore faster improvement of movement function and overall reduction of treatment costs.

The game to train the movement of the torso: the child steers a flying dragon by leaning to the front, to the back, and sideways. Along the way the child and the dragon carry out various tasks to collect points. 

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Magician’s apprentice

This application was developed per client specifications for gait and balance training of stroke patients. The patient walks through a virtual castle and must open doors with his left or right hand to enter the next room. The challenge lies in dual tasking: walking and opening doors at the same time.

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Virtual mirror box

Visual illusions provided by a mirror box can have a beneficial effect in phantom limb pain. Mirror box therapy involves placing a mirror in the mid-sagittal plane so as to create the illusion that the amputated limb is again intact. The clinical evidence from therapies using the mirror box suggests considerable promise in reducing pain.

The Virtual mirror box application (VMB) is used for people who have had a stroke and have lost the use of function in a leg or by people who suffer from pain after amputation. VMB provides real-time visual feedback of the appearance and movement of any limb or limbs as needed.  The application uses both static and dynamic mirroring of the intact limb.

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Motek Medical technology uses integrated reality exposure therapy in combination with physiological monitoring and feedback to treat specific phobias such as fear of flying, fear of driving, fear of heights, claustrophobia, and posttraumatic stress disorder (PTSD). General stress management and relaxation skills can be trained for stress-related disorders.

Virtual reality exposure therapy immerses the patient in a virtual world where they experience the various stimuli related to their phobia. The patient is engulfed in alarge screen or dome projection and subjected to surround sound receiving both visual and auditory cues. Furthermore the ground is standing, walking or sitting on is acting as part of the environment and is able to react in 6 Degrees of freedom to any given stimuli, thus triggering also responses from the vestibular and proprioceptive systems.

After an introduction session teaching the control of automatic responses to anxiety-provoking situations, the therapist and patient collaborate to create a gradual increase of anxiety-inducing situations. In careful, controlled stages, the patient is exposed to these experiences that elicit increasingly higher levels of anxiety. 

At every step, the therapist can see and hear what the patient is experiencing in the virtual world. If the level of anxiety becomes overwhelming, the patient can return to a less stressful level of treatment, or simply stop the process. 

Fear of Heights (ACROPHOBIA)

The CAREN system can be used also for treatment of Acrophobia, or the fear of heights. This phobia is manifested by an irrational fear of height situations resulting in the avoidance of such situations altogether, or the confrontationof such situations. This fear for some patients is so intense that they avoid height situations at allcosts.

One of the Virtual environments used with the CAREN system is the Elevator.

Acrophobia can be treated with the use of exposure therapy. The patientis exposed to progressively higher anxiety conditions.These may include a situation where the 6 Degrees of freedom motion base is mimicking the elevator being stuck, or even gradual falling.

The same environmentcan also be used (with a slightly different 3D scene to treat fear of closed places (CLAUSTROPHOBIA) one of the signs of claustrophobia is refusal to ride in an enclosed elevator.
This virtual reality setting provides an environment for patients to be exposed to these situations without any real world risks to personal safety.