VR Aids Rehabilitation Through Entertainment

VR Aids Rehabilitation Through Entertainment
January 25, 2017

Now that virtual reality is enjoying mainstream adoption with the likes of PlayStation VR, Gear VR, and Google Cardboard, the conversation is starting to turn to the huge potential that virtual reality presents in terms of allowing us to immerse ourselves in environments and experiences we could never experience in the real world.


One group for whom VR has enormous potential is people with disabilities. Anyone who experiences certain barriers to physical mobility in the real world could take control of a digital avatar’s body and visit new places, play games, or take part in rehabilitative experiences in ways that are more immersive and more meaningful than those that previous digital technologies could offer.


But designing tech that caters to the needs of disabled people doesn't come without challenges. People who live with physical or mental disability are notoriously overlooked by large tech brands, and while the potential for VR to change that looms large, no one is yet making a considered effort to buck the trend.


It's not all about climbing Everest


You don’t need to have a huge knowledge of cutting-edge VR applications to imagine how immersion within a virtual environment could be hugely beneficial to people living with disabilities, enabling participation across a range of activities within a space that feels relatively safe and free of limitations.


When we think of VR experiences, most of us will probably imagine things like climbing Everest or flying through space. But Shannon Garcia, a communication designer specialising in design for neurodiversity, explains that rather more prosaic experiences have the potential to change lives.


“If you have mobility issues, traveling to a friend's hometown might have been too difficult, especially somewhere that's logistically complicated,” she says. “Google Earth VR lets people travel and experience that spatial presence together in a way that makes it so much more accessible than a physical trip would ever be.”


"When done correctly, virtual reality will literally change the lives of people with disabilities.”


Steve Spohn of AbleGamers


She adds “for someone who has issues with social anxiety, or has difficulty navigating crowded areas, a VR-accessible concert or sports event could introduce a lot of opportunities that you and I take for granted, because we can physically participate in them”.


Not only that, but VR provides access to numerous applications that are being developed to potentially reduce the pain and stress experienced by individuals who live with physical or mental disabilities that require treatment.


Steve Spohn, Chief Operations Officer at the AbleGamers, charity explains: “Virtual reality has huge potential for people with disabilities in ways outside of ordinary gaming. Testing is being done on a variety of applications, including  using 3-D sound to soothe people with autism, lowering anxiety and loneliness for people with PTSD, soothing pain for people in burn units, and improving the quality of life for people who are bed-bound or completely immobilized.


"When done correctly, virtual reality will literally change the lives of people with disabilities.”

People with disabilities don't have to simulate space travel to enjoy rewarding VR experiences


What these VR solutions will look like, and how they'll work, will depend on the types of disabilities an individual has. But as VR technology continues to evolve, so too do the practical solutions that make controlling how games and software behave easier to engage with for anyone who has until now been restricted by physical barriers of one sort or another. The challenge now is how to seamlessly integrate the two. 


“The challenge is figuring out the ways to control the virtual reality experience for people with disabilities who have limited ability to operate standard controllers and devices,” Spohn adds. 


“For example, if you take a virtual reality experience of climbing Mount Kilimanjaro and give it to someone who has lost the ability to walk, it might improve their spirits, bringing them to a happier place. But if you gave that same experience to someone who also doesn't have the ability to move any muscles, the virtual experience would be just as frustrating as the real thing.”


A wealth of control options


Barrie Ellis, Accessibility Technical Specialist at gamer’s charity SpecialEffect, offers an overview of the kinds of tech currently available that allow people with disabilities to control games and software.


“Today there's a huge number of options, including control through eye-gaze, blinking, facial gestures, breath, muscle movement, sound and/or speech control, head-trackers, and chin, lip and mouth-controlled joysticks.


“There are bite and tongue switches [originally used for skydiving photography as I understand], sip-puff tubes and tongue trackers. There's even the possibility for changes in skin-colour, heart-rate and brain waves to control games.”


The challenge comes with adding this hardware to VR experiences in a way that feels seamless, and Steve Spohn believes there’s particularly big potential for eye tracking tech in this space. 


“The Steel Series Sentry is an eye gaze controller that allows you to move the mouse with your eyes," he explains. "In combination with fancy software, you can play games like Diablo, Hearthstone, and any other mouse-based game with only your eyes.”


Developing new tools


We spoke with Tobii, a tech company that specialises in eye-tracking tech, and which has recently made a multi-million dollar investment in VR with a commitment to exploring and developing ways that it can solve problems and open up new opportunities.


A spokesperson told use: “Eye-tracking implementation in VR will provide users the opportunity for true immersion based off what you are looking at, instead of the way your head is moving.”


Tobii uses what’s known as foveated rendering, which means an image’s resolution and detail will change according to fixation points: points which Tobii defines as being where a user’s vision is focused, moment to moment.

Eye-tracking tech company Tobii has made a multi-million dollar investment in VR


“Foveated rendering is a major technology leap for VR, as it lowers GPU/power consumption, provides 4K graphics to the user at all times and brings the device closer to an untethered experience [you don't need a gaming notebook to power the current GPU requirements]” the spokesperson added.


“These advancements make the experience more immersive, which is the ultimate goal of VR.”


But eye tracking is just one way to better control VR experiences, and many more are either already on the market or are currently being developed.


At CES earlier this year, the 3dRudder was showcased, a foot-powered virtual reality and gaming controller that allows the user to move intuitively through any 3D space. It readily emulates keyboard keys, a full mouse, or a joystick at your feet, allowing people with disabilities to do new and more things with their computers and hardware.


Although the combination of tech solutions and virtual reality sounds promising, for many it still feels like we're a long way off from the experiences living up to our expectations, and reaching the level of immersion experienced by non-disabled people. 


Shannon Garcia told us that there are many barriers to entry for people with disability, including cost. “Unfortunately price will always be a barrier to widespread adoption of more sophisticated accessibility options,” she says.


“As VR-capable devices become more affordable, this will be less of a barrier. Projects developed for mobile-centric platforms like Daydream are going to play a big role, even if they're lower visual quality, simply because more disabled people will have access to them.”


Shaping the culture


As well as price, there are a number of concerns that also impact on the experience of disabled people and non-disabled people alike, such as motion sickness and harassment.


Garcia explains: “The ultimate success of VR social environments as accessible public spaces is going to be be highly dependent on the degree to which developers take responsibility for shaping the culture and ethics of the shared spaces they create.”


As you’d expect, Virtual Reality presents a big challenge for people who live with any form of visual impairment, as so much of the consumer VR experience is based on sight.


Shaun Cheeseman, Director and Accessibility Expert, explains: “Virtual reality will always be a stumbling block for people with sight issues, because you put on a headset and need to be able to see everything around you, and what’s going on, to feel fully immersed.

There are already lots of input technologies that enable those with disabilities to navigate virtual worlds, and more are being developed


“Yes, things could be made bigger so more people can see it, but that also has a detrimental effect on people with the disability, and will only ever enable them to play a game for short periods of time.”


The Beacon Centre Tech Forum has been testing VR headsets and handsets with people who live with a range of sight-loss conditions. Nick Comley, who runs the forum says: “We've discovered that the lack of fine adjustment to the lens headsets is a barrier to making the most of what sight someone has available to benefit from the immersive experience of VR.


“It would be great if lenses adjusted to overcome central or peripheral sight loss to deliver a real 3D experience for people with a wide range of conditions.”


The challenge of movement


Another important consideration is movement. “We're hopeful for virtual eeality, but it's still relatively new and very inaccessible to many gamers,” Steve Spohn says. “If you have a severe physical disability, you aren't able to move in the ways that developers intend you to move to play the games.”


From the restrictions of a tethered device, through to games and experiences that require a certain level of movement to be played effectively, there are a lot of challenges that developers need to overcome.


Spohn adds: “For many VR games you have to be able to rotate in a circle, to be able to duck and lean, and use both arms. Even sitting in a wheelchair with full upper body mobility can be a problem, because you're not sitting at the height developers made the game for.”


Why it’s still too early to tell


VR is still in its infancy, so it’s difficult to tell whether it will live up to its promise for users both with and without disabilities. What’s clearly required is a joined-up approach between hardware manufacturers and developers, as well as an understanding of what it takes to design games and experiences for people living with disability. 


Like most experts working within this space, Spohn believes the answer is variety. “Make your games as flexible as possible, and make the platform as open as possible so that software developers can include accessibility easily,” he says. 


Accessibility Specialist Ian Hamilton agrees. “People are different, different in both abilities and preferences,” he says. “So don't make assumptions about what people can do, don't assume they have two arms and hands and legs, all in full working order, don't rely on a single novel input method.

Game developers can play their part by making it as easy as possible for accessibility features to be included


“Instead, just offer up as many options as you can. Every extra option is another way in for another group of people.


“Many people with disabilities are justifiably afraid of new developments like these, seeing them as another way that they'll be forgotten in the excitement, and designed out of taking part in society and culture. But with the right design considerations these new ways in can be a huge accessibility enabler, instead of an accessibility barrier.”


Spohn adds: “Virtual reality has some amazing potential, but it also has the ability to crush the souls of those people hoping for new virtual lives.”


“If we proceed with caution, learn how to conquer the obstacles of inaccessibility, and work together to create experiences accessible to a diverse and wide-ranging population of people with varying disabilities, virtual reality has a real chance to become one of the greatest things ever invented.”

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