The Ukrainian VRNow project: a revolution in the rehabilitation and reduction of phantom pain in people with amputated limbs

In the spring of 2022, three months after the Russian invasion of Ukraine, the virtual and augmented reality application development studio Advin presented a new social project - a rehabilitation VR simulator called VRNow. This innovative product is designed to help amputees and patients with musculoskeletal injuries overcome phantom pains through exercises in virtual space.

After long tests carried out over several months, the VRNow project installed the first simulator in a rehabilitation center in Dnipro. The company plans to install 100 more simulators in various medical facilities during 2024.

Artem Chygyrinsky, head of Advin, talked about the start of the VRNow project and its financing. Noting that it is 100% developed by Advin, he revealed the details of the investment, noting that the company has invested €128,000 as of the end of the third quarter of 2023. The team consists of 11 people, including a project manager, UX designer, QA engineer, and Unity and Unreal Engine developers.

Chygyrinsky shared that the product was tested on real patients, including those with various musculoskeletal disorders and amputees. He also emphasized the importance of including rehabilitation professionals and psychologists in the development process to constantly consider their therapeutic guidelines and improve the product over time. It is noted that VRNow received a certificate of conformity from the Ministry of Health, which allows its use in medical facilities, and the demand for such technologies in Ukraine is growing, in particular among rehabilitation centers.

Our market covers rehabilitation centers, both public and private. After the successful launch of the VRNow simulator, we conduct training for all medical staff who work with patients, in supervision of maintenance and effective management of the complex. In total, VRNow includes 18 exercises in four virtual environments. The main goal is to demonstrate the possibilities of these exercises to doctors, so that they can independently choose the order and execution of exercises, taking into account the specifics of the patient's injury.

Currently, the equipment has already been installed in the "Path of Health" rehabilitation center in Dnipro after receiving certification in September. The next simulator is planned to be installed in January or February 2024. This is only the beginning of the introduction of the product, and by the end of the year, hundreds of such simulators should be installed in rehabilitation centers of Ukraine.

Regarding funding, the company plans to work with private rehabilitation centers that have grant programs and donors to cover costs. The possibility of attracting donor funds is also being considered for state rehabilitation centers. It is important to note that the technology has already been developed, so the funds go only to the purchase of equipment.

The locations in the simulator cover four spaces, including rooms, a gym and a kitchen. There are plans to expand the virtual locations, including the river, the garden and the shop, which will add new opportunities for patients.

An important element of the project implementation is the use of in-house development in the field of software, as well as the use of high-quality hardware, such as Valve Index virtual reality glasses and HTC trackers. The company provides complete office equipment and training of doctors for effective use of technology in rehabilitation centers.

Yes, you understand correctly that the average duration of the course is very individual. Our program is a tool for the rehabilitator, similar to the conditional Swedish wall. The doctor independently determines the proportions of using the program in the rehabilitation course. Usually, the average duration of the course is 15 sessions over three weeks. However, we recommend that the patient does not use the glasses for more than 45 minutes in a row, as this may affect the vestibular apparatus.

Our technology has the greatest potential in dealing with phantom pain, especially in cases of amputations. Trackers attached to the amputated limbs allow the patient to see his 3D avatar from the first person of the virtual environment. This includes imitating the movements of the amputated body part, which promotes neuroplasticity of the brain and reduces the level of phantom pain. We replace the mirror therapy technique by tricking the brain through visual stimulation.

Our future plans include continuous development of new exercises and remote software updates. We also plan to explore the possibilities of augmented reality with Apple's AR glasses coming to market. For example, this could include the application of AR for exercises with a ball, where its image is integrated into the real environment of the patient.

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