Virtual Reality System Boosts Rehab at Sheba

TEL AVIV, Israel - On most days, a tumor on Zvulun Muola‘s spinal cord keeps him confined to a wheelchair, but today he is standing on a small, wooden dinghy gliding downstream, navigating between the islands of a tropical paradise.

Muola, whose legs are partially paralyzed, is among a handful of disabled patients in Israel using the Computer Assisted Rehabilitation Environment. The virtual-reality system puts patients at the helm of a life-size video game, forces them to use atrophied muscles and teaches the basic skills necessary to recover from severe injuries and disorders.

The $650,000 computer system at the Chaim Sheba Rehabilitation Hospital near Tel Aviv is the only one of only a dozen worldwide in clinical use. The others are still in the research phase. But doctors using the system say it can cut rehabilitation times and make the process far easier by helping distract patients from their pain.

Sgt. Idan Borovski, 23, was wounded in a Lebanese village when shrapnel from a Hezbollah anti-tank missile ripped through a crowd of soldiers, killing nine and injuring 30. The metal shards severed the nerves and muscles in Borovski‘s foot, leaving him with little feeling and limited use of his leg.

The system immerses the patients in a fully reactive virtual and physical environment, using tiny sensors placed on the body, 12 high-speed infrared cameras, a moving platform that reacts to the patients‘ weight distribution and a life-size 3-D projection screen.

The dinghy can be steered by leaning in left or right, forward and back, between a slalom of checkpoints and land masses to reach the finish line.

Dr. Itzhak Siev-Ner, head of orthopedic rehabilitation at Sheba, said virtual reality helps his patients retrain their brains and bodies to function and works much faster than traditional rehabilitation methods.

Siev-Ner said the video game scenarios, which keep scores to allow doctors to monitor progress, distract the patient from pain and involve more complex coordination than normal physical therapy.

Since Sheba‘s system came into regular use in 2005, it has logged 600 hours of rehabilitation time with more than 50 patients.

"It‘s something that looks very promising and there‘s a lot of research going on in that area now," he said. "It allows for reproducing different scenarios that we can‘t necessarily reproduce in the clinic."

It is no accident that the first clinical use of virtual reality is in Israel, where a perpetual state of war has led to a constant flow of casualties.

"Unfortunately there is a quite a good industry here," said Oshri Even-Zohar, the Israeli who first conceived the system in 1990 but said the necessary computer technology wasn‘t available for seven years. Even-Zohar built the prototype in the Netherlands using a grant from the European Commission .

A new scenario being developed will be set in the aisles of a supermarket, where the patient will have to pick items from the shelves and bring them to the virtual cashier - a decision-oriented game particularly helpful for recovery from brain injuries.

Over the next two years, next-generation models will be installed in Brooke Army Medical Center in Houston and Walter Reed Army Medical Center in Washington D.C., Even-Zohar said.

Yochelson, the American doctor, said it is a sign that the U.S. market for innovative rehabilitation is also growing.

"We always see a lot more advances in amputee care and prosthetics during war time," he said. "Israel has the population to support that. Unfortunately, now our military does too."

© 2006 The Associated Press. All rights reserved.