It’s ski and ABI season! Boost Rehabilitation with Virtual Reality!

In most cases, the injury occurs following a pivot movement with locking of the foot. It is a valgus-flexion mechanism, then the foot remaining attached to the ski, the external rotation gives the final blow. Equipped with more and more efficient equipment, skiers tend to increase their descent speed and consequently the injuries turn out to be more serious [1]. With more than 15,000 operations per year for rupture of the anterior cruciate ligament (ACL), it is the most common serious sprain injury [2].

The multidimensional approach of VR to optimize functional rehabilitation

After a traumatic injury resulting in surgery, immobilization, and functional incapacity, it is very common for patients to experience fear of moving or to suffer from kinesiophobia.

During the early stages of rehabilitation, Virtual Reality will be a tool of choice to immerse our patient and divert their attention from the pain [3]. This will allow us to get it moving again and recover normal joint ranges more quickly and thus avoid, for example, analgesic flexum. Regarding muscular reeducation, there is no secret, if we want to work the endurance, strength, power and contraction speed, it will be necessary to gradually increase the number of repetitions and the load. It will also be necessary to modulate the recovery time between each series while remaining constant to obtain better results.

It is sometimes demotivating for a patient, session after session, to have to repeat the same exercises over and over again.

Faced with boredom, the patient will tend to miss sessions and their recovery will be impacted. The possibility of carrying out these hundreds of repetitions in a fun way will make it possible to deal with the weariness that the most apathetic patients may experience.

Regarding the preliminary stage of returning to sport, virtual reality also has its say. According to Gokeler et al. (2016), an operated knee presents an alteration in movement patterns. In this study, the use of immersive Virtual Reality made it possible to perfect these patterns, and therefore to improve the rehabilitation of motor learning to reduce the risk of relapse in patients post-ACL reconstruction. The evaluation of the criteria for returning to sport has proven to be more accurate [4].

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Preparing for a return to sport

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Today, it is also possible to stimulate the patient's vision to immerse them in an environment close to the ecological conditions of skiing. This makes it possible to couple this visual input to a proprioceptive stimulus using a dynamic posturography platform (Figure 1) which can recreate the inclination of the track, the relief of the terrain, the visual scrolling due to movement in space, the all in a controlled, secure environment where parameters can be modified in real time.

Thanks to VR (Virtual Reality), it is now easier to present to our patient clear and objective data on the progress made and the progress of their rehabilitation. Patients regain joint range of motion more quickly, and all of the literature reflects an increased motivation of patients, who commit and become more involved in their own rehabilitation. Therapeutic VR, an "tout-schuss" rehabilitation!

Bibliography :

_{[1] B. Dohin; R.Kohler (2008). Traumatologie du ski et du snowboard chez l’enfant et l’adolescent : épidémiologie, physiopathologie, prévention et principales lésions. , 15(11), 0–1723.}

_{[2] LIGAMENTAIRES, L.(2007). Lésions ligamentaires et méniscales du genou et de la cheville. LaRevue du praticien, 57, 407.}

_{[3] Anita Gupta, DO,Kevin Scott, BS, Matthew Dukewich, PharmD, Innovative Technology Using VirtualReality in the Treatment of Pain: Does It Reduce Pain via Distraction, or IsThere More to It?, Pain Medicine, Volume 19, Issue 1, January 2018, Pages 151–159}

_{[4] Gokeler, Alli;Bisschop, Marsha; Myer, Gregory D.; Benjaminse, Anne; Dijkstra, Pieter U.; vanKeeken, Helco G.; van Raay, Jos J. A. M.; Burgerhof, Johannes G. M.; Otten,Egbert (2016). Immersive virtual reality improves movement patterns in patientsafter ACL reconstruction: implications for enhanced criteria-basedreturn-to-sport rehabilitation. Knee Surgery, Sports Traumatology, Arthroscopy,24(7), 2280–2286. doi:10.1007/s00167-014-3374-x}

_{Source : Dr RomainLetartre, Les ligaments croisé antérieur et croisé postérieur : les rupturesconsultées le 16.12.2021
URL : https://www.irbms.com/genou-ligaments-croise-anterieur-posterieur/}