Nearly Wholesome -Researching the Advantages of VR Gaming on Health and Rehabilitation Therapies
In this article, I speak with Katie Hoolahan, CEO of Virtually Healthy, an innovative new company engaged in active research involving the creation of exercise programs for fitness, rehabilitation, and therapy. Based in the southwest of England Katie has enlisted local volunteers to participate in an intriguing research project that involves them actively gaming in motion capture suits, in order to find out how a variety of games and applications work specific areas of the body. The resulting data will then be used to develop virtual reality software and programs designed to treat a range of specific mental and physical health conditions and to assist in a patient’s rehabilitation. Katie has an ambitious vision for the future of virtual reality use in healthcare, as a tool to improve fitness and aid recovery. I spoke with her to find out more;
Katie Hoolahan is CEO of Virtually Healthy, a virtual reality research company studying the effects of VR gaming on exercise, fitness, and rehabilitation.
VRFI: Katie, thanks for talking with VRFI today. Before we get to the research you are doing can you first tell me a little about yourself, your own background and how you got inspired to start your own VR research-based company?
Katie: I had a very active childhood, playing a wide range of sports – from being part of the school tchouckball team to playing cricket for Hampshire! PC games have also been a big part of my life, but I never really thought about them as a career path. When I was younger, I couldn’t decide what I wanted to do as a career, so I just put together the two things I was good at, sport and maths, and chose to do a BSc in Applied Sport & Exercise Science. During this degree, I found so many health conditions that are preventable and treatable with exercise, but time and time again I kept coming back to the severe lack of participation in physical activity, in both the fitness and healthcare industries. It wasn’t until I finished my degree and applied for an MSc in Biomedical Engineering that I found a great solution to this – VR! The summer that I graduated was when the original HTC Vive was released (2016), and one friend had just bought it. I didn’t expect much at first, maybe something a little better than the Wii/Kinect, but after my first go on AudioShield I was hooked! That weekend I sold my PS4 and bought one for myself. I instantly realized the potential that VR had for getting people up and moving – and it wasn’t something that you could cheat and play from the couch like the Wii Fit. I began to do research into VR and started thinking of VR topics for my MSc dissertation before I had even started the course. For my dissertation, I chose to develop a simple VR game for increasing motivation to exercise and easing chronic pain, then test it with 8 participants. I taught myself to code in C# and develop in Unity (which I had been interested in learning for a couple of years), and the study produced promising results. I have condensed this study into a conference paper that was published in the 2018 Laval Virtual conference proceedings. I initially looked for a job in the VR healthcare industry for when I finished my MSc, but quickly realized that there were no companies in that field! The closest I found was a company using the Xbox Kinect in hospitals. That was the point I thought ‘okay, I guess I’ll just have to do it myself’.
Katie’s approach to fitness and health has always been creative and original!
VRFI: I know you’re doing some exciting trial research currently with local volunteers. That must be exciting for them as I imagine most have not used VR before. Can you give us an overview of the project, and how the volunteers are finding it to engage in such novel research?
Katie: We are about 5-weeks into our research project now, investigating the movements/exercise-induced by various VR games as well as looking into aspects such as enjoyment, effort, and perceived exertion. We have had a great response from game developers and have been sent approximately 40 different VR games to include, with many renowned titles!
We have a good mix of volunteers, between the ages 19-58 and from a variety of different backgrounds. Only a couple of our participants had experienced virtual reality before – it’s such a great feeling showing someone VR for the first time, people are always so amazed. Everyone seems to be loving it so far – I’m always being told about jealous friends and family members when they show them what they’re doing in our sessions.
20 volunteers (10 male & 10 female) are each attending for an hour a week for 20 weeks. In each session, our volunteers will play 2-3 different VR games whilst wearing a 3D motion capture suit and heart rate monitor, as well as answer a questionnaire about each game. From this data, we will create VR exercise programs for a variety of purposes within fitness and healthcare (e.g. general fitness, weight loss, chronic pain, COPD, depression). These programs will include recommendations for how to gain the most benefits from each game, for example how to squat under a wall instead of bending at the waist. Many health interventions focus on either mental or physical health, but the two go hand in hand – I want to create holistic programs that deal with them both together. We are keeping an open mind about which health conditions we will focus on first as this will depend on the data we get.
Volunteers are fully suited to monitor exactly how each part of the body responds to each virtual reality experience.
VRFI: So tell me about the company itself. What are you doing currently and what is your overall vision for Virtually Healthy?
Katie: Virtually Healthy was founded on 24th May 2018 by myself and Yasmin, who had recently finished her MSc in Entrepreneurship. We spent about a year forming plans, making connections in the industry and looking for investment. Unfortunately, we were stuck between a rock and a hard place for a little while as although we got a great response about our idea, investors want to see a prototype or proof of concept. It was difficult to raise funds for our initial research which would be the proof of concept. Eventually between my savings and my family we got enough funds together to run our first research project!
Once we have our first VR exercise programs from this study, our initial plan is to release the general fitness ones through VR arcade software and apply for funding to conduct further research into our healthcare programs. We are currently in discussion with the NHS Trust about collaborating on this research. Our end goal would be to have our programs available through the NHS and develop an app so that people can purchase these programs for use at home. My vision is for physiotherapists and doctors to be able to recommend our programs as an alternative to home/gym exercise. I also have ideas about opening VR health arcades and eventually creating our own VR games to induce specific movements, along with a few other ideas – but we’ve just got to take it one step at a time.
Virtually Healthy logo, courtesy of Katie Hoolahan.
VRFI: Are you partnering with anyone else and have you had much support locally from organizations like the NHS, or colleges and universities?
Katie: We’ve got a couple of partnerships in the works, but nothing set in stone just yet. As for local organizations, we have been discussing with the local NHS Trust and Universities about conducting research into our programs once we’ve completed our initial research – we’re currently looking into potential funding options.
VRFI: What has been the response to your work, firstly from those within the virtual reality industry, developers, hardware manufacturers etc, and also from outside, your local health authority, organizations you’ve approached etc, do people see the value in what you’re doing yet, or VR still an unknown quantity for many?
Katie: In general, we’ve had a great response to our work from people in the industry. Developers have been supportive and enthusiastic about what we’re doing, especially those who have focused on active gameplay. We’ve been sent games, and equipment such as the AgileVR and VirZOOM to include in our research. Juke Performance has also recently sent us their Mass Suit which we will hope to be able to use to increase the strengthening aspects of VR games. Without these developers and the content we have been given to use, our research would have to focus on a different area, such as creating our own content – which would take much more time and money. This way we get to increase the content available for fitness and healthcare in a much more time-efficient way.
Whenever I talk to people about our work such as at conferences, in meetings with people from local universities, the ethical review committee, and the local NHS Trust, the individuals have all shown great interest and enthusiasm.
Although on the other hand, VR in fitness and healthcare is still in its infancy, especially in the UK – so where I see a new and upcoming market, many investors see a risk. I’m hoping that by the end of this project we will have something to show them otherwise. More research in the field will ultimately open up more avenues of funding. Funding through organizations such as InnovateUK and working alongside the NHS is definitely one of our goals, but there are a lot of hoops to jump through first, which we are working on and will get to in time.
VRFI: What do you think virtual reality can bring to the fields of healthcare, rehabilitation, and fitness that is maybe lacking currently? Where do you feel it is most effective?
Katie: The motivation to get people up and moving! A lack of participation in exercise is one of the biggest problems in healthcare – so many conditions can be prevented and treated with exercise, but many people simply don’t exercise. Only 27% of UK citizens and 22.9% of US citizens meet the recommended level of physical activity, and obesity alone costs the NHS approximately £6.1 billion per year! There are many reasons people don’t exercise, but the big one is motivation – exercise just isn’t high enough on people’s list of priorities, and gamified VR has a real potential for helping with that.
Katie’s Gamification of Exercise infographic highlights the benefits and improved outcomes that VR gaming can provide over more traditional fitness models.
VRFI: Are you able to give us any early insights from your project? As you know at VRFI our primary interest is using VR for exercise and fitness. I’m interested to know what games especially are proving to be the most popular with your volunteers. Do you have any favorites yourself?
Katie: I’ve had loads of lovely comments from our participants; things like how they’re really enjoying it so far, how a VR session has improved their mood for that day. Many of them mention how they didn’t think they were exercising in our previous session but then felt it the next day, and just this week I had two people comment on how they ‘haven’t exercised like that in a long time’!
Beat Rhythm games always seem to go down well, although we’re only a few weeks in so not too many games to compare at the moment.
Leg days are not avoided in VR!
VRFI: What headsets and VR equipment are you using? Do you have any favorite hardware and games yourself?
Katie: We are using the HTC Vive and the Oculus Quest. I think both have their merits; the lack of wires with the Quest is so freeing and lets you become so much more immersed for games that utilize a 360° range (e.g. Racket: NX), also the portability is great – at the moment my Vive is mostly at our research studio so wouldn’t get much opportunity to play VR myself without the Quest. The Vive however, is much more comfortable and has better graphics so I prefer that for games that mostly face one direction. Personally, I love a good beat rhythm game, there’s a great variety of games available to keep the genre fresh. Lately, I’ve been playing a lot of SynthRiders, Pistol Whip and Racket: NX. It’s difficult to choose a favorite but Superhot and Space Pirate Trainer are definitely up there!
VRFI: Finally, what do you think about virtual reality’s potential to impact the fitness and exercise industry? Clearly, as the founder of a VR startup company you are sold on its long-term potential, what do you think VR offers that more traditional methods lack?
Katie: VR has been shown to ease pain due to how the user is immersed in the virtual environment. VR distracts the brain, diverting attention away from any mental or physical pain – some researchers even say that is may even change the way that the brain physically registers pain! Although more research is needed into that. I think VR alongside the principle of gamification (see my infographic above) is the perfect way to engage people in exercise – not only does it get people moving to control the game, but people don’t realize how much they are moving and exercising because they are so distracted by the game and the immersive environment.
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