Virtual reality technology improves Veteran care at VA Central Iowa Health Care System

While part of the appeal is that the activities are fun, they are highly developed tools rather than games. 

David McAdon, a physical therapist assistant, with VACIHCS, is putting sensors on a Veteran who agreed to demonstrate how the program works and talk about his experience.

Veteran Jeff Cook first heard about the VR program through Paralyzed Veterans of America and decided to try it as an option for helping with his multiple sclerosis. 

Cook had joined the Iowa Army National Guard looking for opportunity and benefits. He initially joined as a cannon crewmember and attended training at Ft. Sill, Oklahoma, for field artillery in 1991. He finished as a human resources specialist with the 1088th Personnel Services Company, Iowa Army National Guard, in 2005.

With his military benefits, Cook attended Northwestern College in Orange City, Iowa, and received his degree in communications in 1996. 

He would later be diagnosed with multiple sclerosis, a disease of the brain and spinal cord. With MS, the immune system attacks the protective myelin sheath that covers nerve fibers and causes communication problems between the brain and the rest of the body. This diagnosis would eventually mean that Jeff could no longer work, and he had to leave his IT support position at Wells Fargo.

“With my MS, I’ve had a slow, steady decline, so I’m not as active,” said Cook. “When I first was diagnosed with MS, I could still run and now I have to ride a trike that has battery assist.” 

For Cook, one of the main benefits of the VR system is that it allows him to safely exercise and regain mobility because he now struggles with balance and is considered a fall risk. It also allows him to enjoy activities that he once thought had been lost to him. 

“I played racquetball in college, and I tried playing it a couple years after I was diagnosed with MS but couldn’t do it,” said Cook. “I kept running into the wall; it wasn’t safe for me to, so I just had to accept that this sport is gone. Well, through the use of VR, I’m playing racquetball again!”

Cook described with a smile how realistic the game is and how grateful he is to have a sport that he enjoyed back in his life. 

There are a variety of experiences and activities available in the VR program. It allows Veterans to work on their physical and mental health issues as well as being adaptable to individual needs. 

“If I don’t want to exercise or I’m too tired, I can just go a different route and do meditation or combine the two: meditative at one point, then get a little exercise in,” said Cook. “When I have really bad MS fatigue, we can use the pinball activity to get an excellent upper body workout. It’s not until I get home that I feel how great of a workout it really is. While doing VR, you really get into that moment, which is really neat.”

Cook likes to play video games in general, he said, so the VR programs are very fun for him. They even allow the user to test their limits and challenge themselves. 

“There was one activity: I’m ten stories up and there’s a skyscraper and a plank,” recounted Cook. “You’re able to walk out to a plank and face your fear of heights. Dave’s always around you letting you know he’s there and you’re safe. As I was walking out onto the plank, my fear of heights kicked in and you could feel the wind pushing you side to side, see the birds flying around you, there’s a helicopter that flies over—it’s so realistic. To see all that and even to be out there, it’s really surreal how you can get so immersed into that environment.”

The VR program also tracks and analyses metrics from each session, allowing the clinician to measure range of motion, perform assessments, work on improving strength and imbalance, as well as providing data to aid in the clinical decision-making process.   

“In late 2018, we had a Veteran attend a regional conference where he took part in a presentation on virtual reality and how it could be beneficial to the Veteran population,” said McAdon. “Upon his return to VACIHCS, we were tasked with building a VR program for our Veterans.”  

McAdon explained the significant research and development that went into finding the right equipment and experiences for Veterans in the fast-changing world of VR technology. At VACIHCS, COVID slowed the implementation of the VR program but actually provided more time to develop the local VR program and purchase the right systems. 

“At [VACIHCS], we can treat a wide variety of Veterans using these VR devices,” said McAdon. “We have had many successes using VR with our Veterans that have to deal with anxiety, depression, pain, physical and functional limitations, and balance deficits on a daily basis. The new VR system and devices we have purchased allow our Veterans to improve their overall health and well-being in a safe, controlled environment while using virtual activities and experiences to work on the skills necessary to achieve their real-life functional and personal goals.”

The use of VR during treatments increases Veteran engagement and improves outcomes for patients at VACIHCS facilities, community-based outpatient clinics (CBOC’s), and at home. 

“VR has helped us provide our Veterans with a new avenue to help improve our Veterans’ quality of life,” said McAdon. 

Cook recommends the program for fellow Veterans, with the opportunities available and the realism of the experiences. 

“My wife had the opportunity to try [VR], and she saw the northern lights and said, ‘It’s the northern lights! I don’t have to travel to see them!’” said Cook. “That’s what I want people to understand, too. It can also help with mental health. Even if you don’t have any major issues, for a moment it can put you in a better place. Like, with my MS, there’s pain and I don’t think about the pain, I’m there in the [activity] and living.”

Cook says to other Veterans, “Give it a fair shot.”

For McAdon, the difference that VR has made as a resource is invaluable.

“The use of VR and the benefits we are seeing when treating our Veterans seems to be only limited by our imagination,” said McAdon. “The possibilities to improve Veteran care is exciting!”

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