Human Back Problems and Virtual Reality

[Guest guest]

6/1/04

ATHENS, Ohio - (HealthNewsDigest.com)...Virtual reality conjures up

images of video games - dizzying flights on simulated jets or auto

races at death-defying speeds. But researchers at Ohio University

have developed a kinder, gentler use for the technology: the

diagnosis of back problems. Within the next two years, the team hopes

to patent a software and equipment package that could be sold to

schools that train osteopathic physicians, physical therapists and

other medical practitioners.

Using the " Virtual Haptic Back, " instructors can adjust the type and

seriousness of back problems - such as an out-of-position vertebrae

or vertebrae abnormally stiff to rotation - and track students'

progress in making correct diagnoses as dysfunctions are made more

difficult to find. The system works by giving users the sensation of

touching a human back. Users see a three-dimensional image of a back

on a computer screen. Through motor-driven finger cups suspended from

mechanical arms, they can feel the texture and resistance of the skin

and underlying bones. As users push, pull and slide their fingers

through the air, the computer screen responds to their motions.

The key to the system is a sophisticated and highly

sensitive " haptic " interface, which allows users to feel simulated

computer objects, said Bob , an associate professor of

mechanical engineering in the Russ College of Engineering and

Technology whose team has published results of early research on the

system in recent issues of the Haptics-e Electronic Journal and the

Virtual Reality Society Journal. The project is funded by a five-

year, $1.1 million grant from the Osteopathic Heritage Foundation and

received previous support from Ohio University's 1804 Fund.

Developers of the " Virtual Haptic Back " see their project as a way to

make the training of osteopathic doctors and physical therapists more

efficient and potentially more effective because it addresses two

major challenges in the training process. First, it offers students

the chance to practice their " palpation " skills on dysfunctional,

albeit simulated, backs, said Howell, an associate professor of

biomedical sciences at the university's College of Osteopathic

Medicine. This is particularly critical to osteopathic doctors, as a

cornerstone of their methodology is manipulation of patients' muscles

and bones for examination and treatment.

" In the laboratory, students learn by palpating each other, but

they're mostly young, healthy adults who don't have major

dysfunctions, " he said, " so it's difficult at first for them to

appreciate some of these dysfunctions. "

The haptic back also introduces measurability to the practice and

training of palpation, which has historically been " more of an art

than a science, " said. " Right now, even the most experienced

doctors can know it works, but there's no scientific basis for it. "

Feedback from students and practicing osteopathic doctors has

prompted the researchers to program increasing levels of realism into

their virtual back program over the past two years. Users now give

consistently higher ratings for usability and realism to each new

version of the haptic back, according to the journal articles. Most

recently, the researchers have been testing students on a " playback "

mode, which stores experts' haptic back examinations. It can lead

students through the motions of an expert by literally pulling them

through an examination or can allow students to follow the expert's

motions on their own via colored markers on the screen.

Future tests will compare medical students who used playback mode to

those who didn't, to measure how effective the playback mode is in

improving students' ability to identify dysfunctions, Howell said.

The researchers also will take their first hard look at the true

effectiveness of the haptic back for training medical students. For

almost two years, the team has been gathering data about the

performance on the haptic back of medical students versus students

with no medical training, said Bob Conatser Jr., lab research

associate in the College of Osteopathic Medicine and the team's lead

computer programmer. If the medical students have progressed more

rapidly in their skills than the non-medical students, it will

indicate that improvement in performance on the haptic back does, in

fact, correlate to students' medical training and not just to

increased ability on the haptic back itself, he said.

In the long run, wants to develop the team's technology

further so that medical students can train, diagnose and treat back

problems through virtual manipulation. Another long-term goal could

be the development of an entire virtual haptic body that could be

used to train students to find everything from swollen lymph nodes to

cervical cancer, Howell said.

In addition to , Howell and Conatser, co-authors on the

Virtual Reality Society Journal article were Kerry Holland and Dennis

Cade of Ohio University's Department of Mechanical Engineering and

School of Physical Therapy, respectively. Mayank Srivastava of the

Department of Mechanical Engineering was a co-author on the Haptics-e

Electronic Journal paper.

www.HealthNewsDigest.com