Virtual Reality: A New approach in Motion sickness Rehabilitation

Updated in June 2024 - Among travelers on planes, buses and boats, approximately 25% to 30% experience motion sickness. [1] 

What Causes Motion Sickness?

Whether it's a business trip or a vacation, transportation can prove to be a real nightmare for those suffering from motion sickeness. These individuals often endure a range of symptoms, from dizziness and nausea to severe vomiting, making their travel time an unbearable journey.

Motion sickness, also known as kinetosis, typically arises from a sensory conflict between the visual input received by the eyes and the motion detected by the vestibular system in the inner ear. When in motion, our eyes transmit signals to the brain to indicate movement. However, if the motion sensors in the inner ear register differing or contradictory movements, this discordance disrupts the vestibular system. Such disturbances can trigger neurovegetative disorders, manifesting as nausea, dizziness, cold sweats, and other related symptoms.

Why is Vestibular Rehab Recommended for Kinetosis Patients ?

© Vestibular Disorders Association - Peripheral Vestibular System

When the inner ear is overly sensitive, it can trigger responses in both the vestibular labyrinth, which is linked to positional vertigo, and the cochlea, critical for hearing [2]. These responses often lead to a visual-sensory mismatch, causing symptoms such as dizziness associated with motion sickness.

Patients with kinetosis undergo vestibular rehabilitation to realign the vestibular, visual, and proprioceptive information processed by the brain. This therapy involves a variety of exercises conducted under the guidance of a physiotherapist. The primary aim of these exercises is to desensitize the vestibular system through continuous exposure, thereby improving balance and reducing symptoms of motion sickness over time.

To learn more about our vestibular exercises, visit this page.

How Does Virtual Reality Contribute to Rehabilitation?

Used in healthcare, especially in physiotherapy, virtual reality (VR) can serve as a powerful tool for rehabilitating patients with motion sickness.

BVR simulates environments where motion sickness might occur, allowing the principles of cognitive behavioral therapy (CBT) to be implemented through controlled exposure . The goal is not to exactly replicate real-life scenarios, but to provide a gradual and safe introduction to anxiety-inducing situations, with full control over triggers and stimuli.

Additionally, VR offers a significant benefit: a sense of realism. With just a few clicks, patients can immerse themselves in various transportation scenarios, such as sitting in a car or exploring in a boat, all within the safe and controlled environment of their medical facility.

Expose Your Patients to Different Scenarios

The moment patients put on their VR headsets, they are transported to a different dimension where rehabilitation unfolds through a variety of exercises.

In addition to a comprehensive range of vestibular exercises, KineQuantum's software offers five additional exercises pspecifically designed to expose patients to various scenarios of motion sickness.  You can choose from the following options what meets your patients' needs the best:

• Conduite sur autoroute (Highway Driving)

• Conduite en montagne (Mountain Driving )

• Passager sur autoroute (Passenger on the highway)

• Passager en montagne (Passenger in the mountain)

• Naupathie (Seasickness)
  

1- Traveling by car : Navigate the highways or mountain roads

Carsickness in Highway - Passenger and driver

These four exercises are tailored to address motion sickness during car travel. Each session allows you to select a scenario in which your patient acts either as a passenger or a driver, in settings that vary from mountainous to highway environments. These exercises are specifically designed to alleviate carsickness.

During each exercise, the gears shift automatically. But you'll be in control of the exercise duration, night driving activation, the number of vehicles encountered, and your patient's initial position.

Clear instructions are provided through visual and auditory guidelines throughout each session. Based on your patient’s responses and reactions, you have the flexibility to adjust the exercise parameters and difficulty level as needed.

2- Travelling in a Moving Boat : Seasickness Simulation

Managing Seasickness - Exercise Aboard a Boat

This exercise is designed for the patients experiencing seasickness. Upon wearing the VR headset, patients will immediately find themselves aboard a boat. You have the flexibility to position them anywhere on the vessel; be it the bow, stern, roof, or inside the cabin.

You can also customize the severity of the sea conditions through eleven distinct levels, from calm waters to stormy seas. Additionally, you can alter the boat’s movements, including its stationary state, speed, and turning capabilities.

To enhance the realism of the experience and immerse your patients in the virtual environment, you can add static or dynamic elements such as islands or buoys to the surroundings.

How Does Patients' Performance Evolve?

  According to D. Trendel's published research [3], 80% of subjects were able to successfully return to marine environments after undergoing virtual reality rehabilitation. Trendel's study indicates that optokinetic stimulation could be a potent remedy for kinetosis, particularly effective for those prone to seasickness.

Furthermore, M.A. Civrac de Fabian's findings reinforce the value of visual simulators in rehabilitation, showing significant clinical improvements for patients with seasickness. The treatment notably reduced symptoms and functional discomfort, with 85% of subjects no longer experiencing vomiting after the sessions.

Consequently, these patients demonstrated increased resistance to kinetogenic stimuli and a reduced dependency on pharmacological treatments.

Conclusion

While kinetosis rehabilitation may not fully cure the disorder, it significantly enhances patient resilience and alleviates symptoms through repeated exposure and habituation.

Currently, virtual reality presents an innovative approach that boosts patient engagement and builds confidence in environments typically associated with motion sickness.

The primary goal is to fortify their coping mechanisms, enabling them to travel in comfort.

For a free demonstration of our innovative solution, click here to book an appointment.

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Bibliography

[1] Jean-François Lemoine, émission « Pourquoi, docteur ? » sur Europe 1, 29 juillet 2012

[2] Sensibilité vestibulaire et vertiges - Centre Tomatis® Genève

[3] D. Trendel, R. Haus-Cheymol, T. Erauso, G. Bertin, J.-L. Florentin, P.-Y. Vaillant, L. Bonne, "Optokinetic stimulation rehabilitation in preventing seasickness", European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 127, Issue 4,2010, Pages 125-129

[4] Marie-Alexandra Civrac de Fabian. "Intérêt de la simulation visuelle dans la rééducation de la naupathie". Sciences du Vivant [q-bio]. 2017. dumas-01830569

[5]  Behrang Keshavarz, Aaron Emile Philipp-Muller, Wanja Hemmerich, Bernhard E. Riecke, Jennifer L. Campos, "The effect of visual motion stimulus characteristics on vection and visually induced motion sickness", Displays,Volume 58,2019,Pages 71-81,ISSN 0141-9382.

[6] Rose Marie Rine, Michael C Schubert, Thomas J Balkany, "Visual-Vestibular Habituation and Balance Training for Motion Sickness", Physical Therapy, Volume 79, Issue 10, 1 October 1999, Pages 949–957.

[7] Dai M, Raphan T, Cohen B. "Prolonged reduction of motion sickness sensitivity by visual-vestibular interaction". Exp Brain Res. 2011 May;210(3-4):503-13.

[8] Hoffer ME, Gottshall K, Kopke RD, Weisskopf P, Moore R, Allen KA, Wester D. "Vestibular testing abnormalities in individuals with motion sickness". OtolNeurotol. 2003 Jul;24(4):633-6.