Written by Emily Sinitski, Canadian Forces Health Services CAREN Coordinator
What is a Computer Assisted Rehabilitation Environment (CAREN)?
The Centres of Excellence (CoEs) in Ottawa, Ontario and Edmonton, Alberta each have a CAREN facility. The CAREN is a virtual reality environment that allows clinicians and researchers to systematically manipulate the walking surface and/or visual field to address patients’ treatment needs for physical, cognitive and mental health rehabilitation. The CAREN includes a multi-axis tilting platform that can provide a variety of surfaces including, steep incline/decline, side slopes, and non-level. The CAREN also includes a treadmill with left and right belts that can be controlled independently to provide stability challenging scenarios such as a tripping and slipping. The large curved projection screen is not only used display the virtual world, but to provide busy, interactive environments and cognitive tasks. The primary advantage of a CAREN system is that it can be used to simulate a variety of challenging real-world activities in a safe, controlled environment, which is ideal for both rehabilitation and research settings.
Who can benefit?
The CAREN is used to support traditional rehab modalities and can benefit members with balance and proprioception impairments, visual dysfunction, vestibular impairments, and cognitive processes disturbances. Assessment and treatment goals may include, balance, gait, functional training, sensory desensitization, range-of-motion, cognitive re-training, mental health, complex regional pain syndrome, and high performance training. Currently, the CAREN is used primarily to help our complex members’ rehabilitation. The virtual reality rehabilitation intends to prepare members to return to a full life and duty, allowing stimulations of various systems that are limited in clinic setting.
What is a typical CAREN session like?
At the start of each CAREN session, the CAF clinician and member discuss events since the last session and complete required clinical outcome measures, such as the Simulator Sickness Questionnaire and Borg scale. The clinician determines what applications to use during the session, the appropriate dosage, and other CAREN modalities. The clinician may consult with the operator for recommendations on applications appropriate for the specific treatment goal of the session. Weekly CAREN sessions typically range 20-45 minutes long.
Canadian Forces Member Inclusion Criteria
- No severe visual impairment – must be able to look at screen without severe nausea and/or stomach sickness
- No severe motion sickness – must be able to tolerate visual flow without severe nausea and/or stomach sickness
- Must be able to tolerate wearing a safety harness
- Member must be willing to participate in the program and commit to scheduled sessions
- Participant consent to treatment and briefed on non-compliance policy
Interesting? I know right!?
Virtual Reality Research and Rehabilitation: Part 2 coming next week! Stay tuned!