Sandy Winkler is an assistant professor at NOVA Southeastern University College of Healthcare Sciences in Florida, teaching occupational therapy, and she has brought a unique 3-year study to Second Life: how a virtual world might better serve as a learning environment for amputees when compared to a traditional website.
The study, entitled Dissemination of Amputation and Prosthetic Evidenced-based Medicine, is funded by the United States Agency for Healthcare Research and Quality, and Sandy is half-way through the allotted 3-year study period. Enough time to have started gathering and assessing data based on patient studies, and to provide general feedback – although as Sandy herself states towards the end of the piece, it is still too early to draw definitive conclusions.
A core focus of the study is to increase the acceptance of living with an amputation and the use of prosthetics. Both aspects of this work involve overcoming psychological and physiological issues an amputee faces. Physiological in terms of adjusting to life without a limb or limbs, and also in physically learning to use a prosthetic; psychological in terms of mentally adjusting to the loss of a limb pr limbs, dealing with a range of potential emotional issues which inevitably arise from the loss of a limb or limbs, together with the joint psychological / physiological aspect of learning to adopt their lifestyle, activities and mobility to suit the use of a prosthetic or wheelchair.
The work has involved the use of both traditional 2D-based websites and Second Life to assess how amputees respond to information relating to loss of limbs and the use of prosthetics.
The in-world side of the study offers the same information, history and so on, to patients via the Virtual Health Adventures island (VHA), which is supported both by a website of the same name and developmentally by Virtual Ability Inc.
Here amputees can not only read about exercises, learn about mobility using a prosthetic or wheelchair (such as getting the latter in and out of their car), they can experience them via their avatar, the actions and movements of the latter being sufficiently life-like that they can be replicated in the physical world, encouraging patients to repeat the exercises, etc. Such is the sense of identification subjects feel with their avatar, that Sandy notes those who have balance problems with a prosthetic leg in the physical world make a marked improvement in their sense of balance as a result of seeing their avatar get around within Second Life.
Alongside this, VHA offer a range of in-world activities and opportunities for social engagement, with windsurfing, jet skiing, and more on offer by way of activities, together with opportunities to sit and chat with others and / or participate in the aforementioned exercises. These have been shown to offer what might be called a two-step benefit. On the first, there is the obvious social interactive element and the benefits arising therefrom, together with the sheer enjoyment of kicking back and doing things which are fun. In addition, the activities have been shown to assist in dealing with phantom limb syndrome.
Occupational therapy obviously plays a huge role in adjusting to living with an amputation and learning to operate with a prosthetic limb. The VHA has a special role to play here as well, which is directly focused on therapists and students, allowing them to spend time in-world as an amputee, experiencing first-hand what it is like to have more limited mobility or limited vision, allowing them to better understand situations and circumstances face by amputees and to directly integrate the prosthetic into their own body image, helping them to develop a more empathic bonding with those whom they treat.
While, as noted above, it is still too early to draw definitive conclusions and the VHA’s work, Sandy has a positive view of the potential of virtual worlds. “It’s pretty clear that the virtual world environment is a significant next step in tele-healthcare,” she says. “We live in such exciting times, technology is making huge leaps, and interactions and digital worlds are becoming more and more immersive. If we let our imagination fly, there’s no limit to what can happen.”
So very true.