Dr. Lora Appel’s research explores how virtual reality can improve the lives of people living with dementia, epilepsy, and visual impairments
Imagine hearing your father singing the tunes of Jacques Brel, one of the most influential chanson singers and songwriters of the 20th century, after years of silence.
A virtual tour of Paris succeeded where other interventions had failed.
“His family was laughing so hard nurses stopped by the hospital room to see if everything was okay,” said Dr. Lora Appel, a KITE affiliate scientist, who leads UHN’s Prescribing Virtual Reality (VRx) Lab.
“It was beautiful seeing a phenomenon I know to be true in theory play out in real life. It’s one of the reasons why I love my job.”
The aforementioned patient was a participant in a study that investigated whether VR can help manage symptoms and behaviours, such as apathy and aggressiveness, in people living with dementia and who have been admitted to an acute care setting.
VRx Lab designs and evaluates therapeutic virtual reality (VR) interventions for diverse populations.
Supporting Caregivers
In addition to investigating how VR can support patients VRx Lab also investigates how the technology can benefit caregivers. Earlier this year, Dr. Appel received a Canadian Institutes of Health Research Institute of Aging Mechanisms in Brain Aging and Dementia Operating Grant to explore using VR to provide respite to caregivers of people living with dementia.
In a six-week trial, people with dementia will engage in immersive VR simulations either by themselves or with someone else remotely while their caregivers take a break.
The project seeks to understand how caregivers could benefit from the respite VR provides.
“Often caregivers feel guilty about not spending all their time with their loved ones,” said Dr. Appel, who also serves as an Associate Professor of Health Informatics at York University.
“With this intervention, they can take a much-needed break while their loved ones engage in an activity that has been proven to be beneficial.“
Dr. Appel expects to launch this study in the fall.
Addressing Anxiety
VRx Lab partnered with the Epilepsy Monitoring Unit at Toronto Western Hospital this summer to investigate whether VR can reduce anxiety in people living with epilepsy.
As part of this work, people living with epilepsy will participate in VR exposure therapy that targets their epilepsy-specific anxieties twice a day for up to 10 days.
They will start with a scene that induces the least anxiety and progressively work up to more challenging situations, such as experiencing a seizure in VR from a first-person point of view.
The aim is to gradually increase their tolerance to anxiety-inducing situations in virtual reality so they are better equipped to handle them in real life.
"One participant from our pilot shared that after their VR training when they experienced a seizure for the first time in a busy mall, they felt more prepared and less fearful,” said Dr. Appel. “This approach is truly making a difference in how individuals manage their situations."
Preliminary results of this study will be presented at the Canadian League Against Epilepsy’s annual scientific meeting in October, 2024.
Low Vision Rehab
VRx Lab will collaborate with Krembil Research Institute Senior Scientist Dr. Michael Reber and KITE Senior Scientist Dr. Jennifer Campos to investigate the effectiveness of VR-based visual rehabilitation for stroke patients.
Some stroke patients suffer visual impairments that can lead to them losing the ability to drive and perform daily tasks safely.
In this study, stroke patients with visual impairments will use a VR headset for at-home visual rehabilitation to improve their driving abilities.
As part of their rehabilitation, they will attempt to track a moving ball among distracting elements. The speed of the ball will increase or decrease based on their performance.
After six weeks, participants will test their progress in DriverLab –a state-of-the-art driving simulator that allows researchers to recreate real-world driving situations in a safe environment.
“We hope this intervention will help stroke survivors improve their vision and potentially regain the ability to drive,” said Dr. Reber.
The study will begin this fall.
Through these groundbreaking studies, VRx Lab is leading healthcare into an exciting new realm.
“Virtual reality has the potential to improve the lives of many diverse patient populations,” said Dr. Appel.
“I’m dedicated to exploring its vast possibilities while staying rooted in evidence, hoping to bring comfort and joy to those in need while never forgetting the importance of care in the pursuit of cures.”