Special communication| Volume 94, ISSUE 4, P795-798, April 2013

When Is Virtual Reality “Therapy”?

  • Danielle E. Levac
    Corresponding author Danielle E. Levac, PhD, Motor Control Laboratory, School of Rehabilitation Science, University of Ottawa, 200 Lees Ave, Ottawa, ON K1S 5S9, Canada.
    School of Rehabilitation Science, University of Ottawa, Ottawa, Ontario, Canada
    Search for articles by this author
  • Jane Galvin
    School of Occupational Therapy, Latrobe University, Melbourne, Victoria, Australia

    Victorian Paediatric Rehabilitation Service, The Royal Children's Hospital, Parkville, Victoria, Australia

    Murdoch Children's Research Institute, Parkville, Victoria, Australia
    Search for articles by this author
Published:November 05, 2012DOI:


      The use of virtual reality (VR) systems within physical rehabilitation clinical practice and research is rapidly developing, highlighting the need for consensus as to the meaning and relevance of the label “VR therapy.” The purpose of this communication is to argue that explicit examination of the inferences underlying this label and discussion regarding the role of clinicians in VR implementation are required. In this vein, we propose what we consider to be a more relevant label and discuss the need for evidence to support knowledge translation initiatives for therapists interested in integrating VR systems within clinical practice.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Wilson P.N.
        • Foreman N.
        • Stanton D.
        Virtual reality, disability and rehabilitation.
        Disabil Rehabil. 1997; 19: 213-220
        • Galvin J.
        • Levac D.
        Facilitating clinical decision-making about the use of virtual reality within paediatric motor rehabilitation: describing and classifying virtual reality systems.
        Dev Neurorehabil. 2011; 14: 112-122
      1. Merriam-Webster I. Tool [definition]. Available at: Accessed July 30, 2012.

      2. Merriam-Webster I. Therapy [definition]. Available at: Accessed July 30, 2012.

        • Laufer Y.
        • Weiss P.L.
        Virtual reality in the assessment and treatment of children with motor impairment: a systematic review.
        J Phys Ther Educ. 2011; 25: 59-71
        • Weiss P.L.
        • Kizony R.
        • Feintuch U.
        • Rand D.
        • Katz N.
        Virtual reality applications in neurorehabilitation.
        in: Selzer M.E. Cohen L. Gage F.H. Clarke S. Textbook of neural repair and rehabilitation. University Pr, Cambridge2006: 182-197
        • Mirelman A.
        • Bonato P.
        • Deutsch J.E.
        Effects of training with a robot-virtual reality system compared with a robot alone on the gait of individuals after stroke.
        Stroke. 2009; 40: 169-174
        • Levac D.
        • Rivard L.
        • Missiuna C.
        Defining the active ingredients of interactive computer play interventions for children with neuromotor impairments: a scoping review.
        Res Dev Disabil. 2012; 33: 214-223
        • Subramanian S.K.
        • Lourenço C.B.
        • Chilingaryan G.
        • Sveistrup H.
        • Levin M.F.
        Adaptive arm-motor recovery using a virtual reality intervention in chronic stroke: randomized control trial.
        Neurorehabil Neural Repair. 2012 Jul 10; ([Epub ahead of print])
        • Rizzo A.
        • Kim G.J.
        A SWOT analysis of the field of virtual reality rehabilitation and therapy.
        Presence. 2005; 14: 119-146
        • Deutsch J.E.
        • Brettler A.
        • Smith C.
        • et al.
        Nintendo Wii sports and Wii fit game analysis, validation, and application to stroke rehabilitation.
        Top Stroke Rehabil. 2011; 18: 701-719
        • Levac D.E.
        • Galvin J.
        Facilitating clinical decision-making about the use of virtual reality within paediatric motor rehabilitation: application of a classification framework.
        Dev Neurorehabil. 2011; 14: 177-184
        • Levac D.
        • Miller P.
        • Missiuna C.
        Usual and virtual reality video game-based physiotherapy interventions for children and youth with acquired brain injuries.
        Phys Occup Ther Pediatr. 2012; 32: 180-195
        • Brutsch K.
        • Koenig A.
        • Zimmerli L.
        • et al.
        Virtual reality for enhancement of robot-assisted gait training in children with central gait disorders.
        J Rehabil Med. 2011; 43: 493-499
        • Lewis G.N.
        • Rosie J.A.
        Virtual reality games for movement rehabilitation in neurological conditions: how do we meet the needs of users?.
        Disabil Rehabil. 2012; 34: 1880-1886
        • Lange B.
        • Koenig S.
        • Chang C.
        • et al.
        Designing informed game-based rehabilitation tasks leveraging advances in virtual reality.
        Disabil Rehabil. 2012; 34: 1863-1870
        • Grimshaw J.M.
        • Shirran L.
        • Thomas R.
        • Mowatt G.
        • Fraser C.
        • Bero L.
        Changing provider behavior: an overview of systematic reviews of interventions.
        Med Care. 2001; 29: 2-45
        • Glegg S.
        • Holsti L.
        • Velikonja D.
        • Ansley B.
        • Brum C.
        • Sartor D.
        Factors influencing therapists' adoption of virtual reality for brain injury rehabilitation.
        J Cyber Ther Rehabil. 2012; ([Epub ahead of print]): 5
        • Laver K.E.
        • George S.
        • Thomas S.
        • Deutsch J.E.
        • Crotty M.
        Virtual reality for stroke rehabilitation.
        Cochrane Database Syst Rev. 2011; (CD008349)
        • World Health Organization
        International Classification of Functioning, Disability and Health.
        World Health Organization, Geneva, Switzerland2001