We’re the only private clinic in the US using a Computer Assisted Rehabilitation Environment—a state of the art rehabilitation technology developed for the military. Traditionally, physical therapists taught healthy movement by demonstrating a motion, then correcting patients as they repeat it. At our clinic, patients interact with a virtual reality environment while CAREN captures their motion with 12 infrared cameras and provides real-time feedback. By removing human error from physical therapy, we save time and can deliver unparalleled results.

DNR patients during CAREN session in NYC
We are thrilled to be able to offer our patients treatment using Computer Assisted Rehabilitation Environment (CAREN) is a versatile, multi sensory Virtual Reality system for treatment and rehabilitation of the human locomotion (walking), back pain, posture, balance , spinal stability and motor control integration. A physical therapist can name every muscle in the body, but if they asked you to put more force on the deltoid or the adductor longus muscle, would you know what they meant?

The fact is that physical therapy is a constant back-and-forth interaction between the patient and the therapist. The therapist has to communicate the right motions to strengthen and move the muscles, the patient has to take that command and execute the required motion. The therapist must then evaluate the motion and decide whether the exercise served its purpose or the motion needs to be adjusted. In this scenario, it can be hard for the patient to understand how to move properly and the therapist may not be able to see which muscles were used to complete the motion.

If a patient favors one muscle group over another, it may be that the ones that actually need the work never get the appropriate attention. Now, with a revolutionary tool for physical therapy sessions that use a Computer Assisted Rehabilitation Environment (CAREN), these types of issues are no longer a concern. This virtual reality tool creates a simulated environment whereby people who have suffered an injury can receive physical therapy in a way that makes it clear what muscles are being activated. The computer assisted rehabilitation environment is like walking into a Star Trek holodeck in its ability to immerse the patient in a variety of virtual environments with games or exercises programmed to help with specific motor actions.

The floor of the deck consists of a circular platform, three meters in diameter, that integrates a treadmill and a force plate to measure the movements on the platform. The patient is strapped into a harness to remove any fear of falling. Then, sensors and reflective strips are put on the body. Twelve cameras sit around the platform getting a 360 degree view of the motion as the patient attempts to do the exercises or run through the virtual program which plays on the screen in front of them. These measurements can then provide real-time feedback during the program to help the patient improve their performance.

A woman during CAREN procedure
How CAREN works
A man during CAREN procedure
The Effect of CAREN
Computerized Human Body Model (HBM) done with CAREN
Human Body Model (HBM) Software

CAREN is a virtual reality environment that takes force measurements as the patient is engaging a program on the screen. These precise measurements can then be mapped along the body in front of the patient to show which muscles were used. If a muscle is red, it shows that the muscle was at rest during the exercise. With this type of visual feedback, when the therapist asks them to exercise a particular muscle, the patient can now see in front of them which one they mean.

This provides an excellent way to address a variety of issues in physical therapy including:Balance – Since there is six degrees of freedom in the system, the patient is challenged to maintain balance during the routines. The sensors will also be able to track the range of motion and give real-time feedback to adjust the posture to maintain a better balance during the routines.

Force – The plate at the bottom can measure force and will provide feedback on how well the patient is doing. The treadmill can be adjusted as the patient gains more strength to keep challenging them to progress further. Individual Muscles – If only one muscle needs to be stimulated, the routine can be changed to do more repetitions on that one muscle and be able to measure it accurately. With the muscle mapping program, the patient can pick out visually the muscle that needs to be exerted to turn the red color to blue or green. Cognitive Feedback – CAREN works well with brain injury patients as well because it provides the cognitive feedback in real-time, making it easier for these patients to adjust their motions within the session. Since it does it automatically, the patient can receive that feedback instantly and have more time to process the changes, versus trying to remember complicated instructions after the fact.

Muscle Groups – The environment can also be programmed to include sophisticated routines that will help a patient exercise a group of muscles, not just one, if that is needed. Routine Boredom – Since the routines are done within a virtual environment, the programs can be exciting and novel.

They include such scenarios as being a sailor on a ship having to maneuver a boat with your hips or a game where you have to hit some balls with your hands while avoiding others. The patient is completely immersed in the virtual reality program to the point where they are fully engaged with their physical therapy session, unlike other routines which don’t have this type of environment. It can treat a variety of people and conditions including: more at …