Torbay and South Devon NHS Foundation Trust (TSDFT) has teamed up with Professor Bob Stone and the Human Interface Technologies (HIT) Team from University of Birmingham to install and trial their “Virtual Reality Wembury” project within Torbay Hospital’s Intensive Care Unit (ICU), to improve patient rehabilitation. This is the first time the device has been used for intensive care rehabilitation in the South West.

Virtual Wembury is a Virtual Reality (VR) system connected to an exercise bike, which allows patients to cycle and escape the hospital setting, without leaving the building. The TV screen shows a character cycling through Wembury in Devon, with the speed of the cyclist changing depending on how fast the patient moves. In addition to making rehabilitation more engaging and interesting, the device cleverly registers the distance covered of the patient using the cycle apparatus.

The system also uses patients’ daily achievement levels to generate a second virtual cycling character against which they can “compete” on subsequent days, thereby helping them to improve their performance gradually.

Intensive Care patient, Nick Richards, broke his neck a number of years ago. The accident resulted in him being a tetraplegic, meaning four limbs were affected. He is paralysed and unable to walk or grip anything with his hands. Nick was admitted to Torbay Hospital on 29 November 2017 with pneumonia, and developed severe breathing difficulties at home following a bad cold. Nick was intubated for a number of days before having a tracheostomy*. His condition was life threatening, and was exacerbated by his high level spinal cord injury. He is now being slowly rehabilitated and attempting to wean from the tracheostomy.

After using the VR device, Nick said: “This was so much better than I expected. I found it fun chasing my own tail, catching myself and passing my own ghost! It was a very good diversion from just peddling the bike which can be rather monotonous at times. The time flew by and instead of achieving the usual 5 minutes on the bike, I actually managed to cycle for at least 20 minutes!

“I enjoyed the terrain. I had a sense of leaning and tipping and going downhill. I love the beach and the scenery suited me very well - I could lose myself in this programme. I’m looking forward to using it again and seeing how it develops.”

Nick’s wife, Sandra Richards, noticed a difference in Nick’s attitude straight away: “At the time of taking part Nick had been in the intensive care unit for a long nine weeks and his discharge is not imminent. So it was wonderful to see Nick taking part. He clearly enjoyed himself and was happy to feed back to Bob and his team whilst cycling. There’s no doubt that this helped his mood and the fact that he was able to cycle further than he expected left him feeling optimistic about his potential and his future. A super experience and we both believe this has an important part to play in Nick’s rehabilitation and those with similar conditions.”

Nick Peres, Lead for Learning Technologies Research and Development at TSDFT, said: “VR intervention for us is all about making patients feel more comfortable and human again. Virtual reality has serious potential as a platform for how we can approach care, comfort and treatment of our patients. We have been using VR at Torbay for the past three years with great success, to show our staff the patient’s perspective, helping us realise the importance of empathy and humanistic skills between clinician and patient interaction. In Nick's case, he was able to cycle around the locations which he dearly loves. This is what I love most about virtual reality.”

Professor Bob Stone , who runs the Human Interface Technologies Team at the University of Birmingham and grew up in Devon, said: “Nick Peres and I share some very common goals when it comes to using virtual reality in healthcare. We visited Torbay a couple of weeks ago to give a presentation to the team at the Horizon Centre and decided to donate the Virtual Wembury software to Torbay, free of charge. We then came down with the device and tried it in the Intensive Care Unit to great success.

“The result took my breath away. We’ve seen one or two patients who loved it in the Queen Elizabeth Hospital at Birmingham, but Nick was absolutely awesome in terms of his engagement and the miles he covered, bearing in mind he is in intensive care.”

Tod Guest, Intensive Care Consultant, said: “I frequently see patients who, having come through very serious illnesses and surgery, go on to have a long recovery due to muscle weakness and also suffer with psychological challenges such as anxiety, fear, loss of self-confidence and dignity. My first impressions of VR were the incredible sense of escape and being able to take a break from reality for a while. I thought of the patients I look after on the ICU, and that their reality is frequently unpleasant despite our best efforts to make them as comfortable as possible. Having now seen a patient on our ICU enjoying the use of Virtual Wembury, I see that the benefits psychologically are far greater than just helping motivate physical exercise. I hope we can build on our initial experiences and give our patients a boost with some help from cutting edge digital technologies.”

*Tracheostomy: A tracheostomy is an opening created at the front of the neck so a tube can be inserted into the windpipe (trachea) to help you breathe.

It is with great sadness that we report that Nick Richards, the Intensive Care patient who so enthusiastically participated in the first trial of the Team’s Virtual Wembury rehabilitation system at Torbay Hospital, passed away on the morning of 13 March 2018.

Professor Bob Stone, who heard the news as he and his Team were driving to Devon to deliver two VR lectures for The Institute of Engineering & Technology, said: "We were devastated to hear of Nick’s passing, especially as we were looking forward so much to reporting his involvement in our research at the IET lectures".

Nick's wife, Sandy, gave her blessing for the HIT Team and their Torbay Hospital colleagues to go ahead and describe publicly how, just one month previously, he had taken part in the first trial of the Virtual Wembury rehabilitation system.  Sandy said: "He was so proud to be a part of this and just before he passed he read the press release and again mentioned how proud he was of being a part of it".

Prof. Stone continued: "Nick’s enthusiasm on that first day – “cycling” for mile after mile around the virtual coastal path – was nothing short of incredible and, for me, was a clear demonstration of why we do this kind of research. Something and someone I will never forget.  Indeed, as our good friends from Torbay Hospital said, 'I think we made a difference".