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<a href="https://www.realsystem.com/?gclid=CjwKCAjwkPX0BRBKEiwA7THxiOktTrzVzoLFit73isskcAcD4f3tDQbESJzbzhe6ypy2m32MmXB65RoCsBQQAvD_BwE" target="_blank">The REAL™ Immersive System</a> is a radically different approach to stroke rehab that’s designed to be accessible, effective, and fun. It’s the first virtual reality (VR) system that is purpose-built from the ground up for rehabilitation in a healthcare environment.

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In a REAL therapy session, the patient sees their avatar moving like it’s their own body, which encourages development of new neural pathways. The therapist uses an app on a tablet to see what the patient sees and can customize activities to meet patient needs.

The inspiration for the REAL System came from a mutual friend of the CEOs of Penumbra, which specializes in solutions in the neuro and vascular interventional space, and Sixense, a company focused on enterprise use of VR hardware and software. 
Their friend’s neighbor, Deb, experienced a stroke and was coming into Sixense’s offices to play VR games with her therapist. Watching her joy at interacting in this virtual environment, the companies saw the opportunity to create a life-changing technology for people recovering from strokes. Deb remained the team’s muse throughout the development process.
Neither company had experience providing solutions in the rehab environment. That’s where Delve came into the picture. Our engineers and designers went into the field to interview and observe physical therapists. Their goal was to help adapt Sixense’s immersive VR technology to easily work in a variety of rehab settings including the gym, bedside, and mobile facilities. Throughout the process, we focused on the needs of two users – physical therapists and patients.

REAL 4

There were many technical requirements to be addressed. Highly accurate electromagnetic sensors are used rather than the typical optical sensors used in gaming systems, which require “line of sight” tracking. Electromagnetic tracking allows the therapist to be wherever they need to be around their patient without disrupting position tracking, creating a more stable and consistent user experience. These sensors required careful placement of a sensing coil and battery inside a compact package. 
We designed the organic form of REAL’s sensors to mimic the curves of the human body, with a little valley in the center to hold a band securely and provide necessary separation of the components. Sensors are attached with soft neoprene bands that are easy for the therapist to place on the patient. The bands come in a set that is assigned to the patient for the duration of therapy for sanitation reasons.
The headset was engineered from existing technology, which limited customization. We focused on achieving well-balanced weight distribution, making it more comfortable.

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About 75 percent of stroke rehab patients are over age 65 and many are unfamiliar with VR technology, so minimizing the intimidation factor through design was important. Components were designed to look small, easy to grip, sleek, and integrated. The dark gray lower half reduces visual mass and the white upper half provides modern, clean design. There are no buttons, switches or externally mounted lights. Once the sensors are strapped on, which takes about two minutes, the patient can focus on interacting with the virtual world through upper body movement with the assistance of the therapist. 
Progress still takes time and repetition, but the data collected from therapy sessions enables therapists to show patients their steady progress, helping them to stay motivated. Equally important, the Happy Valley VR game is designed to be empowering.
Here’s a real-life example from the Penumbra team: “I went to get feedback from a patient. She was four months out from a stroke – in her late 40s with a child at home. Her left arm had almost no motor control. She seemed depressed. When she put on the system and I lifted her arm for her, she broke down sobbing. She couldn’t see me in this environment, but she could ‘see’ her arm working normally. It gave her hope.”

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Penumbra launched REAL in institutions but intends to adapt the system for home use. The market potential is huge – there are tens of thousands of institutions to reach and millions of people in the home market who could benefit.&nbsp;
There are likely many applications for VR-based therapy beyond stroke and brain injury, which could further broaden the market for the REAL system and help millions of people on the road to recovery.
The REAL Immersive System is the Winner of the 2020 <a href="https://designawards.core77.com/health-wellness/96173/REAL-Immersive-System" target="_blank">Core77 Design Awards </a>in the Health & Wellness category and a 2020 <a href="https://www.idsa.org/awards/idea/medical-health/real-immersive-system" target="_blank">Gold IDEA</a> in the Medical & Health category . It also won the Virtual Tech category of 2020 <a href="https://sfdesignweek.org/awards/real-immersive-system/" target="_blank">San Francisco Design Week Awards</a>.

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REAL™ Immersive System

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