Whole-Body VR for Pediatric Yoga Therapy

Chronic pain is the leading cause of morbidity in pediatrics, affecting some 25-30% of children, where 1 in 20 experience limitation to social participation and incur a high risk for chronic/recurrent pain, psychological disorders, and opioid abuse later in life. In-clinic treatment adopts an integrative mind-body intervention (MBI) approach that includes yoga therapy as a means of relaxation, reduced hyper arousal state, and graded exposure to gentle whole-body exercises designed to reverse fear of movement and catastrophizing. However, limited access to in-clinic treatment, due to the scarcity of specialized pain treatment centers and disruption to school/family life, prevents the majority of these children from achieving efficient reintegration into normal family/school activities. There is a need for innovative solutions offering remote access to MBIs, such as yoga therapy, that are sufficiently engaging for children to overcome their typical poor adherence to home programs. These should support therapist-patient interaction to allow supervision, facilitate compliance, and encourage movement while providing quantitative measures of performance (range of motion), adherence, and physiologic response (heart and respiratory rate) in support of evidence-based MBIs. Our solution leverages recent advances in low-cost Virtual Reality (VR) systems and computer vision technologies from the gaming and cellphone industries that will be adapted to develop the first VR system with whole-body tracking to instruct and monitor yoga poses through patient-therapist avatar interaction in an engaging immersive environment that supports tracking of clinical outcomes. Our research group has experience integrating computer vision algorithms for whole-body tracking from smartphone cameras into Augmented and Virtual environments. In Phase I, we will partner with pediatric pain and MBI rehabilitation experts from Boston’s Children’s Hospital and Mass General Hospital to test the feasibility of tracking and faithfully rendering real time whole-body yoga poses for relaxation and mind-body movements from child/therapist sharing a virtual environment. Aim 1 will build upon our pilot work to develop real-time algorithms that can estimate 3D whole-body core and limb movements from a depth- enabled camera while children and adults enact yoga poses used clinically. In Aim 2 we will translate this tracking capability to provide a VR architecture that renders these poses as biomechanically driven whole-body 3D avatars involving two interactive participants, while tracking range of motion and heart/respiratory rate. Aim 3 will test the VR prototype among pediatric patients and therapists to demonstrate the feasibility of safely and effectively achieving whole-body yoga poses through immersed interaction. Phase II will expand the platform to support patient-therapist and autonomous modes of VR yoga therapy that includes a dashboard for configuring additional yoga modules, movement scaling, and providing secure cloud-based outcomes of performance, adherence, and physiology. This innovation will provide the first MBI device to offer home-based yoga therapy that leverages VR to overcome current barriers for transferring an MBI from in-clinic to home use.