Application of virtual reality to the rehabilitation field to aid amputee rehabilitation: findings from a systematic review.

PURPOSE: To determine the scope and use of virtual reality (VR) applications in the gait rehabilitation field and to review and characterise VR approaches for application in amputee rehabilitation. METHOD: A state-of-the-art research analysis was completed to review different approaches of VR to the gait rehabilitation field. Systematic research using Medline, EBSCOhost and Science Direct (ISI Web of Knowledge) was conducted to analyse various VR rehabilitation methods, and we developed a framework to characterise different research findings. RESULTS: Framework for a research approach in the field of VR and rehabilitation was developed based on the literature review. On the basis of outcomes from gait rehabilitation using VR, trials for amputee rehabilitation using VR is warranted and an outline of this potential VR rehabilitation area was identified. CONCLUSIONS: Evidence supports the investigation of VR as applied to amputee rehabilitation based on general gait rehabilitation results. Research should be expanded to better understand the role and use of technology in community-based rehabilitation to enhance the quality of life of individuals.

Can a transitional work grant program in a workers' compensation system reduce cost and facilitate return to work?

Although previous research has shown returning the injured worker to work as soon as possible is important to the long-term prospects of the worker remaining in the work force, there is limited economic support for implementing such programs. Thus, the purpose of this case control study was to determine the cost savings of the implementation of a Transitional Work Grant (TWG) program, which consisted of several components including job analyses, education, communication and transitional work (TW). Companies that enrolled in the TWG program were matched to nonparticipating companies (NTW) based on employer size, type of industry, number of overall claims, and number of claims with > 7 days lost time (LT claims) submitted the year prior to enrollment. The study analyzed economic data: number of claims, number of LT claims, indemnity costs, medical costs, and days lost (days away from the workplace). An additional outcome was the ratio of LT claims (> 7 days lost work) to medical only (MO) claims (LT/MO ratio). Overall, participation in the TWG program was associated with decreased indemnity cost and decreased LT/MO ratio. However, effectiveness of the program varied by employer size and industry. In terms of the state of Ohio, these costs translate into substantial savings: more than $2.3 million per year. Although the cost savings and reduction in lost time claims is encouraging, the true benefit of TW has yet to be completely quantified. Future work must account for other potential co-factors and programs that could also contribute to the savings as well as document further the indirect benefits associated with a TWG program, such as improved employee morale and increased productivity and product quality that could be four times greater than the direct savings. In summary, programs such as this one adopted by several companies in Ohio can reduce the cost burden of injuries.