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Movers & Shakers I Virtual Reality I Hunter Hoffman

July 8, 2022 • Behavioral Health • Larry Benz

Join host Dr. Larry Benz, nationally recognized for his expertise in private practice physical therapy and occupational medicine alongside NEW co-hosts Tim Reynolds and Bryan Guzski. From Evidence In Motion, The Practice Leadership Podcast’s Movers and Shakers Season will go straight to the source, asking the industry heavyweights about research, social media, what technology challenges lie ahead, their seasoned advice form the clinic floor, and where to take action in advocacy.

This week on the nineth episode of the season Larry Benz, Tim Reynolds and Bryan Guzski are joined by Hunter Hoffman, PhD. He is the Director of the Virtual Reality Research Center at the Human Photonics Lab at the University of Washington Dept of Mechanical Engineering in Seattle and he is affiliate faculty in the University of Washington Depts of Radiology and UW Dept of Psychology. He also collaborates with researchers in UW departments of Radiology, Psychology, Rehabilitation Medicine, Orthopedic and Sports Medicine, and Anesthesiology.

Since 1993, he has developed, Virtual Reality Monitoring World, SpiderWorld (For treating spider phobia), World Trade Center World, an immersive virtual reality simulation of the 9/1 attacks for treating civilian PTSD with VR exposure therapy, SnoWorld, the first VR world designed for treating pain and VR DBT Mindfulness Skills learning World (in collaboration with Marsha M. Linehan et al).  In 1997, Hoffman and clinical researcher David Patterson originated the technique of using immersive virtual reality for pain distraction during painful medical procedures, at Harborview Burn Center in Seattle. Hoffman, Patterson, and Walter Meyer MD have recently conducted joint research using VR distraction to reduce pain in children with unusually large severe burn wound injuries at Shriners Hospitals for Children in Galveston Texas. Hoffman is also collaborating with researchers at the University of Montreal, using VR distraction to reduce the pain of young children (average age 2 years old) during burn wound care.

SnowWorld went on a one year exhibit tour at the Smithsonian Cooper Hewitt National Museum of Design Triennial in Manhattan, and the Boston Museum of Contemporary Art. Hoffman was identified by as one of the Fast 50 people most likely to influence the next 10 years.

Dr. Hoffman says he started out using immersive virtual reality in the 1990s and his colleague and him were the first publish using virtual reality as a distraction. A lot of their early research done was with burn patients during physical therapy range of motion exercises. It worked well for reducing the pain of children and adults with severe burns. As the they were recovering from the burns the skin contracts so there are two things happening, the muscles atrophy from not being used and the skin contracts so the range of motion exercise helps maintain the elasticity of the skin also it helps to strengthen the muscles. As a universal problem with physical therapy, all living organisms avoid pain, so it is hard to get people to do things that make them feel pain. The nice thing about virtual reality is it reduces your pain while you are wearing the helmet. Using it as a simple distraction was easier to get people in. Hunter and his team then developed a question to measure success, How much fun did you have during your wound care or physical therapy? The medical community said that was inappropriate but what was found was that the patients fun went from a 0 or 1 to a 7or 8 out of a 10. Some people pushed back and said they must not of understood the question. Hunter says whether they did or not the answer to the question is how much pain  the patient had during their physical therapy, and they are answering that they had fun. It is easier to get someone to do something they remember doing that was fun than painful.

In dealing with persistent pain patients Hunter says virtual reality has a lot of potential for at home patient work because it can be more motivating by being intrinsically interesting.  To get long-term benefits, he sees an opportunity in changing the persons memories by performing movements with less pain. Avatars are being introduced into virtual reality where you do not need anything on your hand and this is good news for patients with chronic pain. Often, chronic pain patients do not like having any equipment on their bodies. If you start getting more effective treatment you are going to start seeing  an increase in retention of physical therapy.

Learn more about the recent and past experiments with thermal pain stimulation Hunter has conducted. The role that phycological influence has in our pain perception, his previous projects, how this technology might be used in a clinic in the future and more!

More Links:
Larry Benz – Twitter – @PhysicalTherapy
Tim Reynolds – Twitter –@ TimReynoldsDPT
Movers & Mentors – Twitter – @MoversMentors
Evidence In Motion – Twitter- @EIMTeam 

Additional Research

Ad Info: Evidence In Motion is excited to be back in person and back to hands-on learning for the 2022 Align Conference. This year you can join an all-star lineup of speakers in Dallas, Texas, August 26 through the 28. The labs and lectures focus on sharpening the physical, hands-on treatments essential to patient care. Save 5% on registration as a practice Leadership Podcast listener. Visit and use the promo code PRACTICELEADERSHIP at checkout.

Larry Benz

Dr. Larry Benz, DPT, OCS, MBA, MAPP, is the President/CEO of Confluent Health. He is nationally recognized for his expertise in private practice physical therapy and occupational medicine. Dr. Benz’s current areas of interest include conducting research and integrating empathy, compassion, and positive psychology interventions within physical therapy. He released a book on September 15,...

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