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Frog Designs A Distraction Device For Burn Patients In Pain

VR could be the ideal distraction for hospital-bound patients in pain. Less ideal? Current headset design. Frog is changing that.

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The biggest criticism of VR is that it removes us from the wonders of reality. But the truth is, sometimes reality sucks. Anyone who’s ever been admitted to a hospital knows this, and patients admitted in the burn unit may know it better than anyone else.

It’s why Frog teamed up with Stanford Plastic and Reconstructive Surgery resident Dr. Brian Pridgen to develop VR Care. It’s a new open-source VR headset, designed for hospital contexts, with apps specifically built to distract burn patients from their painful routine treatments.

"Burns are incredibly painful, but imagine it spread all over your whole body, legs, arms, and chest," says Pridgen. "There’s just this intense background pain. And we have to scrub their burns, clean away their debris, all the burned skin. It’s important for treating the burn, but it’s painful."

Drugs can work to reduce pain, of course, though not perfectly—and with risk of side effects. Meanwhile, clinicians do have another tool at their disposal to help counteract pain: distraction. Studies have shown that simply giving a patient something else to think about can reduce their perceived discomfort—and VR has shown promise in this regard.

But VR headsets aren’t optimal for hospital settings. They’re bulky and require even more wires on top of diagnostic equipment. They’re not waterproof. And as burn victims are of particular susceptibility to infection, anything that comes into contact with their skin has to be sterile (and preferably, disposable). There’s also the matter of comfort. For someone stuck in bed with most of their body in pain, the last thing they want to be thinking about is a headset digging into their cheeks.

Ideally, Frog wanted to design something that could meet all these criteria—and could be built for $10. Oh, and just using Google Cardboard was out. First because cardboard wasn’t a material that can work in a sterile environment. And second, it lacks a head strap.

The team got to prototyping with a funny material that any paranoid parent will recognize: jigsaw-style foam tiles. Since they assembled like 3-D puzzle pieces already, Frog was able to cut the tiles with a CNC machine to rapidly build a test headset that was ergonomic. For the screen, the system would just use the patient or hospital’s smartphone. (And the precise information, like focal lengths and distances between internal lenses and the screen, Frog did lift from the Cardboard project.) Theoretically, this kind of foam headset could arrive at the hospital in a sterile bag and be tossed after each use.

The whole approach might sound hacked together. (In fact, your phone is held to the headset by two thick rubber bands, and while the reference version Frog mailed to me is made of black foam, it is still very obviously inspired by kiddie tiles.) That said, it’s easily the most comfortable Cardboard headset I’ve ever tried—and that includes both the cheapo cardboard variety, and a nicer plastic, padded model I picked up on Amazon for about $20. As Charles Yust, principal design technologist at Frog, points out, it’s another proof point for inclusive design. By making a headset for a select few people with special needs (patients report that they find it comfortable), they may have created an inexpensive headset that’s more comfortable for everyone.

So what do patients play when they don the headset? On the software end, the team tried out more than 60 different VR games, actually laying as a patient would, to see what was playable from a hospital bed. Since controllers were out for people who’d burned their hands, the system works like many VR games, requiring you to tilt your head up and down, left and right.

Frog built two simulations—in one, you steer a ship through the cosmos to various planets to pick up passengers. In another, you drive through a cave, dodging stalagmites. While you can try to beat your best distance in the cave simulation, both games are relatively open ended to allow you to play as long as you need a moment of zen. Thematically, they reminded me of those old TI-84 calculator games, the sort of low-stakes ski simulations that would help you kill time during Algebra II. The cave is rendered a lot like Battlezone or Starfox, to pull you into the 3-D environment with minimal graphical detail. Meanwhile, the soundtrack is like something you'd hear while getting a massage or attending a meditation—it's anonymous new age music that, I'll admit, is pretty calming stuff.

"In our user testing so far, you don't need a whole lot of range of motion to operate the more meditative space of the game," says Yust. "It’s up to you how fast you want to move left and right to dodge in the other game."

Testing them on my couch, I had a tough time telling just how well they’d work in context. The space simulation required me to tilt my head up and down, which is tiring, even painful, when reclined. The stalagmite simulation, which I was told was optimized for just looking left and right, was better on my neck. But while I was certainly immersed in the polygonal world—the art and audio design really pulls you into a meditative space—I shut it off within five minutes suffering a bit of motion sickness. (Which I assume was from a low frame rate or lag between my movements and the screen.)

Clearly, it’s a project that’s not totally polished for mass consumption—which may be why Frog has uploaded the game code to Github for anyone to use as they see fit, and the team alluded to making the headset specs available soon, too. But Pridgen has been testing the headset with other software in a pilot study with burn unit patients and hospital staff, and he's seeing a lot of early success. "Data is showing an improvement in pain scores from patients," says Pridgen. "And we're getting good feedback from doctors as well."

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