Growing Bold with Technology

Additional reading on Rohan O'Reilly

• https://www.f6s.com/rohanoreilly
• https://www.abc.net.au/news/2017-03-30/reimagining-rehabilitation-with-help-of-virtual-reality/8397276
• https://anziif.com/members-centre/the-journal-articles/volume-41/issue-3/mind-over-matter?p=6&mbs=&cat=all

Growing Bold with Technology

Welcome to the Grow Bold with Disability podcast, brought to you by Feros Care. A podcast dedicated to smashing stereotypes and talking about the things people with disability care about most, to help us live bolder, healthier, better connected lives. I’m journalist, Pete Timbs. And I’m Tristram Peters. I work for Disability Service Directory, Clickability and am a wheelchair user living with spinal muscular atrophy.

Today's episode of Grow Bold with Disability is Growing Bold with Technology and our guest is Rohan O’ Reilly, the founder of “Smart Bodies. Smarter Minds”, Australia's first integrated virtual reality neuro rehabilitation clinic. In this episode, we'll hear how Rohan is thinking outside the box and using technologies once only used by gamers to help people with brain injuries, strokes and spinal cord injuries. Rohan. Welcome to Grow Bold with Disability.

Thank you very much. Good morning, gentlemen. It's great to be here.

Yeah, thanks for coming along. So, I mean, Rohan, you opened Smart Bodies, Smarter Minds Clinic in 2009. Can you explain to us what it's all about?

Well, can I give you a bit of an update - Smart bodies story ended at the end of last year and a new story begun which is based on the foundation that I put together during that 10-year journey so it's even more exciting now. But yes, I did start in roughly 2009.

And so what was the mission behind that? Why did you feel it was necessary to begin the clinic?

Ah, look, the issue was to me always - I was always interested personally in high kinesthetic. So, it means I love being able to move. And I was always interested in how you improve human performance in a smart type of way, because, you know, there are two ways to do everything obviously. There's sheer effort and there's leverage. And I thought surely you know at this point in time there may be better ways to do this than what would appear to be happening and what has happened for a long time. And the initial goal was about improving human performance, basically to condense a very long story. What happened was that I started to realize that, you know, although the majority of it was pointed towards physical inputs to produce increased physical outputs. The reality of the story was that the physicality is not controlled by our body. It's controlled by our mind and our central nervous system. And, uh, on top of that is really how we feel, our emotional intelligence and our ability to focus our minds. I suppose that's what started me thinking about if that's the case and it appeared obvious that it was, then how do we go about collecting data to actually prove that that is the case? And then how do we use that data to actually create better ways of improving performance? So really, that's what started the whole thing back then.

And so then where did the idea for the virtual reality technology come about?

Well, back then, VR wasn't really an issue. It had started its development in about the 1960’s, and I actually have a friend who was around Princeton at the time who was around the work on the very first versions of VR and they used to refer to it basically as the equivalent to the vomit comet because nobody could stand it for more than a couple of minutes. Interestingly, I showed him a commercialized version of it a couple of years ago, and he hadn't seen it since back then, and he was just jaw to the ground. He couldn't believe it - that was pretty amazing, But look, it wasn't actually that I was looking for VR. It was understanding and coming back to that point that human physicality is growth controlled by the nervous system. And, you know, obviously the mind is a key part of that. There's two parts to our consciousness, and that would be the alert awaking part and the other. And the other for most people plays a much greater role in how we how we exhibit ourselves in in daily life in terms of what we do and why we do it. What I was trying to look into was a way we could more effectively connect with the subconscious mind. Because a lot of sports people of the top end use hypnotherapy, for example, for long periods of times to various degrees of success. The problem with hypnotherapy is only about half the population is susceptible to it in most cases. Some people it works well for and for others it does nothing. I was actually looking for that type of input and I was hearing memories about VR for quite a while. But it was nowhere near commercially ready yet. But I just sort of realized, well, hang on a second, because the visual part of our brain represents such a massive part of our neural infrastructure it basically dawned on me that hang on, human beings basically believe what they see. And if you could convince the brain to the great extent that what it was seeing was real, that would probably be a very good way to act on a more subconscious or older brain pathway. And that's really when I came to that sort of conclusion thought this is where VR really could be a fantastic new tool. So that's actually how came into it.

And what's the feedback been from your patients?

Look the truth is that VR worked better than what I had hoped. And that's a really cool thing, because first generation technologies, and I have been involved in a lot of them, I mean, you know, some of them are really fantastic and some of them are just brilliant in theory but woeful in practice execution. VR luckily has been close to flawless, which is being very, very good. I think, you know, in terms of using it in rehabilitation compared to standardised rehabilitation which can produce a lot of good results but has finite limits to maintaining engagement. And engagement is a really big thing in rehab. It's huge. It is probably 50% of the whole game, in my opinion. And when you're trying to keep people exerting, putting focus and energy into a particular set of rehabilitation movement patterns, um, trying to keep the level of enthusiasm up normally is really problematic over a long period time. VR does a magnificent job of making that so much easier. Because fundamental what we do is we go to great lengths to find out what people are really into and then try and find VR environments to match that. So that they just naturally, subconsciously, already really associate to the environment they are in. So you're ahead of the ball game, if that makes sense.

Yeah, it breaks down the monotony, really, doesn’t it. It just gives them something a little more exciting to do than just sitting there moving their legs up and down.

True. So true. It is interesting when you realize even in 2020 the overwhelming majority values in rehabilitation therapy over a period of time are due to engagement not due to the therapy not being technically correct.

So what's been the feedback from more traditional practitioners in the industry?

Oh, I think I think like every technology, you know, you have people who can see why that would be a good idea and others just can't connect with it. You know, I don't know what people say about it behind closed doors, but like people involved have very quickly seen the obvious capability of it to improve outcomes, through a number of ways. And overall I think it's very positive. I would appear to me that this is the way of the future.

You just spoke there about achieving positive outcomes. The results speak for themselves. What are some of the results that you've seen with stroke, spinal injury, brain injuries?

Well, again, basically almost all the clients that we deal with have essentially being through the gamut of conventional therapies. And they've been able to help them extensively in most cases. But then, particularly if you say, looking at brain injuries, people get can get really fantastic acceleration in the early days and then they plateau. The problematic thing becomes what do you do when the set of prescribe imports or movements for that, you don't have any other options? That's really problematic. And it's problematic again from an emotional and mental point of view as well. As from a physical point of view. So people have been stoked with the ability to keep changing the environments and, I think, succinctly putting it, a lot of what we're trying to do is create a state of heighten neuro plasticity that just simply means to create new pathways. New connections in the brain because those connections in the brain create functional movement in the body. And so you can do things in VR that you can't do in reality. So if, for example, you know you can have someone climbing Mount Everest in a rehab clinic or people fighting zombies, and things like climbing a skyscraper. And that's a brilliant thing to watch. You know, it’s a brilliant thing to see people walking out happier, you know, in a better state than what they were in. You know, that's a really beautiful thing to be part of.

It's incredible. And I was watching a little thing on YouTube that you did with the ABC and Angus McConnell who is a friend of the show. He stood up. He is a paraplegic. Now he stood up using a lot of the rehab and so forth, which is quite incredible. Do you think Gus could have got to that stage using traditional methods, or would it have taken him longer? Or was it just this whole, as you say, this breaking that minority. So he keeps telling he always loved going to see you. He wanted to go there and use the VR equipment, as opposed to just going to a gym.

Angus McConnell is a legend for a start so that helps. The simple answer is, I don't know. I would be speculating now to say because, you know, in order to know that you would have to run regular scans on his spinal cord and his grey matter to actually see where the changes happen. Now, I can speculate that, you know, I certainly had always had a deliberate plan for Angus and it was based around what seemed to be a plausible hypothesis to me. To encourage him to have some recovery of movement. But again, I don't want to be say things that I that I can't back up with hard facts. But my personal opinion would be that after many decades in rehabilitation it certainly accelerated things. And I think that again taking into account where I was when I was working with Angus initially and where I am now are very different. It's been an exponential growth learning path, and VR, for example, has just hit its 1st and 2nd generation tech now. I mean, what's ahead is going to be vastly different to what is here now. And therefore the ability to convince the brain of what it is experiencing is real is going to be vastly different. That is the key salient thing to understand.

Absolutely. I'm a powerchair user myself and I know that when I was a kid I was loathe to do my rehab and stretches and all that sort of thing. Is VR used a lot for kids as well or do you primarily see adults? And what is the demographic spread?

So it's reasonably broad but I say the main difference is that generally with kids, you know, it is more for behavioural issues. Here is a classic scenario. You have a kid who basically ends up in some trouble so he becomes a chronic gamer. And with chronic gaming you basically develop a hyper sedentary life and then your nutrition your movement and your interactions all take a somewhat downward trend because you're looking for this, in effect, hit. A rewarded structure that you get out of engagement with the game. The problematic thing is, when we saturate any type of reward system in the brain, the outer campus, the reality of that scenario is we get approached by moms often distraught that they simply can't get their child to do anything. And they have tried psychologists, psychiatrists, everything. It's fundamentally because what you trying to say to that kid is you should get outside and you should exercise, and you should eat well because it is good for you. But that's just bypassing the important structure of the brain where it is supposed to be because the behaviour is not coming from the part you are having a conversation with, it is coming from the subconscious mind, which just wants a hit. The alternate to that, that we would provide it's generally pretty relatively funny that when you get kids and parents in and they are doing their first assessment, you're effectively having a conversation with parents around wishing you were somewhere else. We've been through this scenario multiple times before. The interesting point of it is we soon say to them again you know, you know how you doing? Grunts are generally the order of the day. Man I hear that you are into gaming. And he just like ‘huh”. What type of game are you into. And he will mention a number of games and I'm not a gamer by the way at all. I'd rather be at the beach. But essentially you say to them “okay, so you are into first person shooter games” and most of them are and essentially means you're in a game and you have shooting zombies or whatever. They will say “hum yeah”. And I’ll say “have you heard of VR?’ And then I say, well you know, how would you like to, you know, try some shooting some zombies in VR. Or driving a tank in VR and shooting other tanks. And all of a sudden attention on? And you put him into it. And their parents are like thinking crossing their fingers and toes going “Oh, please, let's work”. And we have VR called VR locomotion systems, where you have to put physical energy into a device to dictate your experience. So, for example, we have what looks like an exercise bike but it is actually fully integrated with VR. So, for example, we have an environment where you're driving a tank. So you'd be the tank commander and you are in a field with obstacles and other tanks are trying to get you. But in order for you to integrate, you have to push pedal right on the pedals. We set the resistance so it feels like grinding a tank. It's got like head up aiming, and so you need spatial awareness which means you need to be a alert and you need to be peddling. So you'll go from a kid who won't even walk around the block to a kid is being in, you know, peddling his heart out. They come out the drenched in sweat. Eyeballs the size of saucers and smiling, and the parents were just like Oh my God. That is what's beautiful about it because you're not forcing anyone to do anything. You simply saying “here's something that we think you might like.” It is self-guided interaction. That's what's so cool about. Yeah, and then we can attach different types of technologies or biometric data technologies and find out exactly what it's doing to them.

Incredible. It's tricking them into it, it's great. Now we mentioned at the start Smart Bodies, Smarter Minds and you said that wrapped up at the end of last year. What's the new project? Are you allowed to talk about it?

Yeah, absolutely. It's really exciting. So the new project is called Engage VR Rehab. So this one's much more collaboration. We have some partners who are very well respected in the Allied Health field. And essentially, what it is, is taking the best elements out of Virtual Allied Health practices for rehabilitation across body and mind. And then combining what I have been working on and developing over the last 10 years, this technology and biometric data acquisition model. That sounds dull but why it is so completely relevant is that say, for example, you've had a serious injury and you may be facing a very prolonged rehabilitation journey. The thing is that, you know, again, what you want is to be sure that all of that consistent effort that you have to put in, time, money, hard work is actually doing what you want it to do. Okay, so what happens traditionally now is that you essentially have a combination of what are called subjective and objective measures. Subjective is “well, how do you feel about it?” Are you're doing well. An objective will be “can you actually move your arm or your legs more, okay. And so whether that happens or not in a time frame that you want it to is a very different thing, for most people it can never happen soon enough. And that's completely obvious why that would be the case. But what we're moving to is, um, a position where we can interact with people in our clinic and set them up with a series of stimulation. So it might be VR, it may be locomotion. It might be combined with electrical stimulation either on their brain or on their body. And then we can attach senses to that that are basically connected up in a way that shows exactly what it's doing to the person. So, for example, if we're trying to create more movement in a leg, we want to see that the part on the brain that's responsible for moving that leg or creating the signals to output that movement is actually being stimulated. And that could be done on a real time basis. So that every session and during the course of this session, you have someone like air traffic control's looking at your data and going “you might want to pedal just a little bit harder there or just turn to the left a little bit more” and then all of a sudden you know because we can see that light is on. Now you're hitting the target and then we're collecting this information in files. And then we can show you exactly what your effort is doing and we can share that also with whoever has referred you, your GP, your specialist, your allied health team to say here is where they are. And here's what I want happening That's really cool. That's the coolest thing about it.

Incredible. And so in terms, you mention there were VR is going, do you think that will get more widespread adoption of it? Are we getting to the point where more practitioners will take this on because as we have said so many times the results are amazing.

Well, put it this way, you know, at the moment VR is being used to train tens of thousands of healthcare workers to upskill them so you're seeing different circumstances dictating a method or a more lifelike training of people in general in situations where it's just not plausible to do all of that physically. So what I think is one of three things is going to dictate its progression more into Allied Health is training. Uh, and so you would have essentially, like, a model I think you made from a model where you have theory and practice to a model where you have theory, you have VR and you have practice. The beautiful thing about that is that I'm also involved with another medical technology company which we founded a couple years ago on and basically, what we're doing is working on technology to enhance the sensory and motor function of people have had strokes or brain injuries and don't have hand or arm function. The relevance of that story is that the technology we're delivering is taking it to the next level about how VR can allow you to interact on a deeper level of immersion, And immersion just means your brain believes more. So VR now you can see it right and as I've mentioned before, your brain greatly believes what you can see. But if you could do things like feel in VR as well that's where it's moving. VR is going to move to a point where you can have multi-sensory, where you could feel, you could smell, you could have a resistance. You could have hot and cold. That's where it's going and that'll be the thing that will make it an indispensable tool in health.

Incredible. Now Rohan if I'm listening to this podcast and I wanted to get in contact with you guys or if I think this stuff can work for me what's the easiest way of other people around Australia – because you are based in Newcastle - are there other people in Australia or is it just you working in this?

So we have a team based at Mayfield and are engaged in a VR rehab clinic. And so that clinic is a pilot clinic and so we basically have firmly made plans to be able to expand that clinic model into other capitals, cities and it looks either like that's going to go offshore as well. Because again, the idea is in healthcare. Healthcare's moving more and more towards a data based outcome and be able to provide proof and the people who pay for health care. You have got this completely different experience of rehab for the purpose of the client. And then, on the other hand, you have proof of it that's really the secret also.

Yeah, exactly.

Rohan, as you are aware this podcast is called Grow Bold with Disability. And we like to ask all our guests what does growing bold mean to you?

Well, I think Growing Bold to me means basically, everyone's got their limit a personal safety limit for the lack of better words when it comes to emotional stuff. I think in order to grow bold is to grow larger and the only way to do that is push that boundary and I think that ultimately means being more comfortable being at a place where you're not comfortable. You know, I think that's the only way you can truly make significant advances.

Beautiful. There are thanks so much for joining us today on Grow Bold with Disability brought to you by Feros Care. Our listeners can find out a lot more about Rohan’s amazing work in the links provided in today's episode show notes. Rohan O Reilly, thanks for joining us today.

It’s a great honor, thank you so much. I love your great work. Thank you.

Thank you for listening. And if you have enjoyed today's episode that make sure you subscribe to the podcast, Grow Bold with Disability and if you like what you heard please take a few moments to pop over iTunes and give this a podcast a quick rating so we can continue these conversations and encourage people to grow bold.

This podcast is brought to you by Feros Care, an NDIS partner delivering local area coordination services in Queensland, South Australia and the Australian Capital Territory. Feros Care is a people care organisation committed to helping people live bolder lives. We call it Growing Bold and for over 25 years Feros has been making it real for both older Australians and those living with disability. To find out more, head to Feroscare.com.au.

The content and views discussed in this podcast series are those of the individuals involved. They are not necessarily condoned by, or, are the views of Feros Care or its employees.