The use of virtual-reality technology in the areas of rehabilitation and therapy continues to grow, with encouraging results being reported for applications that address human physical, cognitive, and psychological functioning. This article presents a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis for the field of VR rehabilitation and therapy. The SWOT analysis is a commonly employed framework in the business world for analyzing the factors that influence a company’s competitive position in the marketplace with an eye to the future. However, the SWOT framework can also be usefully applied outside of the pure business domain. A quick check on the Internet will turn up SWOT analyses for urban-renewal projects, career planning, website design, youth sports programs, and evaluation of academic research centers, and it becomes obvious that it can be usefully applied to assess and guide any organized human endeavor designed to accomplish a mission. It is hoped that this structured examination of the factors relevant to the current and future status of VR rehabilitation will provide a good overview of the key issues and concerns that are relevant for understanding and advancing this vital application area.
Virtual reality (VR) has now emerged as a promising tool in many domains of therapy and rehabilitation (Weiss & Jessel, 1998; Glantz, Rizzo, & Graap, 2003; Zimand et al. 2003; Rizzo, Schultheis, Kerns, & Mateer, 2004). Continuing advances in VR technology, along with concomitant system-cost reductions, have supported the development of more usable, useful, and accessible VR systems that can uniquely target a wide range of physical, psychological, and cognitive rehabilitation concerns and research questions. What makes VR application development in the therapy and rehabilitation sciences so distinctively important is that it represents more than a simple linear extension of existing computer technology for human use. VR offers the potential to create systematic human testing, training, and treatment environments that allow for the precise control of complex, immersive, dynamic 3D stimulus presentations, within which sophisticated interaction, behavioral tracking, and performance recording is possible. Much like an aircraft simulator serves to test and train piloting ability, virtual environments (VEs) can be developed to present simulations that assess and rehabilitate human functional performance under a range of stimulus conditions that are not easily deliverable and controllable in the real world. When combining these assets within the context of functionally relevant, ecologically enhanced VEs, a fundamental advancement could emerge in how human functioning can be addressed in many rehabilitation disciplines.
But we know that already. What we don’t know is: What place will VR occupy in the future of rehabilitation?
Depending on who you ask, you’re likely to hear a variety of responses to that question that might include such words as: “Visionary!” “too expensive,” “just what the field needs,” “but how will that impact the therapist’s role?” “sounds like the Holodeck,” “need better interfaces,” “hmm . . . interesting possibilities,” “can they really do that?” and so forth. In essence, the view that one takes of VR and its potential to add value over existing rehabilitation tools and methods is often influenced by such factors as one’s faith in technology, economic concerns, frustration with the existing limitations of traditional tools, fear of technology, popular-media influences, pragmatic awareness of current hardware limitations, curiosity, and healthy skepticism.
For those working in the “trenches” trying to employ VR in a meaningful way for rehabilitation purposes (or for those just getting their feet wet), a more systematic strategy for evaluating the state of the field could be of value for informing one’s judgment, decision making, and guesses as to what’s possible now and what lies ahead in the future. Without applying a structured framework to aid one’s thinking about the current status and future of VR and rehabilitation, it is quite easy to regularly oscillate between flights of wishful thinking and bouts of abject discouragement, depending on the daily ebb and flow of provocative data and system crashes. Perhaps our susceptibility to this sort of bipolar “second-guessing” of VR could be reduced if one is armed with a comprehensive yet intuitive method for organizing the myriad factors that will serve both to enable and to limit how well we can successfully translate our virtual-reality rehabilitation vision into actual reality! Such a strategy may also help us to identify realistic goals and establish priorities regarding which clients are the most appropriate candidates for VR and which technologies are best suited to creating applications to meet their needs. Although a high capacity to live with ambiguity is a requirement for those who explore novel emerging approaches in any discipline, a focused approach for guiding guiding our expectations could make that process more manageable and productive in the long run.
In view of these issues, this paper will present a SWOT analysis for the field of VR and the rehabilitation sciences (see Figure 1). SWOT is actually an acronym that stands for strengths, weaknesses, opportunities, and threats, and is a commonly employed framework in the business world for analyzing the factors that influence a company’s competitive position in the marketplace with an eye to the future. A classic success story for the value of a SWOT analysis is Dell Computer Corporation’s use of the framework to make the strategic decision to implement mass customization, just-in-time manufacturing, and direct Internet sales (Collett, 1999). However, the SWOT framework can also be usefully applied outside of the pure business domain. A quick check on the Internet will turn up SWOT analyses for urban-renewal projects, career planning, website design, youth sports programs, evaluation of academic research centers, and it becomes obvious that it can be usefully applied to guide any organized human endeavor designed to accomplish a mission.
Generally, a SWOT analysis serves to uncover the optimal match between the internal strengths and weaknesses of a given entity and the environmental trends (opportunities and threats) that the entity must face in the marketplace.
- A strength can be viewed as a resource, a unique approach, or capacity that allows an entity to achieve its defined goals (e.g., VR can allow for precise control of stimulus delivery within a realistic training or rehabilitation simulation).
- A weakness is a limitation, fault, or defect in the entity that impedes progress toward defined goals (e.g., the limited field of view and resolution in a head-mounted display can limit usability and perceptual realism).
- An opportunity pertains to internal or external forces in the entity’s operating environment, such as a trend that increases demand for what the entity can provide or allows the entity to provide it more effectively (e.g., tremendous growth in the interactive digital gaming area has driven development of the high-quality, yet low-cost graphics cards needed to make VR deliverable on a basic PC).
- A threat can be any unfavorable situation in the entity’s environment that impedes its strategy by presenting a barrier or constraint that limits achievement of goals (e.g., clinical administrators’ and financial officers’ belief that VR equipment is too expensive to incorporate into mainstream practice).
From Presence, Vol. 14, No. 2, April 2005, 119-146. Copyright © 2005 by the Massachusetts Institute of Technology. Reprinted with permission from Albert Rizzo.