When a patient has a stroke, a traumatic brain injury, or any other condition that limits movement, occupational therapy is paramount to helping that patient maximize the mobility they do have.

The work has often entailed simple simulations. A therapist, for example, may lead a stroke patient through a cooking exercise using bean bags and balls inside a rehab clinic. But improvements in technology are also giving therapists new tools. Virtual technology can provide patients with a real-life scenario allowing them to visualize the utensils and ingredients in the kitchen.

This is just one example, according to occupational therapy assistant professor Jonathan Legarte, of how new technology can be used to re-teach the brain on its journey to regain the functions it lost after a brain injury.

But for a simulation to have occupational therapy value, the technology must be designed with the patient in mind. That's where his class — Assistive Technology and Environmental Modifications — comes in. 

“Virtual reality is only one component,” Legarte said. “In this class, students learn about different low-tech and high-tech options to assist those with disabilities, about 80% low-tech and 20% high-tech. Assistive technology should be low cost for somebody and easily replaceable.”

The Course: Occupational Therapy 750 - Assistive Technology and Environmental Modifications

This course is offered to second-year occupational therapy students within UNLV’s School of Integrated Health Sciences. Students tap into their creativity as they learn how to design assistive devices for individuals with disabilities.

This class takes place every Tuesday from noon to 3 p.m. on the university’s Shadow Lane campus, where the occupational therapy doctorate program is located.

How does this course benefit UNLV’s occupational therapy students?

“In this class, our students gain an understanding of the bigger picture," Legarte said. "Everything we do technology-wise has been built off of trying to meet the needs of someone with a disability."

Students learn how to use accessibility options that already exist. "The current iteration of Air Pods is aiming to be functional hearing aids," he said. "So what can we provide that’s already out there for people with disabilities? Do we have to make them ourselves? Or do we have to rely on assistive technology experts?”

Legarte said students need to put themselves into the shoes of those with mobility limitations so that they can better envision which tool might be useful as they regain the ability to complete their daily tasks.

At the end of the spring semester, students participate in the assistive technology fair, held inside the Lied Library, where they present their invention and show their faculty members and fellow classmates how they can help patients improve their mobility.

“The environmental modifications allow our students to review home environments and make recommendations to better accommodate individuals with disabilities,” Legarte said. “This could include helping someone reach a higher area, or maybe creating something to help someone who lacks the fine motor skills to write, or maybe an idea that helps someone regain their ability to walk or get out of bed.”

How can virtual reality serve as an intervention for pain?

Virtual reality can be used for meditation, pain management, and — more recently — rehabilitative benefits, like stroke rehab. 

“When it comes to occupational therapy rehab, we look at giving patients therapeutic power, which means giving them treatment options they find appealing. Machines and weights can be intimidating, but virtual reality offers a different avenue,” Legarte said. “Research since the Nintendo Wii and the Xbox Kinect [came out] show video games have therapy appeal. Virtual reality is that next step in therapeutic gaming but has a lot more potential than just video games.”

Legarte added that virtual reality creates a functional environment. For people who had a stroke, simulated activities are beneficial because there is a tangible goal in mind. 

“Let’s say they use virtual reality to simulate a cooking task. They can see the stove and the utensils which registers in the brain. Compare that with a simulated task in the therapy gym that typically includes using bean bags and balls. The virtual reality essentially improves their perception and creates a better environment to perceive tangible functions,” he said. “Even though the task isn’t there, it’s more there than it would be using bean bags and balls in a therapy gym.”

Are there any books or TV shows that might give people a better understanding of what this class entails?

“This class really teaches you to be the MacGyver of the therapy field. You’re only limited as to what you can imagine,” Legarte said.

What should the lay person know about this class, and how can they benefit from it?

“For the lay person who is struggling financially to obtain a certain device or struggling to complete certain tasks, the future is in 3-D printed technologies,” Legarte said. “What would typically be an expensive splint to make, you can now find a file and 3-D print it at your local library, or even your own home if you have a 3-D printer.

"That technology is more mainstream and is becoming more affordable these days. You don’t even need to know how to code. If you can think of it, someone has probably already made it.”