Virtual reality for people who have limb loss or limb difference: a multidisciplinary perspective on needs for clinical translation and future research

Virtual reality programs, ranging from laboratory-based simulation environments to home-based immersive headsets, have the potential to improve rehabilitation for people with limb loss (e.g., acquired amputation) and limb difference (e.g., congenital limb absence). Over the past several years, virtual reality programs have become more ubiquitous in research studies and healthcare systems. However, the integration of virtual reality into rehabilitative care for people with limb loss or limb difference remains overlooked. While prior systematic reviews have evaluated the efficacy of virtual reality (VR) in rehabilitation and phantom limb pain, there is a lack of literature on how these findings translate into clinical rehabilitation for people with limb loss and limb difference while accounting for access, equity, workflow, and implementation barriers, along with considering multidisciplinary perspectives from researchers, clinicians, and people with lived experiences. Our perspective article discusses the potential benefits of virtual reality for people with limb loss or limb difference, areas of need for future research, and considerations for implementation in clinical practice to improve rehabilitation. We provide our multidisciplinary views as researchers in virtual reality (authors RBT and KT), psychological wellbeing (RBT and CM), motor functions (AK), physical activities (RP), and body composition (AG); clinical researchers with expertise in people with limb loss and limb difference, who are also prosthetists (CM and MGF), occupational therapists (KT), and physical therapists (SC); and a nurse who is also a person with lived experience (DH). The target audience for this article includes researchers and clinicians working with people who have limb loss and limb difference. Based on our views as experts across the spectrum of health, we present some future research needs and clinical implications to inform the adoption of virtual reality for people with limb loss and limb difference and to improve rehabilitation.