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CAREN: Computer Assisted Rehabilitation Environment

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The CAREN system at the Midwestern University Therapy Institute is an immersive virtual reality environment for advanced clinical evaluation, analysis, and rehabilitation for a variety of neuro-physical conditions. These may include conditions that affect vision, balance, and physical abilities, as well as many others.

This highly interactive system consists of a moving platform with an embedded, instrumented treadmill, wrap-around projection screens, integrated motion capture system, and electromyography, which measures electrical activity in skeletal muscle to help diagnose neuromuscular disorders or provide biofeedback. These specialized features create controlled virtual environments, from walking down a forest path to steering a speedboat on a lake or navigating objects on a road, in which patients can interact safely and healthcare providers can obtain important kinetic and kinematic data.

CAREN can be customized for individual patient needs, and will be utilized at MWU for assessment and rehabilitation for patients with Parkinson’s disease, strokes, brain injuries, physical injuries, visual skills training, and more. It also offers balance and gait assessment programs, falls assessment, and manual propulsion for patients in wheelchairs.

Healthcare providers across many disciplines will be able to utilize this state-of-the-art technology, including physical therapy, podiatry, vision therapy, low vision rehabilitation, sports vision performance training, speech-language pathology, occupational therapy, and others.

“We are excited to bring the CAREN to the community,” says Kaila Osmotherly, O.D., Medical Director for the Therapy Institute and Associate Dean for the Arizona College of Optometry.  “This technology is truly at the forefront of rehabilitation and research. It’s incredible to think of the progress that individual patients will gain from this device as part of their treatment and of the knowledge that we as a healthcare community will gain from the research possibilities.”

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What is it?

The CAREN (Computer Assisted Rehabilitation ENvironment) is an immersive virtual reality experience that provides advanced clinical evaluation, analysis, and rehabilitation for a variety of neurophysical disorders. Consisting of a moving platform, an embedded treadmill, and wrap-around projection screens, this highly interactive system also includes electromyography, which measures electrical activity from skeletal muscle and helps clinicians diagnose neuromuscular disorders or provide biofeedback. This machine simulates controlled environments so patients can interact safely, and clinicians can obtain force and motion data to assist with patient treatment.

What Does It Do?

The CAREN provides rehabilitation services for patients with a variety of conditions that affect vision, balance, and other physical abilities. Think of a gaming system– instead of just controlling an on-screen movement with a device you hold in your hand, you control the movements on screen with your entire body.

Treatment is provided through a variety of highly realistic feedback and training programs including environments simulating activities such as:

  • Walking through a park
  • Hiking a mountain
  • Shopping at a grocery store
  • Hitting a ball
  • Steering a car or boat
  • Cognitive activities

How Can the CAREN Help Me?

At Midwestern University, our expert healthcare team across many disciplines utilizes the CAREN to provide highly customized treatment for patients. New, creative virtual environments can be tailored to specific patients, designed by faculty and the University’s CAREN engineer, one of the top experts in the country in a growing and exciting field. Some of our specialty disciplines include:

  • Physical Therapy
  • Occupational Therapy
  • Speech-Language Pathology
  • Vision Rehabilitation
  • Acquired Brain Injury

Due to its versatility, the CAREN can also assist with more specific treatments for things like balance and gait assessments, fall prevention, weight distribution, physical capacity assessments and training, sports vision performance training, cognitive and physical dual-tasks, and exposure therapy.

Treatment combinations through the CAREN are always determined by the provider, and specifically designed to support that specific patient’s treatment goals. Ultimately, the CAREN technology is used by our providers to help transition therapies and treatments from the clinic into the patient’s everyday life.

How Does the CAREN Promote Research?

The CAREN is the world’s most advanced biomechanical lab. Its interactive, immersive design allows clinical researchers to obtain important data from a research subject on things like weight distribution, balance, gait, electrical activity from skeletal muscle, and much more. With more military hospitals utilizing this technology, many advancements have been made in treating patients with amputations and traumatic brain injuries. Other clinical research has shown that the CAREN can help those who have suffered a stroke, Parkinson’s disease, and other neurophysical disorders that affect mobility, vision, or activities of daily living.

For more information on research and video clips of the CAREN in action, visit:


The CAREN was originally designed to give medical researchers the ability to study balance and movement disorders in a more in-depth manner than ever before. While most of its use continues to revolve around medical research, some facilities are putting the CAREN to use in the rehabilitation field, actively treating patients with a variety of neurophysical disorders. There are fewer than 20 of these systems in the United States, and the Midwestern University Therapy Institute team recognizes how important it is to invest in this technology to assist in providing care for our patients. With only a few machines worldwide, most are based at military treatment centers and used to treat veterans with traumatic brain injuries, amputations, and other movement and balance disorders.

What Should I Expect?

If you are already receiving treatment at the Midwestern University Therapy Institute or have been referred to the Therapy Institute by another provider, there are a few things you should know before you have your first treatment session with the CAREN.

Wear athletic clothing and comfortable walking shoes, as many of the activities on the CAREN involve walking or other movements.

The CAREN is equipped with many safety features, including a harness that you will be strapped into while you are on the machine. This is done to prevent falling, and the harness system is designed to safely keep you in place so your treatment can be as effective as possible. In some cases, your provider may also be on the machine with you, secured in their own safety harness as well.

How do I Make an Appointment?

Most patients that would benefit from the CAREN need a referral from a healthcare provider. They will typically already be receiving physical therapy, podiatry services, low vision rehabilitation, sports vision performance training, speech-language pathology services, occupational therapy, clinical psychology, or other services that can be specifically enhanced using targeted CAREN treatments.

If you feel you are a good candidate for treatment using the CAREN machine, please have your current healthcare provider contact us at 623-537-6000.

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