KVET for mTBI.

What is Karuna Virtual Embodiment Training?

In KVET you wear a VR headset, see a virtual body from the inside, and move it through graded activities, with a coach working with you one-on-one. It rests on the same idea as mirror therapy and graded motor imagery. Give the brain clear, believable evidence that the body is moving safely, then build on it.

After a mild traumatic brain injury, that means working on what the concussion knocked out. That includes how much activity you can take, how well your eyes track and keep up with your hands, how confident you feel getting around, and how well you can calm a nervous system that has been running hot. How it works lays out the full program.

What does the program work on physically?

The physical work targets the everyday abilities that shrink after a concussion, and keep shrinking when people avoid what sets symptoms off.

Fear runs through most of that list. After a concussion, people avoid whatever reliably brings symptoms on. Avoiding things costs fitness, and lost fitness lowers the threshold further. Our kinesiophobia page walks through that loop, and graded activity with a coach is largely there to break it.

What does it work on for mood, thinking, and confidence?

Mental health shapes how a concussion recovery goes. Low mood, irritability, and anxiety are common after a mild traumatic brain injury, and a history of mental health problems is one of the known predictors of slower recovery. The program works on these alongside the physical side.

Mood

• Irritability, often the symptom colleagues and family notice before the person does
• Anxiety and low mood, including anxiety about symptoms themselves
• Building a more positive and more hopeful outlook on recovery

Confidence

• Confidence in being able to carry out daily activities without triggering a setback
• Having tools to manage a flare-up when it happens, including in public

Thinking

• Foggy thinking and confusion
• Executive function and decision-making, which most work tasks lean on

Relaxation

• Relaxation skills that lower overall nervous-system arousal
• Applied to migraine and headache management

This ties straight back to the physical work. How confident you feel decides how much you try, and a nervous system on high alert reacts more strongly to whatever you do. Central sensitization explains why a system on alert turns up symptoms that would otherwise settle.

Who is a good candidate for the program?

The program isn't right for everyone who has had a concussion. The criteria are narrow on purpose:

• Not bed-bound. The person is up and able to participate in guided activity
• No PTSD. Post-traumatic stress disorder needs its own specialist treatment, and an immersive VR environment may not be appropriate
• No extreme vision or hearing problems. The program relies on visual and auditory feedback, so severe impairment in either makes it unsuitable

After that it comes down to timing. In the first days after a head injury, you need assessment and relative rest. The program is built for people whose symptoms have lasted past the point where they expected to be better.

When does other care need to come first?

A rehab program is one part of concussion care, and some things have to come before it:

1. Emergency assessment for any red-flag symptom: worsening headache, repeated vomiting, increasing drowsiness, weakness, seizures, or confusion. See the full red-flag list.
2. Medical assessment after any head injury, before returning to driving or safety-sensitive work.
3. Targeted therapy where a specific problem is driving symptoms, such as vestibular rehabilitation for dizziness, or treatment of the neck where headache is cervicogenic.
4. Mental health treatment where PTSD, significant depression, or anxiety disorder is present.

None of these rule out the program later. Sorting them out first means the program works on the right problem.

How does the program fit with returning to work?

When the concussion happened at work, the goal is usually getting back to the job safely, and the program's physical targets line up with that. How much activity you can tolerate sets how long a shift can be. Reach and lifting decide which duties are possible, and how clearly you can think decides how much mental load you can take on.

Written work restrictions are built from those same abilities. Our guides on return to work after concussion and work accommodations explain the three stages and how restrictions get updated as tolerance improves. The program builds the tolerance, and the return-to-work plan turns it into hours and duties.

Doing it at home helps here too. Early on, many people aren't allowed to drive, and getting to a clinic several times a week is tiring in itself.

What can and can't be said about results?

Everything on this page describes what the program is designed to work on, based on Karuna's clinical experience delivering VR embodiment training and coaching to people with lasting symptoms after a mild traumatic brain injury. These are goals. We have not measured them as outcomes.

• There is no controlled trial of this program in an mTBI population.
• The figures Karuna does publish come from a real-world analysis in a chronic pain population, not a concussion population. See the outcomes table and its caveats on how it works.
• Individual results vary, and improvement in one area does not predict improvement in another.
• Nothing here should be read as evidence that the program causes recovery from concussion.

What we can say is narrower. Concussion guidelines agree that lasting symptoms respond to graded activity kept below the symptom threshold, along with education and support. This program is one way to deliver that.