Dr. Chris Riehm explains how his team uses commercial VR headsets to develop advanced diagnostic tools for assessing concussions and preventing secondary athletic injuries. The conversation explores the transition of this technology from specialized labs to clinical and home settings, offering new possibilities for remote patient monitoring and personalized rehabilitation.
Articles/Media mentioned in the episode:
1. Emory SPARC. Dynamic Assessment of Sensorimotor Health (DASH). Retrieved May 12, 2026, from https://emorysparc.com/elementor-page-992/
2. Riehm, C. D., Bonnette, S., Riley, M. A., Diekfuss, J. A., DiCesare, C. A., Schille, A., Kiefer, A. W., Jayanthi, N. A., Kliethermes, S., Lloyd, R. S., Pombo, M. W., & Myer, G. D. (2022). Movement Regularity Differentiates Specialized and Nonspecialized Athletes in a Virtual Reality Soccer Header Task. Journal of sport rehabilitation, 32(3), 248–255. https://doi.org/10.1123/jsr.2021-0432
Melissa: Welcome to Behind the Breakthroughs. I'm Melissa Deuber from the Woodruff Health Sciences Center Library. In each edition, we take a closer look at the research shaping health, healing, and human performance at Emory. Today’s episode is part of the "Off the Field" series, where we explore how science moves from the lab to everyday life.
I’m joined by Dr. Chris Riehm to talk about their work, the questions that drive it, and what it could make possible. So let's go ahead and get started. Tell me a little bit about yourself and how you got into this field of research.
Dr. Riehm: I am an assistant professor at Emory SPARC. My background is in human perception and action generally. Broadly, I try to understand how we do what we do; how our bodies do things in the world; which is very relevant for sports. From my specific background, I look at how your senses (your vision, your hearing, and different things) feed your movement. Ultimately, I look at what's in between: how your nervous system coordinates your sensory inputs to your movement.
Specifically for what we do here, we're really interested in complex, sports-specific movements. A lot of scientific research studies discrete, simple tasks that you can do in a laboratory, but we're really trying to push the envelope with the whole spectrum from simple movements all the way to really dynamic, full-field, competitive, multi-person sports movements. It is really hard, but it's rewarding and very cool to study.
Melissa: It does sound really challenging. So, what question were you trying to answer when you started working with the dynamic assessment of sensory motor health?
Dr. Riehm: That project has evolved a lot over the last couple of years. Originally, when I started working with SPARC five years ago as a postdoc, we were doing a lot of sports-specific virtual reality testing. I came on to help program the virtual reality environments and understand how to look at human movement. Virtual reality is a really great way to control what people are seeing while delivering dynamic visuals like what you would see on a sports field but in a laboratory environment. It gives them complex visuals like a competitive sports environment, and then we are able to do things like motion capture.
That was originally what we were working on when we moved down to Emory. But then, that evolved quite a bit into: what can we do with this virtual reality technology in more of a community-based setting? Or if we want to do this in a setting that isn't a highly specialized laboratory; something you could do at home, in a school setting, or in a clinic.
We focused on a commercial VR headset you could buy at Walmart and looked at what you could do on there. We landed on concussion assessment as a really valuable use case because with concussion, you see a lot of symptoms and sensory motor deficits that are not generally addressed in existing assessment technologies.
There are a lot of things that look at school performance or your ability to focus and do neurocognitive tasks on a tablet. There are tests for balance, eye tracking, and different things like that applied clinically. But we thought virtual reality was a great way to really advance the field of sensory motor assessment. Aside from these neurocognitive aspects, what is going on with someone's balance and coordination? Those are important for understanding concussion generally, but for us, also important in understanding someone's likelihood to get a secondary injury.
Concussion is not a great thing to have, but even worse is getting a secondary concussion, which can be particularly dangerous, and having secondary musculoskeletal injuries. This is a not very well-understood phenomenon, but it is thought that after a concussion, you're much more likely to then have an ACL tear or sprain your ankle. It's likely that those things come from a disruption of the way that your sensory motor system is functioning because you've had a brain injury.
We are using virtual reality, that's what the Dynamic Assessment of Sensory Motor Health (DASH) is: it’s virtual reality software for doing multimodal evaluation after a concussion. We've tested that in clinics with over 500 athletes and non-athletes in schools and clinics. We have reliability work coming out soon and other work showing validation and clinical results that differentiate people with concussions from healthy controls using that technology.
Melissa: Great. So, if you had to explain either your research or what you do all day to a friend or family member who maybe doesn't work in science, what would you say?
Dr. Riehm: I think for me specifically, a lot of the surprising thing would be how much of it is technology development. I mean literally programming and working with game development tools. I think that's often surprising to people who come and see what we do; we can often function more like a game developer studio making software for virtual reality. It is very fun, but I think a lot of people don't think about that as part of the scientific workflow.
We always take the position that it's much better to do those things in-house rather than farm them out to external contractors. One aspect of what we do is really just building games: building software for serious purposes for science and medicine.
Another aspect is the science part, which is taking data that we have collected with these systems and analyzing it, doing statistics, and trying to look at differences between groups or unique things about individuals' performance. So it's a lot of statistics. And then a lot of reading and writing. I am constantly trying to stay in touch with the literature and stay current with understanding concussion. It's a lot of reading and writing papers.
Realistically, for professors and faculty, it's a lot of writing grants to try to pay for this stuff. I think that's confusing to a lot of people, but that is often the hardest and most important part. We don't produce these technologies to sell like a company. You wouldn't pay $29.99 for someone to play a game to make money. We like to give these things away for free or provide them for the good of research, so we have to pay for that by writing grants.
I think traditionally scientists see their output as papers. That's how you give back and disseminate your work. But I think it's very important to also disseminate the tools. People may have heard of open-source technology; I think there's a lot of value in doing that.
You can build an assessment technology and put it up online so if you're in a little clinic in Nebraska and you don't have access to a motion capture lab, you could just pull this off of the internet, install it on your $300 VR headset, and do your assessment. We give you all the data and everything. The development of the software is one part, but also figuring out how to provide that to people and get it into their hands.
Melissa: Right. That's great to hear. If you had to articulate one main challenge to complete either the development of the DASH VR system or another part of your research, what would the biggest challenge be?
Dr. Riehm: Right now, figuring out the right way to provide this to people. I think that is a current challenge: figuring out how you can make this easy to understand and findable. Marketing is a real thing. You could put it up on a web page, but if nobody knows it's there, how does an athletic trainer find it?
Part of my job is doing things like this, giving talks at conferences, and advertising that way. But that's tricky because we don't market like a company; we're not putting out ads on social media. Reaching people and getting our tools and our findings into their hands is tricky.
Melissa: Right. It is definitely a challenge to do outreach as a librarian. How has doing this type of work changed the way you think about progress, success, or even patients in general?
Dr. Riehm: This is one of the biggest projects that I've done since grad school. Moving into real technology development that needs to be sustained over time has shown me the longer-term infrastructure that needs to be in place. I’ve learned a lot about management and mentorship of younger scientists and other types of staff. Unlike a lot of academic organizations, we bring in a lot of non-students. We don't have a lot of grad students but we have a lot of other positions. I've learned a lot about how to manage and do things that are maybe not as traditional for an academic lab.
Melissa: So, in the future if you're going to continue this research, what do you see as being the logical next step?
Dr. Riehm: Definitely getting it into people's hands and seeing what their feedback is. We have feedback from people we've tested with, but having people in diverse areas use virtual reality technologies would be important. I’m working with people at the Shepherd Center, Cleveland Clinic, and other places where they're doing work with other populations. Going beyond concussion to populations like stroke or MS where you have similar sensory motor deficits would be important to the progress of projects like this.
I also think one thing we talk a lot about here is closing the loop with rehabilitation, getting beyond assessment. I wanted to start with assessment because it was easier to think about. We know there's postural control deficits and visual coordination deficits, and these virtual reality tools can be used to capture those. We think we've found some pretty strong results.
But that still doesn't get us back to helping someone recover from a concussion more quickly, which is what everyone is after. There are existing tools for evaluating deficits; most physicians who deal with concussions can tell if there's something off. It's not as distinct a need as solving the problem of how we help people recover quickly.
That is what I think could really drive the longevity of a project like this: turning these from assessments into virtual reality exercises that someone can do at home. We talk a lot about sports-specific games and drills. For sensory motor coordination, one of the most important things is that you're gradually returning to dealing with complex stimuli. The first time someone throws a ball at you might be when you return to practice, and you haven't had something like that during recovery. Your balance might look fine and your eye tracking might look fine when testing with a popsicle stick, but that's very different from running down a field and having a ball coming at you.
Virtual reality has always been this middle layer of getting you back into the environment and complexity of sports without the risk. I think that's one area where VR specifically can be really valuable: gaining exposure and getting back into the motion of sports without the risk of colliding with another player or a real ball hitting you in the face. We do a lot of work developing these sports-specific drills to figure out how that specifically helps you recover safely.
Melissa: Great! Well, thank you so much for your time and thanks for joining us on this episode of Behind the Breakthroughs: Off the Field. I hope today's conversation offered a clearer look at the curiosity, care, and science behind the work happening at Emory.
If you enjoyed this episode, feel free to explore the rest of the series where each researcher brings a new perspective on injury prevention and human performance. Thanks for listening and we’ll see you next time.