Frequently Asked Questions

What is the REAL System?

The REAL Immersive System is one simple, portable rehabilitation tool that you can easily bring to the patient at the bedside, in the gym, or mobile health location. Prior to use, please see the User Manual for complete information, product indications, warnings, precautions, and potential adverse events. Rx only.

Are there any limitations in use of the REAL System?

Yes, the REAL System is intended to be used seated in a clinical environment and prescribed and supervised by a medical professional trained in rehabilitation therapy. The REAL System is designed for adults.

How do I order the REAL System?

Please get in contact with us if you are interested in ordering the REAL System by emailing

What’s included in the REAL System?

The REAL System comes with a storage case, 5 small sensors, 1 large sensor, tablet, and a headset. Sensor bands are sold separately as each patient should have their own for sanitary reasons.

Does the hardware require any initial setup?

The system requires setting up local internet connection via Wi-Fi the first time it is used. The therapist powers up the headset and helps the patient put the headset on. Once the headset is on, the patient can immediately begin interacting in the new environment, while the therapist puts on the sensors. The patient will experience almost zero set-up time.

How much does it cost?

We’d love to talk to you about our product, get in touch with us at

How long does the battery last?

The battery life can vary, but you can expect the system to last 1–2 hours on full charge. We recommend using the system for one hour and charging for a full hour in between sessions.

How often do I need to recharge the system components?

At full charge, the entire system can operate for approximately 2 hours. However, it is recommended that a therapy session does not exceed 60 minutes. All components of the system should be charged for at least 60 minutes in order for he system to be operational for the 60-minute maximum recommended therapy time.

Why does the REAL System use VR and not AR?

Virtual Reality can be thought of as a completely new world you are transported to inside the headset. Augmented reality is the superimposition of virtual objects on a representation of the real world. Patients can sometimes feel depressed or challenged to overcome functional deficits. As such, REAL is designed to transport them to an entirely new world, with a visual representation of themselves that can be controlled by the therapist. This transportation to a different environment is meant to motivate them to adhere to their therapy regimen and empower them to continue their therapy.

How does the REAL System compare to commercial gaming systems?

The REAL System is different from consumer gaming devices in several ways, namely that it was purpose-built for rehabilitation. The activities were specifically designed to meet the needs of patients needing upper body rehabilitation and are aimed at working on exercising specific upper-body functional movement patterns. Also, the REAL System is customizable to meet your patient’s needs. Finally, the REAL System uses multiple body sensors to accurately track movements.

Can you customize a therapy session for a patient when using the REAL System?

A therapy session with the REAL System is customizable by the therapist. Each activity has several different settings that can be adjusted by the therapist to best fit the patient’s needs.

Can I send my patient home with a REAL System to use on their own?

The REAL System is intended to be used seated in a clinical environment and prescribed and supervised by a medical professional trained in rehabilitation therapy. A medical professional must be present at all times to provide direct supervision of the use of the REAL System.

Can a therapist facilitate a patient when using the REAL System?

Because the system is wireless and mobile, the therapist can be as hands-on as they need to be. They can help with a patient’s movement and the patient will see their avatar moving like it is their own body. Volume should be adjusted so the patient can hear the therapist throughout the session.

Are there any contraindications for using the REAL System?

There are no known contraindications. Prior to use, please see the User Manual for complete information, product indications, warnings, precautions, and potential adverse events.

How can I contact support?

For assistance from the REAL Team, please email us at

REAL® System: Upper Body Rehabilitation

REAL® Immersive System is an award-winning rehabilitation technology using virtual reality (VR) designed to empower patients with engaging therapeutic activities that offer endless possibilities.

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REAL i-Series™: Well-Being and Cognition

REAL i-Series is designed for self-guided use in healthcare settings to promote health and mental well-being. The i-Series features REAL Connect™, a first of its kind in-VR visual and audio communication to build social connectedness as well as multiple apps and activities to help enhance memory, exercise mindfulness, foster relaxation, and support cognitive stimulation.

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Frequently asked questions about the REAL® System, how to order, what activities are included, and more.

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Therapeutic & Wellness Overview

REAL® System, with its focus on patient physical, occupational, and cognitive rehabilitation, leverages extensive input from rehabilitation experts to offer multiple activities that cover a range of therapeutic areas.

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Upper Body

Upper body rehabilitation with REAL System offers patients a variety of activities designed to strengthen upper body movement through range of motion, endurance, strengthening, and coordination to support functional tasks and activities.

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Core and Balance

Core and balance rehabilitation with REAL System aims to help patients sit up and maintain posture for an extended length of time. Activities are designed to promote postural control and stability through strength and functional-skill building exercises.

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Patients with cognitive impairment may have difficulty learning new things, retaining memories, concentrating, and/or making decisions that allow for independent living. REAL System offers interactive activities that provide immediate visual feedback, which is designed to help patients monitor their progress and adjust goals accordingly.

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Functional Uses—ADL Training

REAL System is designed to help patients build skills to perform daily living activities such as bathing, dressing, eating, and grooming. Attention to these basic activities, which require healthy doses of practice and motivation, is essential to rehabilitation experiences designed to promote functional independence.

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Virtual reality can be an effective pain distraction tool for short-term relief of both acute and chronic pain during rehabilitation. Patients may benefit from using REAL System as a pain distraction tool during their rehabilitation journeys.

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Low Stimulation Environments

REAL System offers a variety of low-key environments, each designed to help patients focus on specific therapeutic tasks as they pursue individual rehabilitation goals. The reduction or removal of certain environmental distractions can benefit rehabilitation interventions by fostering relaxation and mitigating stress.

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Brandon: Functional Movement Rehabilitation

Brandon suffered from a stroke that, among other deficits, caused right-sided weakness and speech issues. Brandon, who first started using REAL® System in October 2020, continues to use the virtual reality system as part of his regular rehabilitation efforts.

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Derek: Core Strengthening and Trunk Control Rehabilitation

Derek suffered an Incomplete Spinal Cord Injury that caused weakness in his arm, core, and other muscle groups. Derek, who first used REAL System in August 2020, increased the use of both arms in just six weeks. He continues to use REAL System to work toward his therapy goals.

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Deb: Stroke Survivor

Deb had a terrifying experience while asleep; she had a stroke. Follow Deb’s rehabilitation journey and recovery process with REAL System.

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Pete: Core and Postural Control Rehabilitation

Pete was in a coma for three months following a life-threatening motorcycle accident. He suffered from multiple impairments caused by strokes, traumatic brain injury (TBI), and spinal cord injury (SCI). Thanks to REAL System and the creativity of Pete’s therapist, Pete’s rehabilitation sessions have been as engaging as they are challenging.

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Jasmine: Upper Body Rehabilitation

Jasmine suffers from right spastic hemiparesis, a condition in which muscles on the upper right side are in a constant state of contraction. Since using REAL System, Jasmine has become more engaged and motivated in her course of rehabilitation therapy.

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Ray: Functional Rehabilitation

Ray started therapy after a devastating fall that affected his upper body strength, core strength, sitting balance, and overall endurance. With REAL System, Ray has improved his reach range, vertically and horizontally, as well as self-care management skills.

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Sarah: Cognitive Rehabilitation

After a stroke, Sarah suffers from reduced hand strength and control. Using the REAL System, she enjoys relaxing activities that have helped motivate and inspire her during her recovery.

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Dr. Tudor Jovin, Chief of Neurology

Dr. Tudor Jovin, the Chief of Neurology at Cooper University Health, discusses the effect current rehabilitation practices and new technologies like virtual reality will have on the future of patient stroke and therapy care.

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Dr. Rohini Kumar, Physiatrist

Dr. Rohini Kumar, Physiatrist at Cooper University Health, provides an evidence-based review of virtual reality use in the rehabilitation space and shares her experience with REAL® System.

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David E. Owens, Director, Rehabilitation Services

David E. Owens, Director of Rehabilitation Services at Cooper University Health shares his team's experiences with REAL System during occupational and physical therapy sessions.

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Cooper University Health Care Q&A

The team at Cooper University Health discusses REAL System and their thoughts on the future of virtual reality technology in the rehabilitation space.

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Chronic Back Pain

Research highlights the effectiveness of virtual reality (VR) in patients with chronic back pain during rehabilitation.

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Chronic Neck Pain

Research highlights the evaluation of short- and intermediate-term effects of kinematic training using virtual reality (VR) in patients with chronic neck pain.

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Cognitive Impairment

Studies show promise for using virtual reality-enhanced rehabilitation techniques with patients who have mild TBI to create lasting positive outcomes in terms of motor and cognitive skill development and more.

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Concussion/TBI Rehabilitation

Research indicates that virtual reality (VR)-based assessments used in concussion offer novel assessments.

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Multiple Sclerosis (MS) Therapy

Systematic review concludes that virtual reality (VR) represents a motivational and effective addition to traditional motor rehabilitation for MS patients.

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Study results from a comparison of two physical exercise-based programs show that – in relation to Parkinson’s - virtual reality (VR) rehabilitation was more effective in improving gait, balance, upper limb function and mental well-being than conventional rehabilitation.

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Spinal Cord Injuries (SCI) Therapy

Virtual reality-augmented neurorehabilitation improves motor function and reduces neuropathic pain in patients with incomplete spinal cord injury (SCI). The use of virtual reality (VR) technology may lead to increased motivation and engagement.

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Stroke Rehabilitation

Results from multiple studies show that virtual reality systems specifically built for stroke rehabilitation have the potential to impact recovery, body function, and activities of daily living (ADLs).

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Vestibular Rehabilitation

Research highlights long-term effects of vestibular rehabilitation with the use of virtual reality (VR).

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Awards & News

REAL® Immersive System has had stand-out success in the following award categories: 2021 gold winner in Medical and Health, 2020 winner in Virtual Tech, and 2020 winner in Health & Wellness.

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REAL System team supports healthcare and technology events across the country. We hope you will join us at one of our upcoming events!

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About Us

Penumbra, Inc., headquartered in Alameda, California, is a global healthcare company focused on innovative therapies. Penumbra designs, develops, manufactures and markets novel products and has a broad portfolio that addresses challenging medical conditions in markets with significant unmet need. Penumbra supports healthcare providers, hospitals and clinics in more than 100 countries.

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