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#36 - Rethinking Rehabilitation: What Happens When Engagement Becomes the Treatment with Craig Hewat

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What if the missing piece in rehabilitation isn’t a new device, but a reason to show up tomorrow? We sit down with Craig Hewat, Managing Director of Engage VR, to explore how immersive therapy shifts the focus from compliance to genuine engagement—and why this change unlocks neuroplasticity for individuals with stroke, brain injury, Parkinson’s, and Huntington’s.

Craig brings three decades in allied health and a simple mandate: make rehab personal, frequent, and enjoyable enough to repeat. We unpack the science in plain language, offering short, regular sessions and novel challenges that build new brain pathways and map them to real-world design. This includes at-home VR sessions, casted views for caregivers, wearable integrations for safety, and adaptive activities that keep people motivated. From a caravan equipped with Wi-Fi to a farmer strapping a phone to a shovel on a ute to catch a signal, these stories demonstrate how access can become an outcome when therapy can travel anywhere.

Behind the scenes, clinicians co-create modules with developers, transforming sit-to-stand, gait cueing, and speech tasks into interactive experiences that log data and adjust difficulty levels. Partnerships with universities, health services, and insurers add rigour and reach. At the same time, a Primary Health Network project in regional Australia demonstrates strong adherence to three hours of weekly sessions, each twenty minutes long, right where it matters. We also step back to the system level: an ageing population and vast distances demand digital health that is practical, measurable, and cost‑aware. VR isn’t a gimmick here; it’s a helpful way to deliver the repetition and novelty that recovery needs.

If you’re curious about where rehabilitation is headed—and how dignity, independence, and daily function can improve when care meets people where they live, this conversation offers both science and story.

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Leon Goltsman:

Hello and welcome back to Engaging Conversations. I'm your host, Leon Goltsman, and each week we sit down with people who are reshaping what's possible for our health, communities, and future. Today's episode is all about innovation and impact and the courage to challenge what's already been done. My special guest is Craig Hewat, Managing Director of Engage VR, a groundbreaking rehab and allied health service using immersed virtual reality to transform how people recover from conditions like stroke, brain injury, and Parkinson's. Craig brings over 30 years of experience in the health sector, and his approach is simple but powerful. Engage people, personalise their rehab, and empower them to keep going, whether they're in a clinic, at home, or even camping in the bush. Together, we'll explore the science of neuroplasticity, how VR builds new pathways in the brain, and why meeting clients, where they are physically, emotionally, and technologically, is reshaping what recovery can look like. This episode is proudly brought to you by N iaz Cannoth and the team at Napean Advanced Rehab and Allied Health Centre, where lives are changed every day. Through expert rehab services delivered with compassion, integrity, and results, guided by a powerful purpose, empowering movement, restoring life. Their work with people like Craig proves that when care is personal, outcomes are powerful. And for the disclaimer, the views shared in this episode are for informational purposes only and do not constitute for medical advice. If you're curious about where rehabilitation is headed and how technology is creating new possibilities for independence, dignity, and daily living, this is a conversation worth leaning into. So without further ado, let's get into it.

Craig Hewat:

Hi, my name's Craig Hewat. I'm managing director of Engage VR Rehab, which is a business based in Newcastle. We're a multidisciplinary business, so we've got a range of allied health professionals, physiotherapists, occupational therapists, exercise physiologists, speech pathologists, and two visiting rehab physician doctors into our clinic. And we treat a range of clients with complex conditions such as brain injury, stroke, Parkinson's, etc. And I suppose the one differentiating factor about our business is we use virtual reality extensively in our clinic and with clients in regional and remote areas, very much in the digital health space.

Leon Goltsman:

And you've always believed that rehab could be more engaging, more personalized. What was the moment that made you think there has to be a better way than what we are doing right now?

Craig Hewat:

I've always thought that way, Leon, to be honest. I mean, that's been me in my journey of health always challenging can we do this better? And most of it comes back from a just a want to improve clients' function, maintain some clients' function because they've got a degenerative disease, but mostly trying to improve clients' function. In my 30 years that I've been in health, I've always challenged how we can do this better. And when I first saw someone using virtual reality, that that's what clicked with me. I was like, okay, this is it's not the only solution, but it's certainly part of the solution, I think, to really improve how we're delivering health services across Australia.

Leon Goltsman:

Yeah, well, it seems like you're not just tinkering at the edges, you're trying to flip the model. And uh and you said engaged VR challenges the status quo. And we've had a few conversations leading up to this. But what we really want to know is what exactly uh are you challenging and what kind of results are you seeing because of it?

Craig Hewat:

We're challenging engagement. It's the really the the the um the reason why we called the business engage vr because the common uh truth out there is that people don't particularly engage well with their rehabilitation at any level, really. You know, from the days when I was a uh younger physio working in a private practice and I asked people to go home and do their exercises, the engagement level was normally pretty low. When you've got a complex disease or condition like stroke, Parkinson's, Huntington's, you know, you've had a spinal cord injury, the repetition and frequency of rehabs really, really important. So you need to do three, four, five plus hours a week. So if you if you're not enjoying it, things are gonna not go well. So you need to engage. And that's the I suppose the light bulb moment I had when I saw VR was this is one uh one way to really get people engaged in what they're doing. Let me explain what I mean. We have a client uh that's been uh attending our business since inception, even through COVID, that has Huntington's disease, which is a degenerative, aggressive at times degenerative disease, who was previously attending allot health services and wasn't really engaging with his activity, and then he would go home and not really do any other uh form of rehabilitation. As soon as he was exposed to virtual reality experiences that we have in the clinic, and then was able to take that VR headset home and and do those clinical experiences at home, his engagement levels went went through through the roof, really. He he did a lot of rehab activity and he was able to because he had you know he had the time, he was slowing down at work, moving from full-time to part-time, and then eventually retired. But he was he was doing a lot of activity and his results that we track and we do assess a lot of different criteria, his results stabilized. And when he went down to Westmead Hospital to visit his specialist on a regular occurrence, his specialists were actually quite surprised that his results had somewhat stabilized and that his data was reasonably stable, and it has been over the last four or five years, which is very unusual for a Huntington's uh client.

Leon Goltsman:

Well, when people tend to slow down, the um the lack of movement they they become slower, they they lose their ability to um to move forward, to progress. And uh the idea of challenging oneself and doing new activities is creating new pathways, and that runs deeper than just tech. Craig, when you talk about new pathways for clients, professionals, and partners, what does that actually look like in practice?

Craig Hewat:

Well, there's a concept um in in the neur neurological space called neuroplasticity, which a lot of people may have heard of, and that's the ability really for the brain, um, you know, neural connections in the brain to adapt and use other neural connections. So I'll give you I'll give you an example. We all use approximately, the research tells us, around 40% of our neural connections on a regular basis. And because we do the same thing uh every day, we probably get up in the same bed, same car, same family, same environment. There's no other reason why you would want to use other neural connections. So to get that neuroplasticity or new pathways occurring, you need two main things. You need a lot of repetition, which I've already explained. You know, VR is a beautiful um avenue for that. And you also need to expose the body to things it's not used to doing. So, and in VR, we can put people into experiences where they're underwater diving, skiing, hang gliding, boxing with uh Sylvester Sallone. So that that exposes the brain and the body to a totally different experiences that creates potentially creates new pathways. And even you know, you asked me around clinicians, um, we a lot of the clinicians that work in our business don't get exposed to this tech through university. Coming into our business, they get exposed to a new pathway. They they they're doing different things than probably what they thought they were going to be doing in the allied health space.

Leon Goltsman:

And the brand's ability to rewire itself is very powerful if we give it the right input. Uh it seems it seems that way to me anyway.

Craig Hewat:

Yeah, 100%. We see that differently in clients. And obviously, we're still working with a lot of uh universities to uh review research around some of the data that we're presenting, but clinically, clinically we see some really good results with um different clients, Parkinson's, Huntington's, brain injured clients, and yeah, a lot of our clinicians will tell you that using VR, they they notice a significant difference. So, and that's lots of reasons why that happens.

Leon Goltsman:

So tell me, how does VR rehab tap into neuroplasticity in a way traditional therapy might struggle to match?

Craig Hewat:

Yeah, so as I as I said, it's it's basically around the two key principles of neuroplasticity, which is repetition. So the the research is very big on uh shorter duration rehab sessions, so 20 minutes, and more regular, more frequent sessions, so six, eight, ten times a week. Very difficult to do that if you want to attend a clinic and see a clinician to do six to eight to ten sessions a week. One, it'd cost you a lot, two, you'd have to get in your car a lot and come to different areas. So when you've got a VR platform that we've developed, you can do that anywhere. And the recent primary health network project we did in the New England region, our clients use the platform on an average three hours a week. So that's you know, on an average 20 to 25 minute session. So that's basically perfect. That's what we want them to do. So that repetition, the VR enables that repetition, and then as I was saying before, it enables it us to expose clients um to totally different experiences that they're not used to, and that's where the adaptation occurs.

Leon Goltsman:

Well, consistency is the key in rehab, uh, but traditional models, they just don't make it easy. How has Engage VR helped clients to go beyond the standard two times a week model? And what difference does it actually make?

Craig Hewat:

So the I suppose the technology enables clients to to access their health rehab anywhere at home. Um, we've got a great example where a lot of our clients will tell us they're going to visit their son-in-laws or daughter-in-laws, or they're going around Australia for a trip, they're going on a holiday for six weeks, and so they need to stop their rehabilitation. The human body deconditions in 10 days, so that happens very quickly. A lot of our clients that have got access to our VR platform will take it with them and continue doing their rehab exercises at their son-in-law's, at their daughter-in-laws. We've got some beautiful videos of our clients doing their rehab in a caravan because they've put Starlink and they've got Wi-Fi and so they're continuing their rehab. So that that allows them to do that six times a week, shorter duration sessions, um, more regularly.

Leon Goltsman:

And you've answered my next question. The location shouldn't dictate recovery outcomes.

Craig Hewat:

No, we've got a great story around that, actually, which I'd love to share. We work with a lot of clients, um, you know, Narrabro, Narrabrai, Gunadar, uh, obviously very regional, rural areas. Uh, one of our clients particularly was very devoted to his rehab. He was out in the middle of his property and he was camping out with a few of his friends, and um he was trying to get some signal to to use his VR platform. So he taped a shovel to the back of his Ute, drove it to the top of a hill, taped his mobile phone to the to the shovel, and then paired his mobile phone with his VR platform and did his his rehab on the back of his ute in the middle of his farm, which uh was a fascinating story, and it's obviously ran it resonated really well with our clinicians and clients. So there you go. You you literally our clients can do do their rehab wherever they wherever they they can access a connection, and uh and that's getting better and better in Australia these days.

Leon Goltsman:

And they're innovating in new creative ways.

Craig Hewat:

Yeah, correct. Using our shovel. Our clients are uh innovating just as well as we are.

Leon Goltsman:

Craig, is it a um spade or a shovel? Which one would you call it?

Craig Hewat:

Well, he called it a shovel, so I'll call it call it a shovel. It evidently worked well for him. He said he was there for about 20 minutes doing his speech pathology uh exercises in on the VR platform. So well, great story.

Leon Goltsman:

And you get to come across many different people, and even the professionals need a new pathway. Let's say for health professionals feeling burnt out, how does Engage VR give them something fresh to believe in?

Craig Hewat:

Well, I suppose it's a new field for them, and when our clinicians come in, they can certainly collaborate with our development team to build these clinical experiences that experiences that we commonly do in the clinic today, and then they get to use them on our VR platform, which is really exciting for a clinician to see that come to life and for a client to be able to use that on a on a daily basis. Um, and it really opens, I suppose, a lot of our clinicians' eyes and minds in a in how they can deliver their therapy with our clients. Most of the time they really enjoy it. So we uh I suppose our clinicians also really enjoy the fact that we collaborate with larger organizations as well. So, you know, we we're working closely with uh a lot of the support organizations, um, New South Wales Health, Alliance Insurance, those tool type of organizations to really collaborate with our clinicians together to see if we can deliver an innovative product for their clients as well. So that's exciting for our clinicians to be part of that because we're in this together. I'm learning that uh organizations are looking for you know what's coming next. There's a lot of talk around AI, particularly, but more so digital health and technology and how we're going to use that moving forward. So a lot of these larger organizations are looking at can that help us provide better access for clients to access health services, because that is a big issue, and uh more effective health services, which I've spoken about earlier. And then the other thing is obviously you know, more cost-effective services. So, yeah, that collaboration between large organizations and what we're trying to do is essential to our focus. Yeah, I mean, certainly the health system has its challenges at the moment. We've got a large aged care growth of that population, and we need to be able to manage the health of that population well. So we've also got a regional uh rural population which is getting bigger and bigger. So there are some significant challenges in how we manage that. And I think digital health, especially VR and the platform we've developed, is part of the solution. And I think we've learned over the years full well that we we we just can't be shipping clinicians out to regional areas. It's not working, it hasn't worked all that well. So we really need to look at digital technology and how we can use that better. And we've proven that, right, with the the primary health network grant that we did last year, uh into this year, that it was extremely effective in in a lot of those regional rural areas like Gunnar, Glen Innis, Narabroy, uh, all of those areas. It it worked really well. So we think it's certainly part of the future.

Leon Goltsman:

Well, you're just scratching the surface.

Craig Hewat:

Yeah, we are very excited. We're working with um a lot of universities, Central Queensland Uni, Newcastle University, um, particularly Flinders University. We're doing a lot of projects with them uh and their biomedical team in their speech pathology team. We were successful with a primary health network game changer grant uh that ran from June 2024 to June 2025. So we've just wrapped up that grant. Uh, and that gave us a lot of information around the use of the digital VR digital health platform. Some of the exciting things we've built in there is the ability to cast the VR image onto a laptop so a carer can see exactly what the client is doing in their VR headset. So that was a really exciting innovation. We're also building in the connection with wearables, so smartwatches and other smart devices, so that we can track physiological data from that client whilst they're doing that experience. And that's really important from us, for us as clinicians, but it's also important for the client so they can be safe and you know, really, really do a uh specific uh experience relevant to what they need. So there's a lot of different things happening. Um, we're doing a lot of work with different universities, particularly Flinders University, in their biomedic with their biomedical team and also their speech pathology team, where we've got some exciting things happening.

Leon Goltsman:

There certainly are lots of exciting things. But if someone's listening walks away remembering only one thing, what should it be?

Craig Hewat:

Engage VR is challenging the status quo, the the status of rehabilitation for lots of different complex injuries over the years. It's it's challenging that really and look at the delivery of how we deliver rehab um for better function, but also for better access. And essentially it's really stripping back to a data-based science because we're scientists at the end of the day looking at how we can use data, assessment data, but also the data we get from um people doing these experiences regularly, and how we can m improve or maintain their function to get better results.

Leon Goltsman:

Now, if someone wanted to get in contact with you, what's the easiest way?

Craig Hewat:

So people can get in touch uh via our website, which is www.engagevr.com.au, or they can call our clinic on 1300engage, which is 1300-364-243.

Leon Goltsman:

So that's uh engage vr.com.au or 1300engage four two four. That's right. Perfect. Craig, thank you so much for coming on. I will have more information in the show notes. It's always wonderful to catch up, to chat, and I look forward to speaking with you again soon.

Craig Hewat:

Thanks, Leon. Appreciate it.

Leon Goltsman:

Now that was a conversation that reminds us what's possible when care meets innovation and when we put people at the heart of progress. Craig Hewat and the team at Engage VR aren't just introducing new technology, they're creating new pathways for healing, recovery, and hope. It's the kind of thinking, forward, compassionate and grounded in real outcomes that's helping reshape how we support individuals, families and communities across the country. If you'd like to learn more, head over to engagevr.com.au or check out the show notes for direct links and contact details. And if this episode sparked something in you, you're in the right place. Engaging conversations isn't just a podcast, it's a platform for real stories, genuine connections, and shine a light on people doing remarkable work, often behind the scenes. Unlike other shows, our mission is clear to celebrate the unsung heroes, help them find their voice, and remind you that your voice matters too. This movement is growing, and now it's expanding into print. Keep an eye out for our new publications celebrating connections, launching in communities across Australia. It's our way to segue into the new year on the high and setting the stage for even bigger things ahead. So if you believe in building something meaningful, if you value depth over noise, and if you want to be part of a community that uplifts and connects, make sure to follow the show. Share it with someone you respect, and stay with us as we step into what's next. And once again, a massive thank you to Niaz Cannoth and the team at Napean Advanced Rehab and Allied Health Centre for supporting the platform and the values it stands for. Empowering movement, restoring life. At Engaging Conversations, we're committed to building communities by empowering voices and celebrating people. And every episode, every story, and every listener brings us one step closer. I'm Leon Goltsman, and until next time, let's keep showing up, lifting each other, and creating something meaningful together.

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Leon Goltsman

Host
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Craig Hewat

Guest