Virtual Reality to Enhance Upper Extremity Physical Therapy and Recovery

Henry M. Jackson Foundation for the Advancement of Military Medicine9 enrolled

Overview

This is a descriptive study assessing the feasibility of using VR rehabilitation with unilateral (or bilateral) impairment of the arm, wrist and or hand resulting in reduced range of motion, dexterity, and/or strength of the hand.

The purpose of this study is to determine the feasibility of using a virtual reality program to monitor and encourage compliance with musculoskeletal home exercise programs. It hypothesizes that the treatment will display improved compliance, range of motion, and general function for individuals with upper extremity musculoskeletal deficits. The primary objectives are to: 1. Describe participant compliance with an immersive game-based virtual reality (VR) rehabilitation device for delivering at-home occupational therapy exercises for the wrist and hand in individuals with motor impairments. 2. Describe and compare functional outcomes among participants before and after completing at-home rehabilitation using the VR system. These objective outcomes will be measured through various standardized tests completed by qualified study team members.

Study Type

INTERVENTIONAL

Allocation

Purpose

DEVICE_FEASIBILITY

Masking

NONE

Enrollment

Conditions

Injuries to the Hand and Wrist

Interventions

Meta Quest 2DEVICE

The Meta/Oculus Quest (along with the SignWave software) delivers an immersive audio/visual-based game environment where the users hand is created and displayed in the virtual environment and matches target gestures to the beat of the music.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * DoD Beneficiary * Exhibiting musculoskeletal impairment requiring continued at-home rehabilitation * Cleared by research or clinical medical provider for participation * Participant no longer has active range of motion movement restrictions. They may still have weight bearing restrictions but nothing that will preclude them from moving their hand and digits to their maximum ability. * Ability to keep hand and arm in the field of view of the VR scene * Must have demonstrated the ability for the Oculus to track all hand and wrist motions of interest (during an initial screening at baseline) * Ability to independently don and doff the VR headset, plus start the app (verified in the Occupational Therapy/Physical Therapy clinic) * Age range between 18-65 * Demonstrate the ability to tolerate wearing the VR headset Exclusion Criteria: * History of photo-induced seizures * History of motion sickness when using VR equipment (especially vestibular effects such as nausea, dizziness, etc.) * Partial amputations of the arm being assessed (including missing digits as they may not enable tracking by the VR)

Locations (1)

Walter Reed National Military Medical Center

Bethesda, Maryland, United States

Outcomes

Primary Outcomes

Jebsen-Taylor Hand Function Test

Assessment of functional use and selection of appropriate grasp for common activities of daily living

Time frame: 30 minutes

Secondary Outcomes

9-hole Peg Test

Speed and accuracy of grasp and release

Time frame: 10 minutes

Hand/wrist goniometric range of motion (ROM)

Hand/wrist range of motion assessment

Time frame: 15 minutes

Data from ClinicalTrials.gov

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