Title: Virtual Reality Prosthetics Training System
Funder: Department of Health and Social Care

Abstract: The project will use an iterative approach to development (Agile software development) which will result in four milestone releases of the system throughout the project. Underpinning our work throughout will be four main pillars: Usability, Engagement, Efficiency and Adaptability. By utilising the flexibility provided by the Unity 3D game engine we have the means to easily adapt the system in order to create prototypes that explore its potential in other areas of rehabilitation training. We will: Develop and refine the system that will produce engaging training activities using VR, motion tracking and the Thalmic Labs Myo armband. Trial aspects of the system with patient participants providing feedback during refinements to the system Evaluate the product using observations of clinician-patient training sessions Interview clinicians about the use of the system and/or the feedback data it produces The workflow for the delivery of objectives is set out in the appended Gantt chart. Work Packages WP 1 Through observations of current patient training and discussions with clinicians and our commercial partners we will: identify the key requirements of prosthetic training systems and the training outcomes required; review current training systems, identifying and evaluating their key features. We will conduct 2 workshops with PPIs (n = 10) and clinicians in order to further establish needs and potential ways that systems could be improved, and what is required of the training. Investigate alternative approaches to registering a patient’s muscle activity. Identify possible critical risks that could have the potential to hold up development to ensure they are addressed early in development. WP 2 will develop and evaluate a training system that can be used by an Occupational Therapist (OT) for training an upper limb amputee to use a myoelectric prosthetic with a researcher present to facilitate use of the system. We anticipate testing the system with an OT and 14 amputees from each of two NHS sites - Sheffield Teaching Hospital (STH) and Nottingham University Hospital (NUH) at each stage, and trialing the resulting system at Birmingham University Hospitals with 4 patients. WP 3 will develop the system further so that it can be used independently by an OT and patient during training. WP 4 will provide support materials for OTs and patients in the independent use and operation of the system, both print and digital. WP 5 will make the system suitable for patients to use independently in their homes, providing a one-box system with leads to attach the provided headset, motion tracking system, and a myo armband. Performance reporting on patient use will be generated by the system and made available for patients and healthcare professionals to more easily evaluate progress. This will be displayed on PCs or mobile devices to suit user needs. WP6 Interviews with patient participants about their use, their views of the system and how they were able to use it by themselves at home. A feature freeze will be introduced in the final quarter of the project with a focus on refining the system into a ready-to-use product. WP 7 will prioritise testing and quality assurance to ensure that the system has a stable release for commericalisation purposes.

Lay abstract: This bid builds on a prior 'Virtual Reality' (VR) pilot study with seven patients. They wore a VR headset and sensors on their amputated arm in a mock training set. They all reported finding this a good way of learning how to use a new prosthetic arm before they had one fitted. We now want to develop this and build a VR system that improves the current NHS training for patients in order for them to get a myo electric prosthetic arm. They could also use the system to learn how to become an advanced user once they have the arm. Digital gaming methods will be used to make the training fun. Therapists will be shown how to set up and use the system in clinics. Patients will also be able to take the system home to practice. We believe that repeated training will make it easier to learn how to have greater control of the arm. This will save time by cutting the number of clinic visits and costs, while giving a better experience and making the training programme more effective. Patient participation is central to this bid to build in their needs, and they will input into and test the early versions of the training system. Some will give direct feedback during real-time changes to the software. The system will collect data during the training sessions to measure progress. This data will be viewed on a PC and smartphone app. Success will be measured by the amount of time taken to use the new arm well (compared to existing data on training times taken), and relative rejection rates. Existing satisfaction measurements will also be used. We will hold events at each site to tell everyone about our results.

Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: MUSCULOSKELETAL