VR Error Augmentation for Bimanual Task Exercise
Condition: Hemiparesis; Cerebral Palsy; Acquired Brain Injury
MeSH terms: Brain Injuries; Cerebral Palsy; Paresis
Study type: Interventional

Summary: 
      This project is a continuing study from the FEATHERS project (NCT02290353) which focuses on
      developing novel home therapy program for persons with hemiparesis. This study will focus on
      examining motor behaviour and adaptation in neurodevelopmental hemiparesis (cerebral palsy,
      acquired brain injury (ABI)). New algorithms for motion control involved in encouraging
      active movement are developed and will be tested, but the study has the same therapeutic goal
      and focus as the original FEATHERS project of creating an engaging at-home bimanual upper
      limb training program. By incorporating existing gaming technology, we hope to discover novel
      ways to adapt commercial motion tracking controllers and visual feedback into engaging
      rehabilitative learning tools. This study will focus on a basic science aspect of human
      bimanual movements that can be incorporated into future applications of the full FEATHERS
      project devices. We believe that together these approaches will yield interventions that
      significantly improve functional ability and lead to improved quality of life.
    

Detailed description: 
      (Main Phase Only - Data Collected with Clinical Population)

      The FEATHERS project at the RREACH Lab at The University of British Columbia focuses on
      developing and evaluating novel physical exercise technologies for kids with motor
      disabilities. The study team would like to study how immersive virtual reality (VR)
      technology can be used to benefit upper limb rehabilitation for persons with hemiplegia. The
      purpose of the experiment is to see how the use of error augmentation (i.e. adding visual or
      game element feedback to accentuate deviation from the desired exercise motion) might
      encourage persons with hemiplegia to engage their affected side more effectively by comparing
      the symmetry between the stronger and weaker limbs. It is also hypothesized that the
      immersive environment of VR and the ability to provide 1:1 direct visual feedback will
      increase active engagement to rehabilitative exercises in these populations. The study will
      address the question of whether error augmentation aids in the rehabilitation of the affected
      upper limb movement quality in hemiparesis when practicing bilateral reaching tasks.
      Specifically, can visual amplification of paretic asymmetry in an immersive VR environment
      improve movement quality in the affected side?

      Adolescents and young adults with hemiplegia (i.e. due to ABI, CP, etc.) and their adjoining
      therapists will be recruited for from the community. We will conduct testing in a
      single-session setup at the participant chosen location with an easily transportable system
      including a standard 2-3 sensor Oculus system hardware setup and software developed by the
      research team. Sessions conducted outside the research lab rooms will require a minimum of a
      2m x 1.5m space for calibration. The participants will test all augmentation factors in a
      randomized order and the sessions are expected to take between 90-120 minutes. A short
      post-session usability survey will be administered and sample population demographic data
      will be recorded including age, gender, and handedness. Manual Ability Classification System
      (MACS) and Bimanual Fine Motor Function (BFMF) scores will be recorded or assessed to
      classify the upper limb motor ability of the sample set.
    

Intervention name(s): Physical Therapy
Intervention type(s): Other
Intervention description(s): Repetitive bimanual task training for upper limb motor function recovery.
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Participant)
Primary purpose: Basic Science
Keywords: Bimanual Task; Motor Adaptation