Feasibility of Virtual Reality Games Using Head-mounted Display on Patients With Brain Disorders

Study Overview
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Brief Summary
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Because virtual reality can provide more enriched environment, repetitive goal-oriented tasks, and increased patients' interest and motivation, it is expected to stimulate neuroplasticity of injured brain and promote recovery in patients with brain disorders. On the other hand, immersive virtual reality using a head-mounted display has not yet been attempted in the rehabilitation of patients with brain disorders. In addition to the benefits of existing virtual reality or game rehabilitation, immersive virtual reality can further enhance brain plasticity, such as the effect of mirror therapy or action observation, through self-awareness of the body in the virtual space. The purpose of this study is to investigate the feasibility of applying the immersive virtual reality using a head-mounted display in patients with upper extremity dysfunction due to brain disorders.

Official Title
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Feasibility of Virtual Reality Games Using Head-mounted Display on Patients With Brain Disorders

Conditions
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Upper Extremity Dysfunction, Brain Diseases

Intervention / Treatment
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* Device: Virtual rehabilitation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with upper extremity dysfunction due to brain disorders (eg, stroke, traumatic brain injury, brain tumor, etc.) Patient who can move the upper limb against the gravity (MRC grade 3 or above in both shoulder and elbow flexion) Patient who can maintain stable sitting position Adults over 18 years old Patients who voluntarily agreed to participate in the study Exclusion Criteria: A moderate-to-severe cognitive impairment score of 18 or less in Mini-Mental Status Examination (MMSE) Peripheral nerve injury, joint disease, other diseases of the upper extremity dysfunctions other than brain disorders Patients with a history of severe dizziness or epilepsy Patients with other medical illness that are difficult to participate in the study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Device Feasibility
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Virtual rehabilitation<br>Upper limb rehabilitation using virtual reality with a head-mounted display (HTC Vive; HTC Co., New Taipei City, Taiwan) | Device: Virtual rehabilitation<br>* A total of 10 sessions were held for 30 minutes, 2 to 3 times a week for upper limb rehabilitation using immersive virtual reality under the assistance of an occupational therapist.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of Action Research Arm Test | 19 items including grasp, grip, pinch, and gross arm movement | at study completion, an average of 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of Box and Block Test | the number of blocks carried over the partition from one compartment to the other during the one-minute trial period | at study completion, an average of 1 month | 
| Change of Modified Barthel Index | Evaluation of activities of daily living | at study completion, an average of 1 month | 
| Time of participation | Total time of patient's participation in the study intervention | at study completion, an average of 1 month | 
| Patient's satisfaction | Evaluation of patient's satisfaction to the study intervention using a Likert scale | at study completion, an average of 1 month | 
| Patient's discomfort | Evaluation of patient's discomfort to the study intervention using a Likert | at study completion, an average of 1 month |