Virtual Reality to Enhance Upper Extremity Physical Therapy and Recovery

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Virtual Reality to Enhance Upper Extremity Physical Therapy and Recovery

Conditions
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Injuries to the Hand and Wrist

Intervention / Treatment
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* Device: Meta Quest 2


Participation Criteria
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Eligibility Criteria
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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)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

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 Reality to Enhance Upper Extremity Physical Therapy and Recovery<br>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. Phase I: Typical Home Exercise Program, Phase II: Use of VR headset in conjunction with current Home Exercise Program. Intervention sessions include the baseline, midpoint and final visits. | Device: Meta Quest 2<br>* 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.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Jebsen-Taylor Hand Function Test | Assessment of functional use and selection of appropriate grasp for common activities of daily living | 30 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 9-hole Peg Test | Speed and accuracy of grasp and release | 10 minutes | 
| Hand/wrist goniometric range of motion (ROM) | Hand/wrist range of motion assessment | 15 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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virtual reality, hand, therapy, immersive, take-home