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Table 4.4 Virtual Reality Interventions for the Rehabilitation of Upper Extremities

by | Dec 5, 2018

Table 4.4 Virtual Reality Interventions for the Rehabilitation of Upper Extremities

Author Year Country Study Design Sample Size Methods Outcome
    Mumford et al. (2012) Australia Pre-Post N=9 Population: Severe TBI; Mean Age=30.9yr; Gender: Male=5, Female=4; Mean Time Post Injury=33.8mo. Intervention: Participants had two pre-intervention assessments (4wk apart), then received the Virtual Reality (VR) intervention, followed by a follow-up assessment. The intervention consisted of 12, 1-hr training sessions with the Elements virtual reality system (VR therapy, tracking camera, and tangible working LCD surface), over 4wk in addition to their usual care. Outcome measure: System-measured variables, Box and Block Test (BBT), McCarron Assessment of Neuromuscular Dysfunction (MAND), Neurobehavioural Functioning Inventory (NFI). 1.        The intervention provided significant improvements on accuracy percentage for both left (46.26 to 64.25; p=0.01) and right hand (56.86 to 73.62; p=0.02). 2.        No significant changes were seen from pre to post treatment on left hand speed, but there was for right hands (0.23m/s to 0.31m/s; p=0.01). 3.        Efficiency scores improved significantly only for the right hands (92.61 to 97.68; p=0.002). 4.        BBT showed significant improvements from pre to post test for both the left (30.44 to 35.98; p=0.04) and right (46.66 to 53.33; p=0.007) hands. 5.        No significant improvements were noted on the MAND. 6.        From pre to post treatment, significant improvements in total NFI scores were demonstrated with a reduction from 128.67 to 112.89 (p=0.005), however in each subscale, only the memory/attention subscale improved significantly (p=0.049).
Sietsema et al. (1993) USA Prospective Controlled Trial N=20   Population: TBI; Mean Age=31.6yr; Gender: Male=17, Female=3; Mean Time Post Injury=6yr. Intervention: Two interventions were compared: An Occupational Embedded Intervention and rote exercise. The occupational embedded intervention involved leaning forward and reaching out the affected arm to play a computer-controlled game. The rote exercise involved leaning forward and reaching out the affected arm on command. Each participant had two 20min sessions, separated by 1wk. Outcome Measure: Range of motion (trunk inclination, shoulder flexion, elbow extension), Total Movement (leaning forward and reaching). 1.        There were no significant order effects. 2.        There was a significant increase in range of motion concerning hip to wrist movement in the occupational embedded condition compared with the rote exercise group (mean reach length 71.60 cm versus 59.38 cm, p<0.001). 3.        The occupational embedded group had a range of motion for scapula-to-wrist that was a mean of 3.52cm greater than the rote exercise group; however, this was not statistically significant.