Immersive Virtual Reality to Improve Outcomes in Veterans With Stroke: Protocol for a Single-Arm Pilot Study

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Human-Computer Interaction

Background:

• Virtual Reality (VR) is an emerging technology in stroke rehabilitation.
• VR interventions enhance motor, cognitive, and psychological recovery in stroke patients.
• VR shows noninferiority to traditional therapies for stroke rehabilitation.

Purpose of the Study:

• Determine the feasibility and tolerability of a therapeutic VR platform in inpatient stroke rehabilitation.
• Estimate the clinical efficacy of VR for pain distraction and upper extremity exercise post-stroke.
• Assess VR's potential for improving upper extremity neurologic recovery and hand dexterity.

Main Methods:

• Pilot study in a Comprehensive Integrated Inpatient Rehabilitation Program.
• Qualitative interviews with 10 clinical staff members.
• Prospective within-subject pretest-posttest design with 10 veteran inpatients.
• Utilized bedside VR with pain distraction and upper extremity exercise apps.
• Analyzed clinician interviews qualitatively and calculated Cohen's d effect sizes for clinical outcomes.

Main Results:

• Study selected for funding and received IRB approval in late 2020.
• Data collection commencement is pending the lifting of a COVID-19 research moratorium.
• No patient outcome data is available yet due to COVID-19 related delays.

Conclusions:

• A large multi-site clinical trial is the next step, incorporating lessons learned from this pilot study.
• VR in patient rooms can provide supplemental therapy and potentially reduce clinician burden.
• VR offers a pathway for seamless transition from inpatient rehabilitation to home-based practice.