Related Experiment Video
Updated: Jun 18, 2025
Author Spotlight: Rehabilitation of Stroke Patients With a Digital Occupational Training System
Published on: December 29, 2023
Influence of virtual reality and task complexity on digital health metrics assessing upper limb function
Christoph M Kanzler1,2, Tom Armand3, Leonardo Simovic3
1Rehabilitation Engineering Laboratory, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland. c-m.kanzler@gmx.de.
Technology-based assessments using virtual reality (VR) and physical tasks offer valuable digital health metrics for upper limb function. VR assessments may be superior for longitudinal studies in multiple sclerosis, while physical tasks offer better usability for regular clinical use.
Area of Science:
- Biomedical Engineering
- Rehabilitation Technology
- Digital Health
Background:
- Technology-based assessments using 2D virtual reality (VR) and instrumented tasks provide digital health metrics for upper limb sensorimotor function.
- These metrics are promising for sensitive endpoints in clinical studies, but the impact of VR environments and task complexity on their clinimetric properties requires further investigation.
Purpose of the Study:
- To investigate how virtual reality (VR) and task complexity influence the clinimetric properties of digital health metrics for upper limb function.
- To compare a haptic VR-based assessment (Virtual Peg Insertion Test - VPIT) with novel VR (VPIT-2H) and physical (PPIT) tasks of varying complexity.
Main Methods:
- An observational longitudinal study involved 27 able-bodied participants and 31 individuals with multiple sclerosis (pwMS).
- Participants underwent assessments using the VPIT, VPIT-2H, and PPIT to compare kinematic and kinetic metrics, clinimetric properties, and usability.
- The study evaluated intra- and inter-participant variability, measurement error, test-retest reliability, responsiveness, and concurrent validity.
Main Results:
- Increased task complexity and VR environments led to higher intra-participant variability, but did not significantly impact measurement error or test-retest reliability.
- The VR task with high complexity demonstrated significantly higher responsiveness to longitudinal changes in pwMS compared to a physical task with low complexity.
- Usability ratings were higher for the physical instrumented task (PPIT) compared to the VR-based VPIT in pwMS.
Conclusions:
- Both VR haptic-based and physical instrumented assessments demonstrate adequate clinimetric properties for evaluating upper limb function.
- VR assessments may offer advantages for longitudinal monitoring in pwMS due to enhanced responsiveness.
- Physical instrumented tasks may be more suitable for routine clinical practice owing to superior usability, warranting further validation for specific use-cases.
