Feasibility of At-Home Hand Arm Bimanual Intensive Training in Virtual Reality: Case Study.

Area of Science:

• Rehabilitation Engineering
• Pediatric Physical Therapy
• Virtual Reality in Medicine

Background:

• Home-based rehabilitation offers accessibility for children with motor impairments.
• Hand Arm Bimanual Intensive Training (HABIT) is an evidence-based therapy for upper extremity deficits.
• Virtual reality (VR) presents novel platforms for engaging therapeutic interventions.

Observation:

• A 10-year-old with right unilateral cerebral palsy trialed custom VR gaming software for low-dose HABIT at home.
• Intervention involved 14 hours of VR gaming over 22 days, with adherence monitored.
• Standardized motor assessments and VR performance metrics were collected pre- and post-intervention.

Findings:

• No significant changes were observed in standardized fine and gross motor skills (Box and Blocks, Nine-Hole Peg).
• Personalized goal achievement scores (Canadian Occupational Performance Measure) improved but did not reach clinical significance.
• VR-derived data indicated improved motor efficiency and task mastery, suggesting potential benefits.

Implications:

• Custom VR gaming may enhance adherence to HABIT protocols in a home setting.
• HABIT-VR provides preliminary evidence for maintaining upper extremity motor skills.
• Further research with larger cohorts is warranted to validate VR's role in pediatric neurorehabilitation.