In-Home Delivery of Constraint-Induced Movement Therapy via Virtual Reality Gaming

Authors

Alexandra L. Borstad, College of St. ScholasticaFollow
Roger Crawfis, The Ohio State UniversityFollow
Kala Phillips, University of LouisvilleFollow
Linda Pax Lowes, Nationwide Children's HospitalFollow
David Maung, BattelleFollow
Ryan McPherson, The Ohio State UniversityFollow
Amelia Siles, The Ohio State UniversityFollow
Lise Worthen-Chaudhari, Ohio State UniversityFollow
Lynne V. Gauthier, The Ohio State UniversityFollow

Publication Date

1-30-2018

Keywords

stroke, upper extremity, virtual reality exposure, therapy, feasibility, constraint, rehabilitation

Abstract

Purpose: People with chronic hemiparesis are frequently dissatisfied with the recovery of their hand and arm, yet many lack access to effective treatments. Constraint-induced movement therapy (CI therapy) effectively increases arm function and spontaneous use in persons with chronic hemiparesis. The purpose of this study was to determine the feasibility and measure safety and outcomes of an in-home model of delivering CI therapy using a custom, avatar-based virtual reality game.

Methods: Seventeen individuals with chronic hemiparesis participated in this pretest/posttest quasi-experimental design study. The 10-day intervention had three components: 1) high-repetition motor practice using virtual reality gaming; 2) constraint of the stronger arm via a padded restraint mitt; and 3) a transfer package to reinforce arm use. Feasibility of the intervention was evaluated through comparison to traditional CI therapy and through participants’ subjective responses. The primary outcome measures were the Wolf Motor Function Test (WMFT) and the Motor Activity Log quality of movement scale (MAL-QOM).

Results: On average, participants completed 17.2 ± 8 hours and 19,436 repetitions of motor practice. No adverse events were reported. Of 7 feasibility criteria, 4 were met. WMFT rate and MAL-QOM increased, with effect size (Cohen’s d) of 1.5 and 1.1, respectively.

Conclusions: This model of delivering CI therapy using a custom, avatar-based virtual reality game was feasible, well received, and showed preliminary evidence of being a safe intervention to use in the home for persons with chronic hemiparesis.

Recommended Citation

Borstad AL, Crawfis R, Phillips K, Pax Lowes L, Maung D, McPherson R, Siles A, Worthen-Chaudhari L, Gauthier LV. In-home delivery of constraint-induced movement therapy via virtual reality gaming. J Patient Cent Res Rev. 2018;5:6-17. doi: 10.17294/2330-0698.1550