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Gehringer JE, Woodruff Jameson A, Boyer H, Konieczny J, Thomas R, Pierce Iii J, Cunha AB, Willett S. Feasibility of At-Home Hand Arm Bimanual Intensive Training in Virtual Reality: Case Study. JMIR Form Res 2024; 8:e57588. [PMID: 39241226 DOI: 10.2196/57588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 07/12/2024] [Accepted: 07/16/2024] [Indexed: 09/08/2024] Open
Abstract
This single-participant case study examines the feasibility of using custom virtual reality (VR) gaming software in the home environment for low-dose Hand Arm Bimanual Intensive Training (HABIT). A 10-year-old with right unilateral cerebral palsy participated in this trial. Fine and gross motor skills as well as personal goals for motor outcomes were assessed before and after the intervention using the Box and Blocks Test, Nine-Hole Peg Test, and Canadian Occupational Performance Measure. Movement intensities collected via the VR hardware accelerometers, VR game scores, and task accuracy were recorded via the HABIT-VR software as indices of motor performance. The child and family were instructed to use the HABIT-VR games twice daily for 30 minutes over a 14-day period and asked to record when they used the system. The child used the system and completed the 14-hour, low-dose HABIT-VR intervention across 22 days. There was no change in Box and Blocks Test and Nine-Hole Peg Test scores before and after the intervention. Canadian Occupational Performance Measure scores increased but did not reach the clinically relevant threshold, due to high scores at baseline. Changes in motor task intensities during the use of VR and mastery of the VR bimanual tasks suggested improved motor efficiency. This case study provides preliminary evidence that HABIT-VR is useful for promoting adherence to HABIT activities and for the maintenance of upper extremity motor skills in the home setting.
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Affiliation(s)
- James E Gehringer
- Virtual Reality Laboratory, Munroe-Meyer Insitute, University of Nebraska Medical Center, Omaha, NE, United States
- Department of Physical Therapy, Munroe-Meyer Insitute, University of Nebraska Medical Center, Omaha, NE, United States
| | - Anne Woodruff Jameson
- Department of Physical Therapy, Munroe-Meyer Insitute, University of Nebraska Medical Center, Omaha, NE, United States
| | - Hailey Boyer
- Department of Physical Therapy, Munroe-Meyer Insitute, University of Nebraska Medical Center, Omaha, NE, United States
| | - Jennifer Konieczny
- Department of Occupational Therapy, Munroe-Meyer Insitute, University of Nebraska Medical Center, Omaha, NE, United States
| | - Ryan Thomas
- Virtual Reality Laboratory, Munroe-Meyer Insitute, University of Nebraska Medical Center, Omaha, NE, United States
- Department of Physical Therapy, Munroe-Meyer Insitute, University of Nebraska Medical Center, Omaha, NE, United States
| | - James Pierce Iii
- Virtual Reality Laboratory, Munroe-Meyer Insitute, University of Nebraska Medical Center, Omaha, NE, United States
- Department of Physical Therapy, Munroe-Meyer Insitute, University of Nebraska Medical Center, Omaha, NE, United States
| | - Andrea B Cunha
- Department of Physical Therapy, Munroe-Meyer Insitute, University of Nebraska Medical Center, Omaha, NE, United States
| | - Sandra Willett
- Department of Physical Therapy, Munroe-Meyer Insitute, University of Nebraska Medical Center, Omaha, NE, United States
- Physical Therapy Program, Department of Kinesiology, Colorado Mesa University, Grand Junction, CO, United States
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Hand-Arm Bimanual Intensive Training in Virtual Reality: A Feasibility Study. Pediatr Phys Ther 2023; 35:85-91. [PMID: 36459077 DOI: 10.1097/pep.0000000000000975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the feasibility of virtual reality (VR) software built using the core concepts of hand-arm bimanual intensive training (HABIT) for improving upper extremity motor function in children with cerebral palsy (CP). METHODS Eight children with CP participated in a 10-day, 40-hour HABIT program. Half of the time custom VR software, HABIT-VR was used. The children's motor skills were assessed pre- and postintervention with the Assisting Hand Assessment, Box and Blocks Test, and Nine-Hole Peg Test. RESULTS The children had significant and clinically relevant changes in the Assisting Hand Assessment and Box and Blocks Test; however, Nine-Hole Peg Test scores did not change with intervention. CONCLUSION These data suggest that combining traditional HABIT strategies with HABIT-VR games improve upper extremity function and gross motor skills but not fine motor skills.
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Zhang Y, Hua Y, Bai Y. Applications of Functional Magnetic Resonance Imaging in Determining the Pathophysiological Mechanisms and Rehabilitation of Spatial Neglect. Front Neurol 2020; 11:548568. [PMID: 33281698 PMCID: PMC7688780 DOI: 10.3389/fneur.2020.548568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 09/25/2020] [Indexed: 12/16/2022] Open
Abstract
Functional magnetic resonance imaging (fMRI) is a neuroimaging tool which has been applied extensively to explore the pathophysiological mechanisms of neurological disorders. Spatial neglect is considered to be the failure to attend or respond to stimuli on the side of the space or body opposite a cerebral lesion. In this review, we summarize and analyze fMRI studies focused specifically on spatial neglect. Evidence from fMRI studies have highlighted the role of dorsal and ventral attention networks in the pathophysiological mechanisms of spatial neglect, and also support the concept of interhemispheric rivalry as an explanatory model. fMRI studies have shown that several rehabilitation methods can induce activity changes in brain regions implicated in the control of spatial attention. Future investigations with large study cohorts and appropriate subgroup analyses should be conducted to confirm the possibility that fMRI might offer an objective standard for predicting spatial neglect and tracking the response of brain activity to clinical treatment, as well as provide biomarkers to guide rehabilitation for patients with SN.
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Affiliation(s)
- Yuqian Zhang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yan Hua
- Department of Rehabilitation Medicine, Huashan Hospital North, Fudan University, Shanghai, China
| | - Yulong Bai
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
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