Home-Based Immersive Virtual Reality and Spinal Stimulation for Upper Limb Rehabilitation in Tetraplegia
Abstract
The objective of our study is to develop a home-based training platform and instructions for Service Members, Veterans, and civilians with spinal cord injury (SCI)-related tetraplegia to improve their ability to use their arms and hands. The platform we will develop consists of electrical stimulation applied to the back of the neck while users participate in virtual reality arm and hand training (VRArm). We refer to the intervention (platform and instructions) as VRArm+TS as it includes both virtual reality (VR) training experience with the arms and hands, and transspinal stimulation (TS). VR is an engaging artificial environment in which people can exercise their arms and hands in a different, fun world. TS is electrical stimulation applied with surface electrodes (stuck to the skin) placed on the neck, connected to an easy to use commercially available device. Virtual reality will be delivered through a headset that creates an engaging environment. VRArm+TS will be designed so a person with tetraplegia can use it at home with the assistance of one additional person at their home. Development will be completed with and for Service Members, Veterans, and civilians with tetraplegia, caregivers, SCI physicians and therapists. The rationale for the study is that there is strong evidence that combining two powerful approaches (VRArm and TS) in a home-based therapy will ultimately provide greater and more sustainable improvement in arm and hand function relative to existing therapy options. The home-based, low-cost approach we will develop will also significantly increase the amount of people who have access to improve their ability to use their arms and hands. We will incorporate easy to use technology so clinicians can remotely interact with Service Members, Veterans, and civilians with SCI during use of the VRArm+TS intervention as needed. What is the ultimate applicability of the research and impact on the SCI community? Many previous approaches to improve arm and hand function require expensive equipment and/or specialized therapists. Thus, these treatments are only found at large clinical research centers and often require in-person treatment. This is a major limitation for many people who may have trouble reliably getting to the hospital/care center to receive the treatment for various reasons. The home-based, fun, intervention that we will develop with the help of Service Members, Veterans, and civilians with SCI-related tetraplegia will not require travel to a hospital or care center, and thus will increase the number of people who can benefit from the treatment. In the long-term, our intervention can be an option available to U.S. military, Veteran and civilian hospitals, and homes across the nation and world, providing many patients and their rehabilitation specialists with access to an effective training treatment. What persons with SCI will it help, and how will it help them? We will develop the home-based arm and hand training intervention with and for Service Members, Veterans, and civilians with SCI-related tetraplegia who have muscle weakness in their arms due to their SCI and use a wheelchair as their primary way of getting around. Ultimately, the increase in arm and hand function provided by the home-based VRArm+TS training will allow individuals with tetraplegia to do more activities that they want to do, and more easily do activities with their arms and hands. The improvement in arm and hand function will allow people to grip and grasp objects better, and improve their ability to reach with and extend their arms. The improved arm and hand function will increase their health and wellness, independence, participation in the community, and life quality. What is the projected time it may take to achieve a person-related outcome? In the proposed work, will we complete development and testing of safety and how easy to use the intervention is. Following this 3-year study, we will directly test how much
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 28, 2022
- Source ID
- W81XWH2210251
Entities
People
- Carrie Peterson
Organizations
- United States Army
- Virginia Commonwealth University