Children Clinical Trial
— VR4REHAB-MOTOfficial title:
VR4REHAB-MOTIVATION for REHABILITATION: Proof of Concept Evaluation of Virtual Reality Innovations for Therapy for Young People With Brain Injury
Verified date | May 2022 |
Source | Royal Free Hospital NHS Foundation Trust |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Children and young people with movement difficulties such as Cerebral Palsy (CP) and Acquired Brain Injury (ABI) report that traditional therapies are highly repetitive and labourious. This influences enjoyment and participation in regular therapy programmes and may result in reduced adherence to therapy or exercise regimes, limiting effectiveness. This study will build on the team's previous work to explore the potential use of Virtual-Reality (VR) technologies in rehabilitationÍž particularly systems that can be used at home to increase accessibility and reduce need to attend clinics for therapy. During the co-production events of the VR4REHAB Inter Regional North West Europe (NWE) funded programme in 2018, young people desired the use of commercial games for therapeutic purposes. This work has enabled connections between affordable computer technologies: the Raspberry Pi, VR headsets and freely available commercial games. This 2-Phased project is therefore exploring the potential of commercially available virtual reality (VR) systems consoles and games for use in rehabilitation programmes. The Investigators hope to gain information on: 1. Whether commercially produced VR games can provide a motivating environment to support adherence to therapy 2. Whether it is possible to improve reaching and grasp-release hand movements through this method 3. Gain an understanding of the ages of children and young people most likely to benefit from home-based VR therapy User evaluation and performance data and therapist evaluations will be collected and compared to baseline data to provide information on usability, accessibility, acceptability and adaptability.
Status | Completed |
Enrollment | 10 |
Est. completion date | June 30, 2021 |
Est. primary completion date | May 30, 2021 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 10 Years to 30 Years |
Eligibility | Inclusion Criteria: 1. Bilateral and Unilateral CP or ABI with movement difficulties; Gross Motor Function Classification System (GMFCS) levels I to IV e.g. able to sit, independently operate electric wheelchair; 2. Manual Ability Classification System (MACS) levels I to IV - able to move arms and hands and interact with some objects although adaptations may be needed to hold console/interfacing device such as use of velcro strap; 3. Ability to follow simple task instruction; 4. Aged 10 - 30 years; 5)) Ability to cooperate with assessment instructions. 6) Ability to give informed consent or assent if appropriate, participants having an acceptable individual capable of giving consent on the participant's behalf (e.g. parent or guardian of a child under 16 years of age) - Typically developed peers will need to meet criteria 3 to 6 and be eligible with respect to exclusion criteria. Exclusion Criteria: 1. Individuals who are GMFCS or MACS levels V; Inability to follow simple task instructions; 2. less than 10 years or over 30 years; 3. Individual with photosensitive epilepsy 4. Unstable medical condition (in -patient status) 5. Learning or behavior difficulties limiting ability to follow instructions or attend a 2 hour workshop/engage with a rehabilitation programme. 6. Receiving Motor therapy treatment (eg. Botulinum Toxin Injections/A/Constraint Induced Movement Therapy or anticipated to receive such treatment during the 6 months of the study |
Country | Name | City | State |
---|---|---|---|
United Kingdom | Royal Free London NHS Foundation Trust | London |
Lead Sponsor | Collaborator |
---|---|
Royal Free Hospital NHS Foundation Trust | Interreg |
United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Therapist diary of experiences | Research therapists will record the type of support provided to participants, training requirements and their opinion as to whether the system supported therapeutic objectives in order to consider feasibility of delivery. Comments will be analysed qualitatively to understand the types of support and/or refinements to the system set up or information required for participants to use the system at home. | Phase 2: Daily over 2 weeks | |
Other | Therapist diary of time | Research therapists and level of experience/salary banding will record the amount of time provided to participants and any additional training time. Total time will be calculated to determine potential cost to support home-based use of VR systems. | Phase 2: Daily over 2 weeks | |
Primary | User Evaluation Questionnaire Form | User evaluation (experience) questionnaire developed by the Co-production group. 15 closed questions rate aspects of accessibility and usability, enjoyment and relatedness and 5 open-ended questions for more personal feedback of experience, potential for use in rehabilitation and any recommended changes. Total scores will be computed with descriptive statistics recorded. Content and thematic analysis will be used to analyse data from open ended questions and considered with respect to the ratings provided by participants. | Phase 2: 2-weeks (end of 2-week trial) | |
Primary | Participant completed engagement diary | Diaries of participants in which they note whether they chose or were prompted to use the game/system and record their experience of the session along with numbers of games played and reported duration of the session. Qualitative methods using content and thematic analysis will be used to analyse data to assist understanding of barriers or facilitators to user engagement. | Phase 2: Daily over 2 weeks | |
Secondary | Goal Attainment Scaling | Patient reported outcomes using Goal Attainment Scaling will consider potential of system to address 3 identified child/young adult identified goals. Anticipated outcomes are defined on a 5 point scale with -2 = a much less than anticipated outcome; -1= less than anticipated outcome; 0=anticipated outcome; +1 =better than expected outcome; +2=much better than expected outcome. Each goal is weighted by asking the participant to rank them in order of importance and also with respect to anticipated difficulty on a four point scale and a total weigh/per goal determined by multiplying Importance x difficulty=weight of goal. The outcome score for each goal is rated at the review data and the goal attainment 'T-score' calculated using the formula and calculation provided in Turner Stokes (2006) which takes into consideration the sum of weights and score changes and expected correlations. HIgher scores reflect better outcome. | Phase 2: Day 1 and at 2-weeks (end of 2-week trial) | |
Secondary | Functional Reach Test | Functional Reach test measures extent of forward reach of each arm in centimetres while maintaining balance. Larger distance is better function. | Phase 2: Day 1 and at 2-weeks (end of 2-week trial) |
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