Upper-limb virtual rehabilitation for traumatic brain injury: a preliminary within-group evaluation of the Elements System.

Abstract

AIM: The aim of this study was to assess the efficacy of the Elements virtual reality (VR) system for rehabilitation of upper-limb function in patients with traumatic brain injury (TBI). METHODS: Using a within-group design, patients were tested three times, each 4 weeks apart: Pre-intervention 1 and 2 and Post-intervention. During intervention, participants received 12 1-hour training sessions over 4 weeks in addition to their usual care. Five males and four females aged 18-48 years with severe TBI were recruited. The Elements system consisted of a 100-cm tabletop LCD, camera tracking system, tangible user interfaces (i.e. graspable objects of basic shape) and software. The system provided two modes of interaction with augmented feedback: goal-directed and exploratory. Upper-limb performance was assessed using system-rated measures (movement speed, accuracy and efficiency) and standardized tests. RESULTS: Planned comparisons revealed little change in performance over the pre-test period apart from an increase in movement speed. There were significant training effects, with large effect sizes on all measures except the nuts-and-bolts task. CONCLUSIONS: These preliminary findings support the results of an early case study of the Elements system, further demonstrating that VR training is a viable adjunct to conventional physical therapy in facilitating motor learning in patients with TBI.