Feasibility and usability of a new home-based immersive virtual reality headset-based dexterity training in multiple sclerosis

Christian P Kamm; Remo Blättler; Roger Kueng; Tim Vanbellingen

doi:10.1016/j.msard.2023.104525

Feasibility and usability of a new home-based immersive virtual reality headset-based dexterity training in multiple sclerosis

Mult Scler Relat Disord. 2023 Mar:71:104525. doi: 10.1016/j.msard.2023.104525. Epub 2023 Jan 20.

Authors

Christian P Kamm¹, Remo Blättler², Roger Kueng³, Tim Vanbellingen⁴

Affiliations

¹ Neurocenter, Lucerne Cantonal Hospital, 6000 Lucerne, Switzerland; Department of Neurology, Inselspital, Bern University Hospital and University of Bern, 3010 Bern, Switzerland. Electronic address: christian.kamm@luks.ch.
² 12 Parsec, Oberfeld 3, 6037 Root, Switzerland.
³ Holonautic AG, Tannegg 4, 6005 St., Niklausen LU, Switzerland.
⁴ Neurocenter, Lucerne Cantonal Hospital, 6000 Lucerne, Switzerland; Gerontechnology and Rehabilitation Group, University of Bern, 3010 Bern, Switzerland.

PMID: 36738693
DOI: 10.1016/j.msard.2023.104525

Abstract

Background: Impaired manual dexterity is frequent and disabling in patients with multiple sclerosis (MS), affecting activities of daily living and quality of life.

Objective: The aim of this study was to evaluate the feasibility, usability and patient engagement/satisfaction of a home-based immersive virtual reality (VR) headset-based dexterity training in persons with multiple sclerosis (pwMS). In addition, preliminary efficacy data on the impact of this new training on manual dexterity were collected.

Methods: Single arm prospective study. After a waiting period of two weeks, pwMS performed a specifically developed home-based VR headset-based dexterity training using the Oculus quest 2 for two weeks with five training sessions/week, each session for approximately 20 minutes. Primary endpoints were feasibility (measured by the adherence rate), usability (System Usability Scale, SUS) and patient engagement/satisfaction (Custom User Engagement Questionnaire, CUEQ). Secondary exploratory efficacy endpoints, measured before and after the waiting period as well as after the training intervention, were the Nine-hole-Peg-Test (9HPT), Coin rotation task (CRT), Handheld JAMAR dynamometer, Arm Function in Multiple Sclerosis Questionnaire (AMSQ) and the Multiple Sclerosis Impact Scale 29 (MSIS 29).

Results: Eleven pwMS (mean age 49 ± 10.87 SD, mean EDSS 4.28 ± 1.48 SD) participated in the study. Feasibility (adherence rate: 81.8%), usability (median SUS score 94 (IQR = 78-96)) and patient engagement/satisfaction (median 8 on scale of 1-10) of the VR training was very high. In addition, the CRT for the dominant hand improved significantly after training (p = 0.03).

Conclusions: The good results on feasibility, usability, and patient engagement/satisfaction qualify this home-based immersive VR headset-based dexterity training approach for the use in home-based neurorehabilitation in pwMS. Improved fine motor skills for the dominant hand suggest preliminary efficacy, but this needs to be proven in a future randomized-controlled trials.

Keywords: Feasibility; Hand and arm function; Home-based training; Manual dexterity; Multiple sclerosis; Rehabilitation; Virtual reality.

MeSH terms

Activities of Daily Living
Adult
Feasibility Studies
Humans
Middle Aged
Multiple Sclerosis*
Prospective Studies
Quality of Life
Virtual Reality*