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

• Published in: Multiple sclerosis and related disorders 2023-03, Vol.71, p.104525-104525, Article 104525
• Main Authors: Kamm, Christian P, Blättler, Remo, Kueng, Roger, Vanbellingen, Tim
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Adult; Feasibility; Feasibility Studies; Hand and arm function; Home-based training; Humans; Manual dexterity; Middle Aged; Multiple Sclerosis; Prospective Studies; Quality of Life; Rehabilitation; Virtual Reality
• ISSN: 2211-0348; 2211-0356
• DOI: 10.1016/j.msard.2023.104525

•This is the first study evaluating the feasibility and usability of a home-based immersive virtual reality (VR) headset-based dexterity training in people with multiple sclerosis.•The immersive VR headset-based dexterity training was specifically developed for this study.•Feasibility, usability, and patient satisfaction was very high qualifying this treatment approach for the use in home-based neurorehabilitation.•The results hint to an efficacies training intervention regarding improvements in manual dexterity. Impaired manual dexterity is frequent and disabling in patients with multiple sclerosis (MS), affecting activities of daily living and quality of life. 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. 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). 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). 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 random