Authors (including presenting author) :
YIP KH (1), Chan YLD (1), Lau WLC (1), Kan HY (1), Cheung YC (1)
Affiliation :
(1)Occupational Therapy Department, Kowloon Hospital
Introduction :
Spinal Cord Injury (SCI) is associated with physical and psychological impairments which result in functional limitations in the community. Conventional on-site training for community reintegration is labor-intensive (1 therapist: 1 patient) and poses safety concerns. In addition, it is often started in later phase of rehabilitation due to relatively high activity demand.
The use of Virtual Reality (VR) training allows a wide range of tasks to be practiced in a protected and enriched environment before encounter the stressful and dangerous real environment. VR training could also be incorporated earlier during in-patient phase in order to promote quick reintegration in community.
Objectives :
(1) To investigate the efficacy of VR training in promoting return-to-community in SCI case
Methodology :
A 66 years-old female suffered from collapsed T12 SCI with laminectomy and spinal fusion was recruited. She remained dependent in community living despite significant improvement in functional mobility. 6 sessions (30 minutes each) of immersive VR group training for meal preparation, escalator usage and road crossing, in addition to 1 session of individual on-site training were given. Lawton Instrumental Activities of Daily Living (L-IADL) and Fall Efficacy Scale (FES) were used to evaluate community living skills and fall efficacy respectively. Number of on-site trainings required to achieve similar functional outcome was compared to conventional training.
Result & Outcome :
L-IADL showed an 11 scores improvement from 9/27 to 20/27 after VR training. She was able to prepare meal, go grocery shopping, manage finance and take public transportation. FES score improved positively from 39/100 to 68/100. Before VR training, she was wheelchair-bound when going outdoor due to fear of fall. After VR training, she reported significant increase in confidence in accessing different community facilities with quadripod.
The number of labor-intensive on-site trainings required to achieve similar functional outcome reduced from 6 sessions to 1 session after VR. The patient reported the VR training provide opportunity in mental rehearsal and imaginary. She could practice repeatedly and transfer the skills to real life.
Conclusion
VR gives options of group treatment instead of 1:1 community training. Repeated safe and non-failure learning experience gives confidence and competence to patient for community application. This single case study has positive indication to apply in patients with similar needs either individually or in group, in which VR group training plus one individual session by OT or even by smart carer may achieve the functional regain. Further large-scaled study will be planned.
