Influence of virtual reality and task complexity on digital health metrics assessing upper limb function.
Christoph M Kanzler, Tom Armand, Leonardo Simovic and 7 others
PMID 39068424WHAT IT FOUND
For people with MS, virtual reality assessments were more responsive to rehabilitation changes than physical tasks, despite the physical tasks having lower variability and higher usability.
Neither method proved significantly more reliable or valid for detecting upper limb function.
Key findings
01The virtual reality assessment (VPIT) showed better responsiveness to change during rehabilitation in people with MS than the physical assessment (PPIT), with four metrics indicating significant improvement compared to one for the physical task.
02The physical assessment (PPIT) had significantly lower intra-participant variability and higher usability scores in people with MS compared to the virtual reality assessment (VPIT).
03Test-retest reliability and measurement error were not significantly different between the virtual reality and physical assessment conditions in able-bodied participants.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample size was small, particularly for the retest (15 able-bodied) and discharge (21 MS) analyses, which limits the power to detect differences in reliability and responsiveness. The study was conducted in Switzerland, and the specific haptic devices and VR setups may not generalize to other clinical technologies. Responsiveness analysis in MS patients relied on measurement error thresholds (SRD) derived from a young able-bodied population, which may not be appropriate for older adults with MS. There were inherent differences between the physical and VR tasks (e.g., visual feedback mechanisms, presence of a virtual wall) that could have influenced movement kinematics independently of the VR/physical distinction. The study did not include a head-mounted display VR condition, so results apply only to 2D screen-based VR.
Declared interests
The authors declare no conflicts of interest. Funding was provided by the Singapore-ETH Centre, National Research Foundation Singapore, Schweizerische Multiple Sklerose Gesellschaft, and Swiss Federal Institute of Technology Zurich.
The easy way to misread this
Do not conclude that VR assessments are universally superior for clinical practice. While they showed better responsiveness in this specific MS rehabilitation context, the physical task had lower variability and higher usability. The differences in reliability and validity were not statistically significant, and the responsiveness finding requires confirmation in larger studies before changing standard assessment protocols.