Virtual reality for activities of daily living rehabilitation after acquired brain injury.
Jasleen Grewal, Alyssa Turcott, Jodi Ferrer and 3 others
VR-based ADL practice added to usual therapy was associated with a 9.4-point gain on the NADL (max 66) and further improvement at 3 months.
No control group, so the gains cannot be attributed to VR alone.
Key findings
1NADL scores (maximum 66) increased by 9.4 points from pre- to post-intervention (p = 0.005) and by a further 10.6 points from post-intervention to 3-month follow-up (p = 0.005).
2Upper extremity function (FMUE) and cognitive screening (MOCA) also showed significant pre- to post-intervention improvement, while self-efficacy for daily activities (DLSES) did not change significantly at any time point.
3Participants continued to receive standard occupational therapy (three to four 60-minute sessions per week) and other rehabilitation disciplines throughout the VR study, so the contribution of VR alone cannot be separated from the total treatment.
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What it does not show
No control group, no randomization, and no blinding, so it is impossible to tell whether the gains came from VR, from the usual therapy the participants also received, or from natural recovery. Only 15 participants, and only 2 had TBI, so the findings are exploratory and may not apply to the TBI population. No VR sessions were delivered between the post-intervention and 3-month assessments, yet NADL scores continued to rise by 10.6 points in that period. The authors note this gain cannot be attributed to VR. Four participants could not be contacted at 3-month follow-up, and the authors acknowledge it is uncertain whether the missing data were random. Sessions were shortened in 84.3% of cases, mostly for scheduling reasons, so the actual VR practice time (mean 20.1 minutes) was well below the 30-minute target.
Declared interests
Funded by WorkSafeBC and the Michael Smith Foundation for Health Research (BC). No industry sponsor is named.
The easy way to misread this
Do not read the 9.4-point NADL gain as proof that VR caused the improvement. There was no control group, participants received standard occupational therapy and other rehabilitation throughout, and the further 10.6-point gain at 3 months occurred when no VR sessions were being delivered at all.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →