JMIR Publications

ABSTRACT

This single subject case study examines the feasibility of using custom virtual reality (VR) gaming software in the home environment for low dose Hand Arm Bimanual Intensive Training (HABIT). A 10-year-old with right unilateral cerebral palsy participated in this trial. Fine and gross motor skills as well as personal goals for motor outcomes were assessed pre- and post-intervention using the Box and Blocks Test (BBT), Nine-Hole Peg Test (NHPT) and Canadian Occupational Performance Measure (COPM). Movement intensities collected via the virtual reality hardware accelerometers, VR game scores, and task accuracy were recorded via the HABIT-VR software as indices of motor performance. The child/family were instructed to use the HABIT-VR games twice daily for 30 minutes over a 14-day period and asked to record when they used the system. The child utilized the system and completed the 14 hour, low-dose HABIT-VR intervention across 22 days. There was no change in BBT and NHPT scores pre to post-intervention. COPM scores increased but did not reach the clinically relevant threshold, due to high scores at baseline. Changes in motor task intensities during use of VR and mastery of the virtual bimanual tasks suggested improved motor efficiency. This case study provides preliminary evidence that HABIT-VR is useful for promoting adherence to HABIT activities and for maintenance of upper extremity motor skills in the home setting.