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. 2021 May 18;4(2):e132.
doi: 10.1097/OI9.0000000000000132. eCollection 2021 Jun.

Virtual reality-based physical therapy for patients with lower extremity injuries: feasibility and acceptability

Clifford A Reilly  1 , Aimee Burnett Greeley  1 , David S Jevsevar  1 , Ida Leah Gitajn  1
Affiliations

Virtual reality-based physical therapy for patients with lower extremity injuries: feasibility and acceptability

Clifford A Reilly et al. OTA Int. .

Abstract

Introduction: Traditional physical therapy (PT) requires patients to attend weekly in-office supervised physical therapy appointments. However, between 50% and 70% of patients who would benefit do not receive prescribed PT due to barriers to access. Virtual Reality (VR) provides a platform for remote delivery of PT to address these access barriers.

Methods: We developed a VR-PT program consisting of training, games, and a progress dashboard for 3 common lower extremity physical therapy exercises. We enrolled orthopaedic trauma patients with lower extremity injuries. Patients completed a VR-PT session, consisting of training and one of the exercise-based games. Pre- and post-VR-PT questionnaires were completed.

Results: We enrolled 15 patients with an average age of 51 years. Fourteen patients said they would enroll in a randomized trial in which they had a 50% chance of receiving VR-PT vs receiving standard of care. When asked to rate their experience using the VR-PT module on a scale from 0-10-with 0 being anchored as "I hated it" and 10 being anchored as "I loved it"-the average rating was 7.5. Patients rated the acceptability of VR-PT as a 3.9 out of 5, the feasibility as a 4.0 out of 5, and the usability as a 67.5 out of 100.

Conclusion: The response to VR-PT in this pilot study was positive overall. A VR-based PT program may add value for both patients and clinicians in terms of objective data collection (to aid in compliance monitoring, progression toward goals and exercise safety), increased engagement and increased access.

Keywords: acceptability; feasibility; lower extremity injuries; physical therapy; rehabilitation; virtual reality.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Representative screenshots of the immersive view seen through the VR headset on the left and the patient on the right in images (A), (B), (C), and (D), performing the heel slide exercise. In (A) and (B) the patient is looking ahead at the ball and in (C) and (D) the patient is looking at his leg. The goal of the game is to catch the ball with the target over the knee. The patient selects the level of difficulty (amount of flexion) and points are achieved with each successful catch.
Figure 2
Figure 2
Summary screen demonstrating game-related statistics (percentage of goal achieved in the center, maximum knee flexion angle, number of repetitions, number of successful target catches) after the heel slide exercise.
Figure 3
Figure 3
Acceptability of intervention measure (AIM).
Figure 4
Figure 4
Feasibility of intervention measure (FIM).
Figure 5
Figure 5
System usability scale.
See this image and copyright information in PMC

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