Virtual Reality-based Rehabilitation for Traumatic Hand and Wrist Injuries

Condition(s) studied

Investigational drug(s) / intervention(s)

Immersive Virtual Reality Action Observation Therapy: Participants observe and subsequently perform functional wrist and hand movements within immersive virtual reality environments using a Meta Quest Pro headset. The intervention is delivered twice weekly for six weeks, with sessions lasting approximately 45 minutes.

Conventional Rehabilitation: Standard rehabilitation program for traumatic wrist and hand injuries including active and passive mobilization, strengthening exercises, functional training, and pain management.

Study summary

This randomized controlled trial aims to evaluate the effectiveness of immersive virtual reality (VR)-based Action Observation Therapy (AOT) as an adjunct to conventional rehabilitation in patients with traumatic wrist and hand injuries. Participants will receive standard rehabilitation treatment, and the intervention group will additionally undergo a six-week VR program involving observation and execution of functional hand and wrist movements. Outcomes related to hand function, grip strength, pain, proprioception, disability, and psychological factors will be assessed to determine the potential benefits of incorporating VR into rehabilitation programs.

Eligibility

Primary outcome measure(s)

• Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) Score — Baseline (approximately 5 days after immobilization removal), week 6 (beginning of the sixth week of intervention), and 3 months after completion of the intervention
  Self-reported upper limb disability assessed with QuickDASH questionnaire (0-100, higher scores indicate greater disability).
• Patient-Rated Wrist and Hand Evaluation (PRWHE) Total Score — Baseline (approximately 5 days after immobilization removal), week 6 (beginning of the sixth week of intervention), and 3 months after completion of the intervention.
  Wrist and hand pain and function assessed with the PRWHE questionnaire (0-100, lower scores indicate better outcomes).
• Michigan Hand Outcomes Questionnaire (MHQ) Total Score — Baseline (approximately 5 days after immobilization removal), week 6 (beginning of the sixth week of intervention), and 3 months after completion of the intervention.
  Hand-specific function, pain, activities of daily living, work performance, aesthetics and satisfaction assessed with the MHQ (0-100 scale).
• Shoulder Pain and Disability Index (SPADI) Total Score — Baseline (approximately 5 days after immobilization removal), week 6 (beginning of the sixth week of intervention), and 3 months after completion of the intervention.
  Shoulder pain and disability assessed with SPADI questionnaire (0-100, lower scores indicate better outcomes).
• Pain Catastrophizing scale (PCS) Total Score — Baseline (approximately 5 days after immobilization removal), week 6 (beginning of the sixth week of intervention), and 3 months after completion of the intervention.
  Maladaptive pain-related cognitions assessed with the PCS (0-52, higher scores indicate greater catastrophizing).
• Tampa Scale for Kinesiophobia (TSK-11) Total Score — Baseline (approximately 5 days after immobilization removal), week 6 (beginning of the sixth week of intervention), and 3 months after completion of the intervention.
  Fear of movement assessed with the TSK-11 questionnaire (11-44, higher scores indicate greater kinesiophobia).
• Active Wrist range of motion (degrees) — Baseline (approximately 5 days after immobilization removal), week 6 (beginning of the sixth week of intervention), and 3 months after completion of the intervention.
  Active wrist flexion, extension, radial deviation, ulnar deviation, pronation and supination measured with a universal goniometer (degrees).
• Grip strength (Kg) — Baseline (approximately 5 days after immobilization removal), week 6 (beginning of the sixth week of intervention), and 3 months after completion of the intervention.
  Grip strength measured in kilograms using a Jamar dynamometer in standardized position.
• Wrist joint position sense error (Degrees) — Baseline (approximately 5 days after immobilization removal), week 6 (beginning of the sixth week of intervention), and 3 months after completion of the intervention.
  Proprioceptive accuracy assessed as the mean absolute angular error (degrees) between a target wrist joint position set by the examiner and the position actively reproduced by the participant with eyes closed. Lower values indicate better proprioceptive accuracy.

Trial sites (1)

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