Virtual Reality-Based Hand Rehabilitation for Post-Surgical Degenerative Cervical Myelopathy: A Pilot Study
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Medical College of Wisconsin
- Enrollment
- 25
- Locations
- 2
- Primary Endpoint
- Jebsen-Taylor Hand Function Test
Study Overview
Brief Summary
This clinical study aimed to evaluate the effectiveness of a virtual reality-based training intervention for improving hand dexterity and promoting neuroplasticity in individuals with Degenerative Cervical Myelopathy (DCM) after surgical decompression. Participants completed a 4-week training program using the Virtual Keyboard (VK) system, which facilitated repetitive, individualized finger movements in a virtual environment. Outcomes were measured pre- and post-training to quantify improvements in hand dexterity, quality of life, and cortical motor activity.
Detailed Description
Degenerative Cervical Myelopathy (DCM) is a leading cause of non-traumatic spinal cord injury, often resulting in impaired hand dexterity and diminished quality of life. Despite surgical decompression being the primary treatment, over 30% of individuals experience persistent functional disability due to a lack of targeted post-surgical rehabilitative interventions. This study sought to address this clinical gap by implementing and evaluating a virtual reality-based hand training intervention.
The central hypothesis was that an intensive, individualized training program using the Virtual Keyboard (VK) system would improve hand dexterity in individuals with DCM and that these functional gains would be supported by measurable changes in cortical motor activity.
Study Design
This single-arm interventional study recruited participants who had undergone cervical spine surgery within six months. A total of 25 participants were enrolled, each completing:
A 4-week training program consisting of 12 one-hour sessions using the VK system. The system provided engaging, interactive tasks designed to promote finger individuation and precise motor control through real-time visual and auditory feedback.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 85 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Diagnosed with Degenerative Cervical Myelopathy.
- •Completed cervical spine surgery within 6 months.
- •Modified Japanese Orthopaedic Association (mJOA) upper limb motor score between 1-4.
Exclusion Criteria
- •Pregnancy.
- •History of brain or upper extremity surgery within the past year.
- •Significant arm/hand pain limiting movement.
- •Complete paralysis of the hands (mJOA=0).
Outcomes
Primary Outcomes
Jebsen-Taylor Hand Function Test
Time Frame: Baseline, post-training and follow-up.
The Jebsen-Taylor Hand Function Test (JTHFT) is a standardized test used to assess hand function during everyday activities. It consists of seven timed subtests, such as writing, card turning, and object manipulation. The outcome is recorded as the time taken to complete each task in seconds, where lower times indicate better hand function.
Secondary Outcomes
- Quantitative Electroencephalograms (qEEG)(Baseline, post-training and follow-up.)
- Nine-Hole Peg Test (9HPT)(Baseline, post-training and follow-up.)
- Box and Blocks Test (BBT)(Baseline, post-training and follow-up.)
- QuickDASH(Baseline, post-training and follow-up.)
- Three-point pinch strength(Baseline, post-training and follow-up.)
- Touch sensitivity(Baseline, post-training (1 week after VK training), and 4-week follow-up ( 4 weeks after VK training).)
- EuroQol 5-Dimension score(Baseline, post-training and follow-up.)
- Short Form-36 Health Survey version 2(Baseline, post-training and follow-up.)
- Modified Japanese Orthopedic Association scale(Baseline, post-training and follow-up.)
- Myelopathy Disability Index(Baseline, post-training and follow-up.)
Investigators
Aditya Vedantam
Associate Professor
Medical College of Wisconsin