Effectiveness of virtual reality-based movement therapy in peripheral nerve injuries of the hand.

Abstract

Background: In peripheral nerve injuries, the vicious cycle of pain and movement restriction negatively affects functional recovery in rehabilitation.

Aim: This study aimed to examine the effects of virtual reality-based movement therapy (VRBMT) on pain, sensation, quality of life, activity participation, and upper extremity functions in patients with peripheral nerve injury (PNI) of the hand.

Design: Randomized controlled study.

Setting: (1) Department of Physical Medicine and Rehabilitation, (2) Hand rehabilitation clinic.

Population: The study included 42 patients who had undergone early surgical repair for traumatic peripheral nerve injury at the wrist level and above 10 cm, had completed the postoperative fifth week, and had no physical barriers to playing games in a virtual reality environment.

Methods: The patients were randomly assigned to the study (n=21) and control (n=21) groups. Both groups underwent a total of 30 therapy sessions over 6weeks, consisting of five sessions per week, each lasting 60 minutes. In addition to their routine conventional hand rehabilitation programs, those in the study group received 30 sessions of virtual reality-based movement therapy (6weeks, 5days a week, 20 minutes per session). The severity of upper extremity pain was assessed with the Visual Analog Scale, sensory threshold with the Semmes Weinstein Monofilament Test 5-filament version, hand grip strength with the Jamar Dynamometer, activity participation level with the Quick Disabilities of the Arm, Shoulder, and Hand and Duruoz Hand Index, upper extremity functionality with the Jebsen Taylor Hand Function Test, and health-related quality of life with the 5-Dimensional European Quality of Life Scale (EQ-5D-3L).

Results: A total of 42 patients with a median age of 37years (25.75-49.5) completed the study. There were statistically significant differences between the groups' post-test Visual Analog Scale (p=0.001), JAMAR (p=0.004), Quick Disabilities of the Arm, Shoulder, and Hand (p=0.015), and Duruoz Hand Index (p<0.001) scores in favor of those in the study group.

Conclusions: VRBMT demonstrated positive effects on pain, sensation, quality of life, activity participation, and upper extremity functions in patients with hand PNI.

Clinical rehabilitation effect: VRBMT can be used in addition to routine treatment programs due to its ease of application and positive effects.