Clinical, Functional and Kinematic Correlations using the Virtual Reality System Toyra® as Upper Limb Rehabilitation Tool in People with Spinal Cord Injury

The aim of this study was to prove the validity and efficacy of the Virtual Reality (VR) System Toyra® as an assessment and rehabilitation tool for people with tetraplegia. We analysed the correlation between clinical and functional parameters with kinematic variables of upper limbs during a training protocol using Toyra®. Eighteen patients with cervical spinal cord injury (SCI) were selected to perform the study by comparing 2 treatments: patients in an intervention group (IG) conducted a program that included 12 sessions with Toyra® Activities of Daily Living (ADLs) module for 3 weeks, while a control group (CG) only had the traditional rehabilitation. Kinematic variables (shoulder, elbow and hand joint range of motion) were correlated to clinical [Motor Index (MI), Muscle Balance (MB)] and functional [Functional Independence Measure (FIM), Spinal Cord Independence Measure II (SCIM II), Barthel Index (BI)] evaluation scores. The results of the study showed a high correlation between these variables and also statistically significant differences (p=0.039) in a kinematic parameter (wrist extension), after treatment and in the follow-up evaluation. Toyra® system has been validated as upper limb assess and rehabilitation tool in people with SCI, to measure the patient ́s functional evolution and improve the movement in upper limbs.