Recovr reality - Recover after injury or surgery to the brain and spinal cord with virtual Reality: ideal stage 2a clinical feasibility study.

Aim: Neurorehabilitation is fundamental to improve outcomes for patients recovering from injury to the central nervous system. Access to neurorehabilitation is limited by resource shortages; the consequences of which are unfulfilled therapy needs, longer hospital stays and detrimental effects on quality of life. Virtual reality (VR) could be used to enhance neurorehabilitation in a self-directed, safe, virtual environment. The aim of this study is to investigate the feasibility of a VR rehabilitation programme in an acute neurosurgical inpatient environment to improve neurorehabilitation.

Method: A single-group, prospective, clinical feasibility study was conducted in a tertiary UK neurosurgical department. The study included patients aged 16 and over who had neurosurgical care following surgery or traumatic brain or spinal cord injury. Participants were offered a VR session at least once per day for the first 14 days post-surgery/injury or until discharge, whichever came first, with reasons for non-engagement collected. Primary outcomes were feasibility outcomes and secondary outcomes included rehabilitation engagement.

Results: Of the thirty-nine eligible participants approached, thirty-two participants were recruited and received VR at least once. Intervention fidelity was deemed a success, as none of the VR equipment or applications failed. Median time between injury or surgery and first VR use was three days (IQR = 8.25). The Hopkins Rehabilitation Engagement scale and Simulation Sickness Questionnaires were deemed feasible instruments to measure outcomes.

Conclusions: We confirmed feasibility of using a VR rehabilitation tool for neurosurgical patients in this study. This now facilitates progression to a multi-centre, prospective, randomised, controlled, unblinded, parallel-group trial of VR-enhanced neurorehabilitation versus standard neurorehabilitation for improving recovery after neurotrauma or neurosurgery.