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Feasibility of Occupation-Based Immersive Virtual Reality for Upper-Limb Rehabilitation After Stroke

2026年11月10日 更新者:Dimosthenis Lygouras、Democritus University of Thrace

Pilot Feasibility Study of an Occupation-Based Immersive Virtual Reality Intervention for Upper-Limb Rehabilitation After Stroke

This ongoing, single-group pilot feasibility study aims to evaluate the feasibility, usability, and acceptability of an occupation-based immersive virtual reality (IVR) rehabilitation program for adults with stroke-related upper-limb impairment. The study has an anticipated enrollment of 20 participants, of whom eight were enrolled during the initial recruitment period.

The intervention consists of 12 supervised sessions per participant, each including approximately 30 minutes of virtual activities delivered through two custom-developed IVR applications, Virtual Gardening and Virtual Painting, using a Meta Quest 2 head-mounted display (HMD). The intervention is provided as an adjunct to usual occupational therapy.

The study examines intervention completion, session delivery, gameplay duration, technical interruptions, safety, user satisfaction, symptoms associated with virtual reality exposure, and participation during rehabilitation sessions. Upper-limb motor function and independence in activities of daily living are also assessed as exploratory clinical outcomes.

The primary aim is to determine whether this occupation-based IVR rehabilitation program can be feasibly implemented in clinical practice and to identify areas for improvement before larger-scale studies. The study is not designed to establish the effectiveness of the intervention compared with conventional rehabilitation.

調査の概要

状態

募集

条件

介入・治療

詳細な説明

The intervention was developed through a stakeholder-informed process that incorporated occupational therapists' perspectives, stroke survivors' activity preferences, task-level characterization, and preliminary usability evaluation. Two custom-developed IVR applications, Virtual Gardening and Virtual Painting, were implemented using Unity and delivered through a Meta Quest 2 HMD.

This ongoing, single-group pilot feasibility study has an anticipated enrollment of 20 adults with stroke-related upper-limb impairments. Eight participants were enrolled during the initial recruitment period, and recruitment is continuing toward the planned sample size. Participants are scheduled to receive 12 supervised IVR sessions as an adjunct to their usual occupational therapy.

Each session is planned to include approximately 30 minutes of virtual activities: 10 minutes of structured Gardening, 10 minutes of structured Painting, 5 minutes of free Gardening, and 5 minutes of free Painting. Rest breaks and therapist assistance are provided according to individual needs.

The applications include graded activities involving reaching, object interaction, upper-limb coordination, and creative engagement. Different interaction modes, including affected-hand interaction and mirrored control using the unaffected hand, are available to accommodate individual functional abilities. All activities are performed in a seated position under therapist supervision.

Exploratory clinical outcomes include upper-limb motor impairment, assessed using the Fugl-Meyer Assessment for the Upper Extremity (FMA-UE), and independence in activities of daily living, assessed using the Barthel Index. Both measures are administered at baseline (before the first intervention session) and after completion of session 12.

User satisfaction and experience are assessed using the User Satisfaction Evaluation Questionnaire (USEQ), while symptoms associated with virtual reality exposure are monitored using the Simulator Sickness Questionnaire (SSQ). Both questionnaires are administered after intervention sessions 1, 6, and 12.

Participation during rehabilitation is assessed by the therapist using the Pittsburgh Rehabilitation Participation Scale (PRPS) during each intervention session (sessions 1-12).

The study is conducted in supervised rehabilitation settings in Larissa, Greece. Its primary purpose is to examine the feasibility, usability, safety, and acceptability of the occupation-based IVR intervention and to inform the design of future larger-scale investigations. As a single-group pilot feasibility study without a control group, it is not designed to establish treatment efficacy or comparative effectiveness against conventional rehabilitation.

研究の種類

介入

入学 (推定)

20

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

  • 名前:Dimosthenis Lygouras, MSc
  • 電話番号:+306982897261
  • メール:dlygoura@cs.duth.gr

研究場所

    • Thessaly
      • Larissa、Thessaly、ギリシャ
        • 募集
        • Adult Day Care Center Agkaliazhn
        • コンタクト:
      • Larissa、Thessaly、ギリシャ
        • 募集
        • Animus Rehabilitation & Recovery Center
        • コンタクト:
        • 主任研究者:
          • Dimosthenis Lygouras, MSc

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年~90年 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

Inclusion Criteria:

  • Confirmed diagnosis of ischemic or hemorrhagic stroke.
  • Age between 18 and 90 years.
  • First-ever or recurrent stroke associated with acquired motor impairment of the upper limb.
  • Stroke occurring at least 2 months before enrollment.
  • Sufficient cognitive and communicative ability to understand study instructions and complete the questionnaires, defined as a Mini-Mental State Examination (MMSE) score of 24 or higher.
  • Ability to safely participate in an immersive virtual reality (IVR) session using the Meta Quest 2.
  • Greek as the participant's primary language.

Exclusion Criteria:

  • Need for continuous medical monitoring or medical care that could not be safely accommodated during study procedures.
  • Active medical conditions that could interfere with participation or safe IVR exposure, including acute fractures, active skin ulcers, uncontrolled cardiovascular, circulatory, hepatic, or renal conditions, and other clinically significant unstable comorbidities.
  • Epilepsy or a history of seizures considered clinically relevant to IVR exposure.
  • Uncontrolled diabetes mellitus or hypertension.
  • Active malignancy requiring urgent treatment.
  • Severe aphasia or other communication impairments preventing the participant from understanding instructions or completing study questionnaires.
  • Significant visual impairment incompatible with the use of the Meta Quest 2.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:なし
  • 介入モデル:単一グループの割り当て
  • マスキング:なし(オープンラベル)

武器と介入

参加者グループ / アーム
介入・治療
実験的:Occupation-Based Immersive Virtual Reality Rehabilitation

Participants receive a 12-session, therapist-supervised, occupation-based IVR rehabilitation program as an adjunct to conventional occupational therapy. The program includes two custom-developed virtual activities, Virtual Gardening and Virtual Painting, delivered using a Meta Quest 2. Activities include structured, graded tasks and free exploration, with interaction modes adapted to participants' upper-limb functional abilities. Participants continue to receive their usual occupational therapy throughout the study.

The intervention consists of 12 supervised immersive virtual reality (IVR) sessions using two occupation-based applications: Virtual Gardening and Virtual Painting. Each session is planned to include approximately 30 minutes of virtual activities: 10 minutes of structured Gardening, 10 minutes of structured Painting, 5 minutes of free Gardening, and 5 minutes of free Painting.

Gardening activities include reaching toward leaves, harvesting virtual olives, planting seeds, and watering plants. Painting activities include tracing geometric and representational shapes and creating drawings using virtual brushes and colours.

The applications provide graded task difficulty, affected-hand interaction, mirrored control using the unaffected hand, and free exploration. Participants interact with the virtual environment using a Meta Quest 2 head-mounted display and controllers while seated, under therapist supervision. Rest breaks and assistance are provided according to individual needs.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Intervention Completion Rate
時間枠:From enrollment to completion of the 12-session intervention (approximately 4 weeks per participant).

Percentage of enrolled participants who completed the planned 12-session immersive virtual reality rehabilitation program. Calculated as the number of participants completing the intervention divided by the total number enrolled, multiplied by 100.

From enrollment to completion of the 12-session intervention (approximately 4 weeks per participant).
Session Delivery Rate
時間枠:Throughout the 12-session intervention period (approximately 4 weeks per participant).

Percentage of planned immersive virtual reality rehabilitation sessions that were delivered. Calculated as the number of sessions delivered divided by the total number of sessions planned across enrolled participants, multiplied by 100.

Throughout the 12-session intervention period (approximately 4 weeks per participant).

二次結果の測定

結果測定
メジャーの説明
時間枠
Upper-Limb Motor Impairment - Fugl-Meyer Assessment for the Upper Extremity (FMA-UE)
時間枠:Baseline (before intervention) and after session 12 (approximately 4 weeks).

Change in upper-limb motor impairment assessed using the FMA-UE. The motor function subscale ranges from 0 to 66, with higher scores indicating better upper-limb motor performance. Changes from baseline to the post-intervention assessment will be examined.

Baseline (before intervention) and after session 12 (approximately 4 weeks).
Independence in Activities of Daily Living - Barthel Index(BI)
時間枠:Baseline (before intervention) and after session 12 (approximately 4 weeks).

Change in independence in basic activities of daily living assessed using the BI. Total scores range from 0 to 100, with higher scores indicating greater functional independence. Changes from baseline to the post-intervention assessment will be examined.

Baseline (before intervention) and after session 12 (approximately 4 weeks).
User Satisfaction - User Satisfaction Evaluation Questionnaire (USEQ)
時間枠:After session 1, after session 6 (approximately 2 weeks), and after session 12 (approximately 4 weeks).

Participant-reported satisfaction and user experience with immersive virtual reality, assessed using the USEQ. Responses are rated on a five-point Likert scale, with higher scores on positively worded items indicating greater satisfaction. Discomfort-related items are interpreted separately.

After session 1, after session 6 (approximately 2 weeks), and after session 12 (approximately 4 weeks).
Simulator Sickness Symptoms - Simulator Sickness Questionnaire (SSQ)
時間枠:After session 1, after session 6 (approximately 2 weeks), and after session 12 (approximately 4 weeks).

Symptoms associated with virtual reality exposure, including nausea, oculomotor discomfort, and disorientation, assessed using the SSQ. Higher scores indicate greater symptom severity.

After session 1, after session 6 (approximately 2 weeks), and after session 12 (approximately 4 weeks).
Rehabilitation Participation - Pittsburgh Rehabilitation Participation Scale (PRPS)
時間枠:During each intervention session (sessions 1-12), over approximately 4 weeks per participant.

Therapist-rated participation during immersive virtual reality rehabilitation sessions, assessed using the PRPS. Scores range from 1 to 6, with higher scores indicating greater participation.

During each intervention session (sessions 1-12), over approximately 4 weeks per participant.

その他の成果指標

結果測定
メジャーの説明
時間枠
Documented Gameplay Duration
時間枠:During each delivered intervention session (sessions 1-12), over approximately 4 weeks per participant.

Duration of active immersive virtual reality gameplay, recorded in minutes during each intervention session. Descriptive statistics will summarize the documented gameplay duration across delivered sessions.

During each delivered intervention session (sessions 1-12), over approximately 4 weeks per participant.
Technical Interruptions
時間枠:During each delivered intervention session (sessions 1-12), over approximately 4 weeks per participant.

Number and proportion of delivered immersive virtual reality sessions affected by technical interruptions, including headset tracking problems, controller connectivity issues, or signal loss.

During each delivered intervention session (sessions 1-12), over approximately 4 weeks per participant.
Adverse Events
時間枠:From the first intervention session through completion of session 12, approximately 4 weeks per participant.

Number and description of adverse events documented during the immersive virtual reality intervention, including symptoms or incidents potentially associated with virtual reality exposure. Events will be summarized descriptively.

From the first intervention session through completion of session 12, approximately 4 weeks per participant.

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2026年1月12日

一次修了 (推定)

2027年7月20日

研究の完了 (推定)

2027年7月20日

試験登録日

最初に提出

2026年11月4日

QC基準を満たした最初の提出物

2026年11月10日

最初の投稿 (実際)

2026年11月13日

学習記録の更新

投稿された最後の更新 (実際)

2026年11月13日

QC基準を満たした最後の更新が送信されました

2026年11月10日

最終確認日

2026年11月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • DUTH-IVR-STROKE-2025-01

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

いいえ

IPD プランの説明

The individual participant data generated during this study will not be publicly shared due to participant confidentiality considerations and the small sample size. Aggregated study findings will be reported in the resulting publications.

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。