Validity of a Fully-Immersive VR-Based Version of the Box and Blocks Test for Upper Limb Function Assessment in Parkinson’s Disease

Abstract

In recent decades, gaming technology has been accepted as a feasible method for complementing traditional clinical practice, especially in neurorehabilitation; however, the viability of using 3D Virtual Reality (VR) for the assessment of upper limb motor function has not been fully explored. For that purpose, we developed a VR-based version of the Box and Blocks Test (BBT), a clinical test for the assessment of manual dexterity, as an automated alternative to the classical procedure. Our VR-based BBT (VR-BBT) integrates the traditional BBT mechanics into gameplay using the Leap Motion Controller (LMC) to capture the user’s hand motion and the Oculus Rift headset to provide a fully immersive experience. This paper focuses on evaluating the validity of our VR-BBT to reliably measure the manual dexterity in a sample of patients with Parkinson’s Disease (PD). For this study, a group of twenty individuals in a mild to moderate stage of PD were recruited. Participants were asked to perform the physical BBT (once) and our proposed VR-BBT (twice) system, separately. Correlation analysis of collected data was carried out. Statistical analysis proved that the performance data collected by the VR-BBT significantly correlated with the conventional assessment of the BBT. The VR-BBT scores have shown a significant association with PD severity measured by the Hoehn and Yahr scale. This fact suggests that the VR-BBT could be used as a reliable indicator for health improvements in patients with PD. Finally, the VR-BBT system presented high usability and acceptability rated by clinicians and patients.

Effectiveness of Virtual Reality on Functional Performance after Spinal Cord Injury: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Immersive VR devices are more expensive and may need an adequate training to use [ 41 ], and they also need further development in order to integrate this technology into the clinical neurorehabilitation [ 44 ]. These systems allow ADLs to be practiced in safe virtual scenarios, to optimize motor learning [ 45 ], and even to assess and measure the different motor conditions [ 46 ]. Therefore, VR devices could be a promising tool in clinical settings for the rehabilitation of patients with neurological disorders.…”

Virtual Reality Systems for Upper Limb Motor Function Recovery in Patients With Spinal Cord Injury: Systematic Review and Meta-Analysis

“…VR systems allow the creation of virtual environments that can be used to practice, under controlled conditions, different activities that could be hazardous in a real-world setting [ 6 ]. Different characteristics such as difficulty, intensity, exposure duration, and feedback can be adjusted to provide personalized experiences [ 7 ]. Furthermore, VR and interactive video gaming are presented as a motivational therapy that could increase patient adherence to treatment [ 8 , 9 ].…”

Exergaming as Part of the Telerehabilitation Can Be Adequate to the Outpatient Training: Preliminary Findings of a Non-randomized Pilot Study in Parkinson's Disease

“…Significant improvements of strength, fine and gross coordination, dexterity, and speed of movement were shown. The findings on comparable outcomes with the physical world lead to the validation of fully-immersive VR Box and Blocks Test ( 37 ). The authors suggested that virtual BBT could be used as a reliable indicator and may be accepted by clinicians and patients.…”