A virtual tabletop workspace for upper-limb rehabilitation in Traumatic Brain Injury (TBI): A multiple case study evaluation

Deficits in upper limb function are common among patients with traumatic brain injury (TBI). Accordingly, new technologies, such as virtual reality (VR), are being developed to further upper limb rehabilitation. The study described here successfully trialed a table-top VR-based system (called Elements). Two patients with TBI participated in case-studies using a multiple-baseline, AB time-sequence design; the intervention consisted of 12 1-hour sessions. Performance was measured on both system-rated measures and standardized tests of functional skill. Time-sequence plots for each patient were first sight inspected for trends; this was followed by split-middle trend analysis. Participants demonstrated significant improvements in their movement accuracy, efficiency, and bimanual dexterity; and mixed improvement on speed and other measures of movement skill. Taken together, these findings demonstrate that the Elements system facilitated motor learning in both TBI patients. Larger scale clinical trials are now deemed a viable step in further validating the system.