Virtual Reality for paediatric Duchenne Muscular Dystrophy patients
Research type
Research Study
Full title
Investigating the viability and acceptability of an Interactive Virtual Reality (IVR) System on physiotherapy rehabilitation in paediatric Duchenne Muscular Dystrophy (DMD) patients
IRAS ID
310662
Contact name
Paul Dimitri
Contact email
Sponsor organisation
Sheffield Children's NHS Foundation Trust
Clinicaltrials.gov Identifier
Duration of Study in the UK
0 years, 9 months, 28 days
Research summary
Research Summary
Duchenne Muscular Dystrophy (DMD) is a genetic disease causing muscle weakness and wasting affecting 2,500 people in the UK. International Standards of Care recommend that children with DMD undertake a daily stretching programme to maintain maximum muscle extensibility and optimise function. Many boys find it difficult to consistently engage in physiotherapy exercises, leading to earlier complications, reduced function and a poorer long-term prognosis.
Our collaborative research group has previously developed an interactive Immersive Virtual Reality (IVR) system to improve the delivery, engagement and success of physiotherapy for adult amputees, burns’ patients and children with upper limb injuries. VR headsets have become more accessible in terms of price, usability and portability.In a recent PPI survey (appendix A), 78% of paediatric DMD patients stated that a VR system could improve physiotherapy engagement and performance. This study will investigate the feasibility and acceptability of an IVR device on paediatric DMD rehabilitation.
It is envisaged that the study will have 4 phases:
• Phase 1: An IVR platform will be developed that will emulate current DMD physiotherapy.
• Phase 2: Therapists and children will test the IVR platform in a development workshop.
• Phase 3: VR scenarios will be further developed and tested in a trial with 16 DMD patients aged 6-12 years.
• Phase 4: Commercialisation review of market opportunities.In phase 3, pre and post-trial assessments will be performed to determine the effect of the IVR system on improving physiotherapy adherence, and to see if there are effects on muscle length and functional strength using qualitative assessments. Interviews and questionnaires will be conducted with patients and clinical staff to obtain feedback on acceptability and practicality of using IVR in a clinical setting.
This study will help determine if an IVR system can improve adherence to physiotherapy exercises of young patients with DMD.
Summary of Results
Participants and their caregivers were invited to take part in a qualitative interview to feedback on their experiences using the device during the trial. All participants reported being satisfied with the explanation and understanding of the system and its configuration provided by the team to the clinic, as well as finding the tutorial very useful. When technical problems arose in the home environment, participants reported that these were swiftly resolved with a call to the research manager.
When asked about their enjoyment in using the device, participants reported thatin the first instance they found the game interesting and fun. A number of participants, however, stated that once the first few sessions had been completed, they found that the game became very difficult, boring and frustrating to play, citing difficulty to progress in the game as a big issue with their enjoyment.
When asked about the rehabilitation benefit of the game, participants felt that the fact that the exercises themselves are not integrated into the mechanics of the game was a big barrier to their enjoyment. The platform was perceived as external to the physiotherapy exercises, meaning that participants often perceived the platform as increasing their burden, and they would rather complete the games they are already familiar with. All participants interviewed reported adhering closely to the physio exercises prescribed prior to the VR intervention, and so the intervention did not change their performance and motivation to perform their exercise.
In conclusion, the game format appears to be appealing and the participants enjoyed using it. However, the levels of difficulty and comprehension of the game dynamics, along with a lack of integration of the exercises, needs to be reviewed, as there is a lack of understanding of how the exercises relate to the game progression. The game has the potential to benefit patients who are reluctant to complete their exercises or are not yet accustomed to them. However, in this group, the recruited participants were already adhering well to the prescribed exercises, and so found minimal clinical benefit.
REC name
East Midlands - Leicester South Research Ethics Committee
REC reference
22/EM/0022
Date of REC Opinion
21 Mar 2022
REC opinion
Further Information Favourable Opinion