Abstract
Emerging technologies like virtual reality (VR) and telerehabilitation (TR) may provide numerous advantages for treatment of patients with neuromuscular and musculoskeletal disorders. Spinal muscular atrophy (SMA), a progressive neuromuscular disorder presents challenges in motor function rehabilitation. However, to date no studies have evaluated the use and usability of new technologies in the treatment of patients with SMA. This case study examines the effectiveness of a particular VR-based telerehabilitation system, Khymeia – Virtual Reality Rehabilitation System, in improving upper limb motor recovery in a 13-year-old patient with Type 2 SMA who is receiving gene-based therapy (GBT) with Risdiplam. Motor function was assessed using the Revised Upper Limb Module (RULM), and usability of K-VRRS was evaluated with the System Usability Scale (SUS). The results indicated stable motor function during the baseline phase, with significant improvement observed at the post-treatment assessment. The SUS score reflected high usability of the K-VRRS. This suggests that combining GBT with VR-based telerehabilitation could enhance upper limb motor function in SMA patients.
Further research is needed to confirm these findings and investigate the potential of K-VRRS in enhancing patient motivation and treatment adherence in SMA rehabilitation.
G. Barraco and L. Macchitella—These authors contributed equally to this work.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Rizzo, A., Buckwalter, J., van der Zaag, C.: Virtual Environment Applications in Clinical Neuropsychology. The Handbook of Virtual Environments, pp. 1027–1064 (2002)
Spina, E., et al.: Digital technologies, web and social media study group of the Italian society of neurology (SIN): how to manage with telemedicine people with neuromuscular diseases? Neurol. Sci. 42, 3553–3559 (2021). https://doi.org/10.1007/s10072-021-05396-8
Riva, G., Mancuso, V., Cavedoni, S., Stramba-Badiale, C.: Virtual reality in neurorehabilitation: a review of its effects on multiple cognitive domains. Expert Rev. Med. Devices 17, 1035–1061 (2020). https://doi.org/10.1080/17434440.2020.1825939
Pournajaf, S., Morone, G., Goffredo, M., Bonaiuti, D., Franceschini, M., Pournajaf, S.: Realtà virtuale applicata alla riabilitazione: evidenze cliniche e prospettive future. https://springerhealthcare.it/mr/archivio/realta-virtuale-applicata-alla-riabilitazione-evidenze-cliniche-e-prospettive-future/. Accessed 11 Apr 2024
Tieri, G., Morone, G., Paolucci, S., Iosa, M.: Virtual reality in cognitive and motor rehabilitation: facts, fiction and fallacies. Expert Rev. Med. Devices 15, 107–117 (2018). https://doi.org/10.1080/17434440.2018.1425613
Piron, L., et al.: Exercises for paretic upper limb after stroke: a combined virtual-reality and telemedicine approach. J Rehabil Med 41, 1016–1102 (2009). https://doi.org/10.2340/16501977-0459
Howard, I.M., Kaufman, M.S.: Telehealth applications for outpatients with neuromuscular or musculoskeletal disorders. Muscle Nerve 58, 475–485 (2018). https://doi.org/10.1002/mus.26115
Massetti, T., et al.: The clinical utility of virtual reality in neurorehabilitation: a systematic review. J. Cent. Nerv. Syst. Dis. 10, 1179573518813541 (2018). https://doi.org/10.1177/1179573518813541
Nuara, A., Fabbri-Destro, M., Scalona, E., Lenzi, S.E., Rizzolatti, G., Avanzini, P.: Telerehabilitation in response to constrained physical distance: an opportunity to rethink neurorehabilitative routines. J. Neurol. 269, 627–638 (2022). https://doi.org/10.1007/s00415-021-10397-w
Schultheis, M.T., Rizzo, A.A.: The application of virtual reality technology in rehabilitation. Rehabil. Psychol. 46, 296–311 (2001). https://doi.org/10.1037/0090-5550.46.3.296
Turolla, A., Rossettini, G., Viceconti, A., Palese, A., Geri, T.: Musculoskeletal physical therapy during the COVID-19 pandemic: is telerehabilitation the answer? Phys. Ther. 100, 1260–1264 (2020). https://doi.org/10.1093/ptj/pzaa093
Zheng, J., Shi, P., Yu, H.: A virtual reality rehabilitation training system based on upper limb exoskeleton robot. Presented at the August 1 (2018). https://doi.org/10.1109/IHMSC.2018.00058
Trabacca, A., Lucarelli, E., Pacifico, R., Vespino, T., Di Liddo, A., Losito, L.: The international classification of functioning, disability and health-children and youth as a framework for the management of spinal muscular atrophy in the era of gene therapy: a proof-of-concept study. Eur. J. Phys. Rehabil. Med. 56, 243–251 (2020). https://doi.org/10.23736/S1973-9087.20.05968-7
Trabacca, A.: Neuromuscular diseases rehabilitation in the era of gene therapy. Neurol. Sci. 41, 1971–1972 (2020). https://doi.org/10.1007/s10072-020-04280-1
Macchitella, L., et al.: A narrative review of the use of a cutting-edge virtual reality rehabilitation technology in neurological and neuropsychological rehabilitation. NeuroRehabilitation 53, 439–457 (2023). https://doi.org/10.3233/NRE-230066
Mazzone, E.S., et al.: Revised upper limb module for spinal muscular atrophy: Development of a new module. Muscle Nerve 55, 869–874 (2017). https://doi.org/10.1002/mus.25430
Manenti, R., et al.: Effectiveness of an innovative cognitive treatment and telerehabilitation on subjects with mild cognitive impairment: a multicenter, randomized Active-Controlled Study. Front. Aging Neurosci. 12, 585988 (2020). https://doi.org/10.3389/fnagi.2020.585988
Pagliari, C., et al.: Effects of home-based virtual reality telerehabilitation system in people with multiple sclerosis: a randomized controlled trial. J. Telemedicine Telecare. 1357633X211054839-N/A (2021). https://doi.org/10.1177/1357633X211054839
Brooke, J.: SUS -- a quick and dirty usability scale. Presented at the January 1 (1996)
Mirea, A., et al.: Physical therapy and nusinersen impact on spinal muscular atrophy rehabilitative outcome. Front. Biosci. (Landmark Ed). 27, 179 (2022). https://doi.org/10.31083/j.fbl2706179
Yi, Y.G., Shin, H.-I., Jang, D.-H.: Rehabilitation of spinal muscular atrophy: current consensus and future direction. J. Genetic Med. 17, 55–61 (2020). https://doi.org/10.5734/JGM.2020.17.2.55
Billeci, L., Tonacci, A., Morales, M., Astrea, G., Battini, R.: An alternative approach to home-based rehabilitation of children with spinal muscular atrophy. Presented at the March 21 (2022). https://doi.org/10.1109/PerComWorkshops53856.2022.9767459
Bangor, A., Kortum, P.T., Miller, J.T.: An empirical evaluation of the system usability scale. Int. J. Hum.-Comput. Interact. 24, 574–594 (2008). https://doi.org/10.1080/10447310802205776
Pera, M.C., et al.: ISMAC Consortium Group: revised upper limb module for spinal muscular atrophy: 12 month changes. Muscle Nerve 59, 426–430 (2019). https://doi.org/10.1002/mus.26419
Nissen, T., Wynn, R.: The clinical case report: a review of its merits and limitations. BMC. Res. Notes 7, 264 (2014). https://doi.org/10.1186/1756-0500-7-264
Acknowledgments
This research was funded by the “5 per mille” 2021 – funds for biomedical research by Antonio Trabacca and by the Italian Ministry of Health (Ricerca Corrente funds).
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Ethics declarations
Disclosure of Interests
The authors have no competing interests to declare that are relevant to the content of this article.
Rights and permissions
Copyright information
© 2024 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this paper
Cite this paper
Barraco, G., Macchitella, L., Accogli, G., Pirani, G., Nicolardi, V., Trabacca, A. (2024). Exploring the Application and Usability of Emerging Technologies in Neuromotor Rehabilitation for a Patient with 5Q-Spinal Muscular Atrophy Type 2 Receiving a Gene-Based Therapy: A Single Case Study. In: De Paolis, L.T., Arpaia, P., Sacco, M. (eds) Extended Reality. XR Salento 2024. Lecture Notes in Computer Science, vol 15029. Springer, Cham. https://doi.org/10.1007/978-3-031-71710-9_4
Download citation
DOI: https://doi.org/10.1007/978-3-031-71710-9_4
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-71709-3
Online ISBN: 978-3-031-71710-9
eBook Packages: Computer ScienceComputer Science (R0)