Virtual Reality Impact on Powered Mobility: a Feasibility Study
NCT ID: NCT06586125
Last Updated: 2025-08-01
Study Results
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Basic Information
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COMPLETED
10 participants
OBSERVATIONAL
2023-09-04
2025-06-30
Brief Summary
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Detailed Description
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Virtual reality (VR) offers a portable solution for safe training at home. However, current VR simulators have not been developed to assess users\' driving skills, and they typically allow control via joysticks or hand trackers, which are unusable for individuals with severe upper limb motor impairments. In this context, brain-computer interfaces (BCIs) represent a potential innovative control interface.
Integrating VR into powered wheelchair (PW) training introduces new possibilities for enhancing rehabilitation programs by offering engaging and personalized experiences tailored to the unique needs of children with CP and NMDs. The VR Powered Mobility Program (VR-PMP), which integrates 3D gaming tailored to PMP tasks accessible via laptops or VR headsets, aims to harness the potential of VR to enhance PW training. VR-PMP seeks to facilitate motor learning through repetitive practice in realistic and engaging contexts.
The primary objective of this study is to assess the feasibility of using immersive and semi-immersive VR for powered mobility (PM) training and to determine the impact of VR technologies on PW driving skills in children with CP and NMDs, including those with severe upper limb motor impairments.
The secondary aims are:
To assess the impact of VR: evaluating the use of VR on the level of assistance, supervision, and autonomy in PW driving, measured through the overall PMP score, comparing PMP scores obtained before and after VR training to determine improvements in PW driving skills.
To correlate physiological signals collected during VR-PMP sessions with motion sickness and workload assessments to understand stress levels and engagement.
To investigate the usability and satisfaction with the VR PMP system through questionnaires and scales, focusing on the feasibility of home training sessions for driving practice.
Conditions
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Study Design
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CASE_ONLY
PROSPECTIVE
Study Groups
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VR - based training
Five children and adolescents with cerebral palsy and/or neuromuscular disease and five children and adolescents with cerebral palsy and/or neuromuscular disease with difficulties to control the VR joysticks
Powered Mobility Training
The study procedure aims to observe the partecipants' behaviour while using the Virtual Reality - Power Mobility Program (VR-PMP) simulator applied during Power Mobility Training in clinical practice for 15 sessions. Participants use either semi-immersive mode (laptop screen with VR-PMP simulator) or immersive mode (head-mounted display with VR-PMP simulator). Five out of ten children unable to use conventional VR controllers or alternative access technologies available on the market, use brain-computer interface (BCI) developed specifically for these children to control the VR-PMP simulator.
Interventions
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Powered Mobility Training
The study procedure aims to observe the partecipants' behaviour while using the Virtual Reality - Power Mobility Program (VR-PMP) simulator applied during Power Mobility Training in clinical practice for 15 sessions. Participants use either semi-immersive mode (laptop screen with VR-PMP simulator) or immersive mode (head-mounted display with VR-PMP simulator). Five out of ten children unable to use conventional VR controllers or alternative access technologies available on the market, use brain-computer interface (BCI) developed specifically for these children to control the VR-PMP simulator.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Age between 6 and 20 years
* Clinical diagnosis: Central motor disability with Gross Motor Function Classification Scale (GMFCS) levels 3-4-5
* Owner of a powered wheelchair or a manual wheelchair with an electric propulsion system
* Powered Mobility Program (PMP) score \> 0 in basic skills
* Signed informed consent
Exclusion Criteria
* Severe cognitive impairments
6 Years
20 Years
ALL
No
Sponsors
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Azienda Usl di Bologna
OTHER_GOV
Responsible Party
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Principal Investigators
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Antonella Cersosimo, Dr.
Role: PRINCIPAL_INVESTIGATOR
IRCCS Istituto delle Scienze Neurologiche di Bologna
Locations
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IRCCS Istituto delle Scienze Neurologiche di Bologna
Bologna, Bologna, Italy
Countries
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References
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Graham HK, Rosenbaum P, Paneth N, Dan B, Lin JP, Damiano DL, Becher JG, Gaebler-Spira D, Colver A, Reddihough DS, Crompton KE, Lieber RL. Cerebral palsy. Nat Rev Dis Primers. 2016 Jan 7;2:15082. doi: 10.1038/nrdp.2015.82.
Mercuri E, Muntoni F. Muscular dystrophies. Lancet. 2013 Mar 9;381(9869):845-60. doi: 10.1016/S0140-6736(12)61897-2.
Jones MA, McEwen IR, Neas BR. Effects of power wheelchairs on the development and function of young children with severe motor impairments. Pediatr Phys Ther. 2012 Summer;24(2):131-40; discussion 140. doi: 10.1097/PEP.0b013e31824c5fdc.
Rosen L, Plummer T, Sabet A, Lange ML, Livingstone R. RESNA position on the application of power mobility devices for pediatric users. Assist Technol. 2023 Jan 2;35(1):14-22. doi: 10.1080/10400435.2017.1415575. Epub 2018 Mar 26.
Bottos M, Bolcati C, Sciuto L, Ruggeri C, Feliciangeli A. Powered wheelchairs and independence in young children with tetraplegia. Dev Med Child Neurol. 2001 Nov;43(11):769-77. doi: 10.1017/s0012162201001402.
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Kirby RL, Dupuis DJ, Macphee AH, Coolen AL, Smith C, Best KL, Newton AM, Mountain AD, Macleod DA, Bonaparte JP. The wheelchair skills test (version 2.4): measurement properties. Arch Phys Med Rehabil. 2004 May;85(5):794-804. doi: 10.1016/j.apmr.2003.07.007.
Gefen N, Weiss PL, Rigbi A, Rosenberg L. Lessons learned from a pediatric powered mobility lending program. Disabil Rehabil Assist Technol. 2024 Aug;19(6):2250-2259. doi: 10.1080/17483107.2023.2276232. Epub 2023 Oct 28.
Field DA, Livingstone RW. Power mobility skill progression for children and adolescents: a systematic review of measures and their clinical application. Dev Med Child Neurol. 2018 Oct;60(10):997-1011. doi: 10.1111/dmcn.13709. Epub 2018 Mar 14.
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Gefen N, Archambault PS, Rigbi A, Weiss PL. Pediatric powered mobility training: powered wheelchair versus simulator-based practice. Assist Technol. 2023 Sep 3;35(5):389-398. doi: 10.1080/10400435.2022.2084183. Epub 2022 Jun 23.
Gefen N, Rigbi A, Weiss PLT. Reliability and validity of pediatric powered mobility outcome measures. Disabil Rehabil Assist Technol. 2022 Nov;17(8):882-887. doi: 10.1080/17483107.2020.1819449. Epub 2020 Sep 12.
Gefen N, Rigbi A, Archambault PS, Weiss PL. Comparing children's driving abilities in physical and virtual environments. Disabil Rehabil Assist Technol. 2021 Aug;16(6):653-660. doi: 10.1080/17483107.2019.1693644. Epub 2019 Dec 5.
Gefen N, Rigbi A, Weiss PL. Predictive model of proficiency in powered mobility of children and young adults with motor impairments. Dev Med Child Neurol. 2019 Dec;61(12):1416-1422. doi: 10.1111/dmcn.14264. Epub 2019 May 21.
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Demers L, Weiss-Lambrou R, Ska B. Item analysis of the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST). Assist Technol. 2000;12(2):96-105. doi: 10.1080/10400435.2000.10132015.
Gianaros PJ, Muth ER, Mordkoff JT, Levine ME, Stern RM. A questionnaire for the assessment of the multiple dimensions of motion sickness. Aviat Space Environ Med. 2001 Feb;72(2):115-9.
Salimi Z, Ferguson-Pell MW. Motion sickness and sense of presence in a virtual reality environment developed for manual wheelchair users, with three different approaches. PLoS One. 2021 Aug 19;16(8):e0255898. doi: 10.1371/journal.pone.0255898. eCollection 2021.
Laurie-Rose C, Frey M, Ennis A, Zamary A. Measuring perceived mental workload in children. Am J Psychol. 2014 Spring;127(1):107-25. doi: 10.5406/amerjpsyc.127.1.0107.
Other Identifiers
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002.2022.ISNB.NeuroRehab.MRI
Identifier Type: -
Identifier Source: org_study_id
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