RECOVR REALITY - Recover after injury or surgery to the brain and spinal cord with virtual Reality: IDEAL Stage 2a Clinical Feasibility Study

Abstract Aim Neurorehabilitation is fundamental to improve outcomes for patients recovering from injury to the central nervous system. Access to neurorehabilitation is limited by resource shortages; the consequences of which are unfulfilled therapy needs, longer hospital stays and detrimental effects on quality of life. Virtual reality (VR) could be used to enhance neurorehabilitation in a self-directed, safe, virtual environment. The aim of this study is to investigate the feasibility of a VR rehabilitation programme in an acute neurosurgical inpatient environment to improve neurorehabilitation. Method A single-group, prospective, clinical feasibility study was conducted in a tertiary UK neurosurgical department. The study included patients aged 16 and over who had neurosurgical care following surgery or traumatic brain or spinal cord injury. Participants were offered a VR session at least once per day for the first 14 days post-surgery/injury or until discharge, whichever came first, with reasons for non-engagement collected. Primary outcomes were feasibility outcomes and secondary outcomes included rehabilitation engagement. Results Of the thirty-nine eligible participants approached, thirty-two participants were recruited and received VR at least once. Intervention fidelity was deemed a success, as none of the VR equipment or applications failed. Median time between injury or surgery and first VR use was three days (IQR = 8.25). The Hopkins Rehabilitation Engagement scale and Simulation Sickness Questionnaires were deemed feasible instruments to measure outcomes. Conclusions We confirmed feasibility of using a VR rehabilitation tool for neurosurgical patients in this study. This now facilitates progression to a multi-centre, prospective, randomised, controlled, unblinded, parallel-group trial of VR-enhanced neurorehabilitation versus standard neurorehabilitation for improving recovery after neurotrauma or neurosurgery.