Virtual Activities of Living for Occupational Rehabilitation

PROJECT SUMMARY/ABSTRACT Introduction: The Virtual Activities of Living for Occupational Rehabilitation (VALOR) SBIR program will support telehealth delivery and remote monitoring of upper extremity (UE) stroke rehabilitation through the practice of virtual activities of daily living (ADLs) and instrumental ADLs (IADLs). The VALOR system marries ground- breaking untethered virtual reality (VR) headset technology and deep learning runtime 3D motion tracking with an existing suite of digital ADL/IADL content to enable functional, repetitive task practice at home with telehealth support. A key technological breakthrough is markerless tracking that employs cameras built into a low-cost VR headset, enabling patients to manually engage in virtual occupations using their affected UE. The VALOR Phase I program pursues two primary investigational objectives through a pilot study conducted by Duke University: (1) assess the usability and technology acceptance of immersive VR ADL/IADL practice for UE therapy by older adult stroke patients; and (2) establish the validity of immersive virtual ADL/IADL practice for tracking a patient's UE motor status to enable telehealth feedback and monitoring. Technical work in Phase I includes integration of a runtime neural network for real-time UE tracking with an existing suite of virtual ADLs/IADLs (originally developed for a non-immersive, PC-based system using the Kinect) to support immersive VR using a low cost standalone, untethered headset (no PC, no monitor, and no additional sensors required). Problem to be addressed: The COVID-19 pandemic exposed a critical lack of options for delivering an evidence-based UE intervention via telehealth. Innovative solutions are needed to enable patients to safely participate from home in a therapist-monitored therapy program. Approximately 50% of the rt795,000 individuals hospitalized due to stroke each year in the U.S. suffer from chronic deficits in UE function [1], [2]. Existing clinical therapy systems for immersive VR are too expensive, complex, and/or bulky for use in patients' homes. Game consoles, exergames, or slipshod, non-evidence-based adaptations of VR technology do not address the integrated motor and cognitive skills required to achieve functional independence in daily living activities. Long-Term Goal: Improved outcomes and functional independence for patients with neurological injury. Phase I Summary: Phase I will produce a prototype VALOR system that consists of a mobile software application that runs on an Oculus Quest 2 untethered (i.e., wireless) VR headset. At least 3 immersive ADL/IADL activities will be fully integrated and tested, leveraging an existing library of virtual world assets from a non- immersive clinical VR system. A pilot study conducted by Duke University with stroke patients will demonstrate usability and technology acceptance, and investigate the hypothesis that metrics captured during immersive ADL/IADL practice will have high criterion validity with respect to gold standard measures of UE function. Commercial Opportunity: The VALOR product is poised to rapidly transition through well-established marketing and distribution channels to meet a critical need for evidence-based telehealth occupational therapy.