Abstract
The risk of traumatic brain injury (TBI) is significantly higher among Veterans compared to non- Veterans. Access to treatment for TBI and post concussive symptoms is sometimes difficult, because of barriers related to distance, finances, and public safety (i.e., COVID-19 infection). Virtual reality rehabilitation (VRR) offers an opportunity to incorporate a virtual space into a rehabilitation environment. To our knowledge, VRR has not been used to assist Veterans with TBI and related health problems with Instrumental Activities of Daily Living (iADLs). The purpose of this study is to investigate the usability of a novel VRR ADL and iADL training protocols, developed by the Gaming Research Integration for Learning Laboratory (GRILL®) at the Air Force Research Laboratory, for cognitive rehabilitation for Veterans with a TBI. We deployed a prototype protocol among healthcare providers (n = 20) to obtain feedback on usability, task demand, and recommended adjustments. Our preliminary analysis shows that providers found the VRR protocol involved low physical demand and would likely recommend it to their patients. Although they had some concerns with vertigo-like symptoms from using a digital technology, they believed the protocol would improve iADL functioning and was a good addition to pre-existing rehabilitation protocols. These outcomes provide justification for more impactful studies investigating the effectiveness of this protocol among Veterans with TBI.
Highlights
Since 2001, up to 23% of deployed service members sustained a traumatic brain injury (TBI) while in combat, and there are currently 415,000 within the Veterans Affairs (VA) Healthcare System receiving treatment for a TBI (Apkarian et al, 2004)
Healthcare access is limited for certain underrepresented populations including veterans who live in rural areas or have no access to VA based care (Ohl et al, 2018)
33.7% of respondents reported in this survey conducted during the early stages of the pandemic that they relied on in-person interaction for Physical Therapy (PT) which was not possible while 20.5% said they had surgery or other appointments that were cancelled (Chronic Pain and COVID-19, 2020)
Summary
Since 2001, up to 23% of deployed service members sustained a traumatic brain injury (TBI) while in combat, and there are currently 415,000 within the Veterans Affairs (VA) Healthcare System receiving treatment for a TBI (Apkarian et al, 2004). Healthcare access is limited for certain underrepresented populations including veterans who live in rural areas or have no access to VA based care (Ohl et al, 2018) This finding is mirrored in a recent survey conducted by the United States pain foundation on April 15th, 2020, in which 77.4% of respondents faced barriers to medical care, such as travel, financial distress, and stigmatization, leading to untreated healthcare needs during the pandemic (Chronic Pain and COVID-19, 2020). The SARSCoV-2 pandemic of 2020, commonly known as COVID-19, has exacerbated these issues by exposing potentially high-risk populations to a deadly virus when visiting a clinic or health care center (Chronic Pain and COVID-19, 2020; Ronnie, 2021) These findings illustrate the need for an effective in-home rehabilitation treatment protocol
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