Assessment of Task Demand and Usability of a Virtual Reality-Based Rehabilitation Protocol for Combat Related Traumatic Brain Injury From the Perspective of Veterans Affairs Healthcare Providers: A Pilot Study

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.

与非退伍军人相比，退伍军人创伤性脑损伤（TBI）的风险明显更高。由于距离、经济和公共安全（如新冠感染）等障碍，获得创伤性脑损伤及脑震荡后症状的治疗有时很困难。虚拟现实康复（VRR）提供了一个将虚拟空间融入康复环境的机会。据我们所知，虚拟现实康复尚未用于帮助患有创伤性脑损伤及相关健康问题的退伍军人进行工具性日常生活活动（iADLs）。本研究的目的是调查由美国空军研究实验室的游戏研究整合学习实验室（GRILL®）开发的一种新型虚拟现实康复日常生活活动和工具性日常生活活动训练方案对患有创伤性脑损伤的退伍军人进行认知康复的可用性。我们在医疗服务提供者（n = 20）中部署了一个原型方案，以获取关于可用性、任务要求和建议调整的反馈。我们的初步分析表明，提供者发现虚拟现实康复方案的体力要求较低，并可能会将其推荐给他们的患者。尽管他们对使用数字技术产生的类似眩晕的症状有些担忧，但他们相信该方案将改善工具性日常生活活动功能，是对现有康复方案的一个很好的补充。这些结果为在患有创伤性脑损伤的退伍军人中开展更有影响力的研究以调查该方案的有效性提供了依据。