Virtual Reality (VR) and Goniometric Methods: Reliability Comparisons for Documenting Shoulder Ranges of Motion

PURPOSE: There have been significant advances in virtual reality (VR) technology in program applications and associated equipment costs. The combination of the Oculus Rift and the XRHealth clinical program represented an opportunity to explore the use of VR for assessment and treatment applications. This study sought to compare the reliability of using the universal goniometer method with the use of VR technology to objectively measure shoulder flexion and abduction active ranges of motions (AROM).

DESIGN: An experimental randomized controlled trial was conducted using a sample size of 40 adult subjects ranging in age between 18 to 62 years old with an average age of 28.8 years old, 12 males and 28 females. The participants were a composite of students, faculty, local community, and staff. Participants included in the study reported no known space occupying lesions of shoulder region, current shoulder fractures, diagnosed shoulder related neurological symptoms/signs, malignant conditions related to the shoulders that may cause pain, or other acute shoulder conditions. Participants were excluded from the study if they reported any of the above shoulder issues.

METHOD: A total of 40 subjects participated in the study with each subject having both their right and left shoulder flexion and abduction ranges of motions measured using the universal goniometer method and a virtual reality (VR) XRHealth clinical program with the Oculus Rift equipment. Each subject performed the same sequence of shoulder motions with one student rater being blinded to the actual measurements taken while the other student rater recorded the measurements for both goniometer and VR methods. The subject repeated the same sequence with another blinded student rater for both goniometer and VR methods to complete the entire trial. All subjects reported no clinical functional limitations, or discomfort for either shoulder. Student raters reviewed the standardized methods and positions for taking and recording the two shoulder motions; bilateral flexion and abduction. The student rater performing the measurements was blinded to the measurements with the rater using the one side of the covered goniometer. Study protocol was reviewed with each subject with the subject signing the informed consent as per IRB approval. Upon completion of their respective trials, each subject completed a survey seeking their preference for goniometer or VR methods for shoulder motion assessment.

RESULTS: The bilateral shoulder measurements data collected by the blinded OT and PT student raters using goniometry and virtual reality methods compared the means of the two trials using a Student’s T-test. The results revealed a statistically significance difference of p=0.01 between methods with the VR shoulder program consistently recording greater shoulder AROM measurements for both right and left shoulders. The combined OT and PT group ranged from 18 to 62 years old with an average age of 28.8 years old, 12 males and 28 females with no declared shoulder issues. There was a minimal difference in the time it took to perform either goniometer or VR method. In addition, 65% of all subjects stated a preference to be measured using VR over the goniometer method.

CONCLUSION: The study showed that the use of VR can be a reliable clinical tool equal to or superior to goniometer methods currently used for examinations. A 65% preference level would suggest that VR methods are more engaging with potential applications for treatments in the future. Lastly, occupational therapy curricula should embrace VR to better prepare students for contemporary healthcare interactions.

References

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