Virtual Activities of Living for Occupational Rehabilitation

PROJECT SUMMARY/ABSTRACT
Introduction: The Virtual Activities of Living for Occupational Rehabilitation (VALOR) SBIR program supports
telehealth delivery and remote monitoring of upper extremity (UE) stroke rehabilitation through immersive
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 human motion
tracking with a library of digital ADL/IADL therapy games to enable functional, repetitive task practice at home
with telehealth support. Key differentiators from other VR therapy offerings are (1) practice of ADLs/IADLs (not
just games) involving realistic activities and manual interaction, (2) fully immersive, ecologically valid
environments, (3) dramatic simplification of system hardware by using the tracking cameras built into the VR
headset to track the UEs (no additional sensors required), and (4) an order of magnitude cost reduction enabling
at home use.
Problem to be addressed: VALOR addresses the critical challenges of: (1) improving outcomes in UE stroke
therapy through repetitive task practice and mental imagery that promote functional recovery; (2) enabling
increased dosage, intensity, and duration through independent home use and teletherapy; (3) minimizing total
cost of rehabilitation by reducing patient/therapist travel; and (4) improving stroke therapy services to
underserved populations and regions.
Long-Term Goal: Improved outcomes and functional independence for patients with acquired brain injury.
Phase I Results: A successful VALOR SBIR Phase I pilot study conducted by Duke University completed by 16
stroke patients (44% Black or African American) has established the usability and technology acceptance of a
prototype immersive VR system for UE therapy. Careful design of the VR activities resulted in excellent (low)
cybersickness scores. The effort also demonstrated the validity of metrics derived during immersive virtual
ADL/IADL practice for tracking a patient’s UE motor status, enabling telehealth monitoring and delivery.
Phase II Summary: A VALOR Phase II will include: (1) development of a market-ready product with a ten-fold
reduction in cost compared to existing VR therapy systems; (2) a Phase II rater-blinded RCT that provides
efficacy and safety data required for regulatory compliance; (3) establishing conformity with applicable FDA,
FCC, ISO, and IEC regulations and standards; and (4) preparation of FDA clearance and CE Marking packages.
Commercial Opportunity: Approximately 50% of the 800,000 individuals hospitalized due to stroke each year
in the U.S. suffer from chronic deficits in hand and/or arm function [1], [2]. VALOR is poised to rapidly transition
the Phase II product to market by leveraging an existing brand with well-defined distribution channels.

Grant Number: 5R44HD107718-03
NIH Institute/Center: NIH
Principal Investigator: Richard Adams