The Effects of Virtual Reality on the Upper Extremity Skills of Girls with Rett Syndrome: A Single Case Study

Kourtney Mraz; Grace Eisenberg; Pamela Diener; Gina Amadio; Matthew H. Foreman; Jack R. Engsberg

doi:10.6000/2292-2598.2016.04.03.2

Authors

Kourtney Mraz Washington University in St. Louis-School of Medicine, Program in Occupational Therapy, 4444 Forest Park Ave, Saint Louis, MO 63018, USA
Grace Eisenberg Washington University in St. Louis-School of Medicine, Program in Occupational Therapy, 4444 Forest Park Ave, Saint Louis, MO 63018, USA
Pamela Diener Georgetown University-School of Medicine, Department of Neuroscience, 3970 Reservoir Rd, NW, Washington, DC 20057, USA
Gina Amadio Washington University in St. Louis-School of Medicine, Program in Occupational Therapy, 4444 Forest Park Ave, Saint Louis, MO 63018, USA
Matthew H. Foreman Washington University in St. Louis-School of Medicine, Program in Occupational Therapy, 4444 Forest Park Ave, Saint Louis, MO 63018, USA
Jack R. Engsberg Washington University in St. Louis-School of Medicine, Program in Occupational Therapy, 4444 Forest Park Ave, Saint Louis, MO 63018, USA

DOI:

https://doi.org/10.6000/2292-2598.2016.04.03.2

Keywords:

Rett Syndrome, internet-based virtual reality, Microsoft Kinect, upper extremity movements, upper extremity stereotypies.

Abstract

Introduction: Rett Syndrome (RTT) is a genetic disorder primarily seen in females that inhibits the use of a girl’s hands in everyday activities. A girl with RTT spends the majority of her day engaged in stereotypical hand wringing/mouthing movements at midline of the body. The probable cause behind the neurological effects of RTT is a mutation in the gene that encodes for methyl-CpG protein 2 (MeCP2). The hand wringing/mouthing behaviors preclude a girl with RTT from using the upper extremities in purposeful tasks such as school work, play skills, and other activities of daily living.

Objectives: To develop a virtual reality (VR)-based therapeutic intervention that 1) decreases upper extremity stereotypies (repetitive movements that serve no function) that interfere with purposeful arm and hand use and 2) promotes purposeful, goal-directed arm function; improve upper extremity motor skills in girls with RTT.

Materials and Methods: Using FAAST Software and Microsoft Kinect sensor, one girl with RTT participated in a 12-week IVR intervention (1 hour/session, 3 sessions/week, 36 total hours). Pre- and post-assessments were administered to examine any changes in upper extremity function.

Results: The VR intervention led to improvements in use of the upper extremities to complete self-care activities, an increased number of reaches completed in a 15-minute period, and decreased time engaged in stereotypical hand movements.

Conclusion: Future work will add additional support to determine the effectiveness of virtual reality as an intervention for girls with RTT.

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