Complementing rehabilitation exercises for hand injuries with a virtual, game-based application (StableHandVR) for rapid reintegration into working life.

Status:

completed 06/2025

Aims:

The aim of this project was the clinical and application-oriented evaluation of digitally supported rehabilitation methods for hand injuries. Specifically, it investigated:

(a) whether VR-based systems like StableHandVR improve therapy adherence and functional outcomes;

(b) whether standardized subjective and objective assessments* validly reflect therapeutic progress; and

(c) whether differences exist in clinical outcomes between operative and conservative treatments (e.g. for distal radius fractures, or carpal tunnel syndrome).

* Active Range of Motion AROM, grip strength, two-point discrimination 2PD, disability of Arm, Shoulder and Hand (DASH) , Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ), Form Health Survey SF-36)

Activities/Methods:

This was a prospective, multicenter observational and interventional study involving 110 healthy participants and 235 patients with various indications: traumatic hand injuries, carpal tunnel syndrome (CTS), and distal radius fractures. The VR feedback system included color-coded motion guidance ("traffic light hands"), progressively unlocked game stations, virtual inhabitants, high scores, and a companion dog. Standardized clinical assessments were conducted, evaluating a total of 52 functional parameters. Patient-reported outcome measures. Patients were randomized into intervention and control groups, and both quantitative and qualitative data were collected.

Results:

Demographic analysis highlighted a high rehabilitation need among patients in physically demanding jobs, especially with dominant hand injuries. StableHandVR was well accepted, demonstrating increased training adherence and perceived benefit. It proved practical, user-friendly, and easy to implement with minimal training requirements. Automated data collection supports long-term monitoring.

In patients with traumatic hand injuries, StableHandVR significantly improved range of motion (ROM, Kapandji) and grip strength, while no significant group differences were found in DASH, pain (NRS), or two-point discrimination (2PD).

CTS patients showed significant improvements in grip strength, sensitivity, Kapandji score, and symptom burden (BCTQ).

For distal radius fractures, significant improvements were seen in ROM, grip strength, and DASH score.

These results support the further development of digital rehabilitation pathways, which may ultimately reduce work absence due to hand-related conditions.

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