Virtual Activities of Living for Occupational Rehabilitation - PROJECT SUMMARY/ABSTRACT
Introduction: The Virtual Activities of Living for Occupational Rehabilitation (VALOR) SBIR program will support
telehealth delivery and remote monitoring of upper extremity (UE) stroke rehabilitation through the 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 motion tracking with
an existing suite of digital ADL/IADL content to enable functional, repetitive task practice at home with telehealth
support. A key technological breakthrough is markerless tracking that employs cameras built into a low-cost VR
headset, enabling patients to manually engage in virtual occupations using their affected UE.
The VALOR Phase I program pursues two primary investigational objectives through a pilot study conducted by
Duke University: (1) assess the usability and technology acceptance of immersive VR ADL/IADL practice for UE
therapy by older adult stroke patients; and (2) establish the validity of immersive virtual ADL/IADL practice for
tracking a patient's UE motor status to enable telehealth feedback and monitoring. Technical work in Phase I
includes integration of a runtime neural network for real-time UE tracking with an existing suite of virtual
ADLs/IADLs (originally developed for a non-immersive, PC-based system using the Kinect) to support immersive
VR using a low cost standalone, untethered headset (no PC, no monitor, and no additional sensors required).
Problem to be addressed: The COVID-19 pandemic exposed a critical lack of options for delivering an
evidence-based UE intervention via telehealth. Innovative solutions are needed to enable patients to safely
participate from home in a therapist-monitored therapy program. Approximately 50% of the >795,000 individuals
hospitalized due to stroke each year in the U.S. suffer from chronic deficits in UE function [1], [2]. Existing clinical
therapy systems for immersive VR are too expensive, complex, and/or bulky for use in patients' homes. Game
consoles, exergames, or slipshod, non-evidence-based adaptations of VR technology do not address the
integrated motor and cognitive skills required to achieve functional independence in daily living activities.
Long-Term Goal: Improved outcomes and functional independence for patients with neurological injury.
Phase I Summary: Phase I will produce a prototype VALOR system that consists of a mobile software
application that runs on an Oculus Quest 2 untethered (i.e., wireless) VR headset. At least 3 immersive ADL/IADL
activities will be fully integrated and tested, leveraging an existing library of virtual world assets from a non-
immersive clinical VR system. A pilot study conducted by Duke University with stroke patients will demonstrate
usability and technology acceptance, and investigate the hypothesis that metrics captured during immersive
ADL/IADL practice will have high criterion validity with respect to gold standard measures of UE function.
Commercial Opportunity: The VALOR product is poised to rapidly transition through well-established
marketing and distribution channels to meet a critical need for evidence-based telehealth occupational therapy.
