Functional grasp training with augmented feedback from an intelligent glove and virtual reality for persons with cervical–level spinal cord injury: A preliminary investigation

Background: Physical therapy is crucial for rehabilitating hand function after spinal cord injury (SCI), but it is time- and effort-intensive. New approaches that foster engagement and accelerate motor learning are needed. Purpose: This study examined whether augmented sensory feedback (ASF) delivered through virtual reality (VR) can improve motor performance and neural activation in persons with SCI. Study Design: Experimental study. Methods: VR compatibility was integrated with a custom-developed smart glove system that informs users when secure object grasp was achieved during training of functional grasp tasks. Six participants with incomplete cervical-level SCI performed a grasp-and-place task under three training conditions: no ASF, glove-based ASF, and VR-based ASF. Training trial-blocks provided multimodal (visual and audio) ASF cues about secure grasp at progressively reduced delays to induce a sense of agency through conditioned perceptions of intentional binding. Results: Compared with no ASF, VR-based ASF significantly improved performance (p < 0.05) for metrics of reduced motion path length (51.5%) and shorter trial completion times (−44.6%). VR training also correspondingly produced the greatest increases in electroencephalography activity. Conclusions: Findings should be interpreted cautiously, given the small sample size and single-session design. Still, results from this study suggest VR-enhanced ASF can positively support motor learning and neuroplasticity after SCI through greater cognitive-level engagement. Clinical Trial Number: NCT04577573.