Virtual reality-based training to augment recovery of hand dexterity after surgery for degenerative cervical myelopathy

Abstract Degenerative cervical myelopathy (DCM), the leading cause of non-traumatic spinal cord injury, frequently results in impaired hand dexterity. While surgical decompression is the primary treatment, over 40% of patients report residual hand disability after surgery. There are no therapies to...

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Main Authors: Viprav B. Raju, Roxanne Hauer, Mohammad Ghassemi, Anjishnu Banerjee, Derek Kamper, Brian D. Schmit, Aditya Vedantam
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-05793-5
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author Viprav B. Raju
Roxanne Hauer
Mohammad Ghassemi
Anjishnu Banerjee
Derek Kamper
Brian D. Schmit
Aditya Vedantam
author_facet Viprav B. Raju
Roxanne Hauer
Mohammad Ghassemi
Anjishnu Banerjee
Derek Kamper
Brian D. Schmit
Aditya Vedantam
author_sort Viprav B. Raju
collection DOAJ
description Abstract Degenerative cervical myelopathy (DCM), the leading cause of non-traumatic spinal cord injury, frequently results in impaired hand dexterity. While surgical decompression is the primary treatment, over 40% of patients report residual hand disability after surgery. There are no therapies to restore hand function after surgery for DCM. In this single-arm clinical trial, post-surgical DCM participants (within 12 months after surgery) underwent a 4-week VR training protocol using the Virtual Keyboard system, which promotes practice of finger individuation. Assessments of hand dexterity were performed at baseline (at week 1), post-training (at week 6) and follow-up (at week 10). The primary outcome measure for hand dexterity assessment was the Jebsen-Taylor Hand Function Test (JTHFT). Twenty-two post-surgical DCM participants were included in the final analysis. Statistically significant improvement in the JTHFT was observed at both post-training (p < 0.001, Δ= -15.21s) and follow-up (p < 0.001, Δ= -17.84s), with changes exceeding the Minimal Clinically Important Difference (MCID) at both time points. VR hand training also produced significant, sustained and clinically meaningful improvements in quantitative hand dexterity tests and health-related quality of life. The results of this uncontrolled, single-arm study demonstrate the feasibility and efficacy of targeted neurorehabilitation to augment post-surgical neurological recovery in people with DCM.
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spelling doaj-art-8e1af59d8b4c4b0ca1af68684b151d412025-08-20T03:03:40ZengNature PortfolioScientific Reports2045-23222025-07-0115111110.1038/s41598-025-05793-5Virtual reality-based training to augment recovery of hand dexterity after surgery for degenerative cervical myelopathyViprav B. Raju0Roxanne Hauer1Mohammad Ghassemi2Anjishnu Banerjee3Derek Kamper4Brian D. Schmit5Aditya Vedantam6Department of Neurosurgery, Medical College of WisconsinJoint Department of Biomedical Engineering, Marquette University- Medical College of WisconsinJoint Department of Biomedical Engineering, North Carolina State University – University of North Carolina at Chapel HillDepartment of Biostatistics, Medical College of WisconsinJoint Department of Biomedical Engineering, North Carolina State University – University of North Carolina at Chapel HillJoint Department of Biomedical Engineering, Marquette University- Medical College of WisconsinDepartment of Neurosurgery, Medical College of WisconsinAbstract Degenerative cervical myelopathy (DCM), the leading cause of non-traumatic spinal cord injury, frequently results in impaired hand dexterity. While surgical decompression is the primary treatment, over 40% of patients report residual hand disability after surgery. There are no therapies to restore hand function after surgery for DCM. In this single-arm clinical trial, post-surgical DCM participants (within 12 months after surgery) underwent a 4-week VR training protocol using the Virtual Keyboard system, which promotes practice of finger individuation. Assessments of hand dexterity were performed at baseline (at week 1), post-training (at week 6) and follow-up (at week 10). The primary outcome measure for hand dexterity assessment was the Jebsen-Taylor Hand Function Test (JTHFT). Twenty-two post-surgical DCM participants were included in the final analysis. Statistically significant improvement in the JTHFT was observed at both post-training (p < 0.001, Δ= -15.21s) and follow-up (p < 0.001, Δ= -17.84s), with changes exceeding the Minimal Clinically Important Difference (MCID) at both time points. VR hand training also produced significant, sustained and clinically meaningful improvements in quantitative hand dexterity tests and health-related quality of life. The results of this uncontrolled, single-arm study demonstrate the feasibility and efficacy of targeted neurorehabilitation to augment post-surgical neurological recovery in people with DCM.https://doi.org/10.1038/s41598-025-05793-5Degenerative cervical myelopathyVirtual realityHand dexterityPost-Surgical rehabilitation
spellingShingle Viprav B. Raju
Roxanne Hauer
Mohammad Ghassemi
Anjishnu Banerjee
Derek Kamper
Brian D. Schmit
Aditya Vedantam
Virtual reality-based training to augment recovery of hand dexterity after surgery for degenerative cervical myelopathy
Scientific Reports
Degenerative cervical myelopathy
Virtual reality
Hand dexterity
Post-Surgical rehabilitation
title Virtual reality-based training to augment recovery of hand dexterity after surgery for degenerative cervical myelopathy
title_full Virtual reality-based training to augment recovery of hand dexterity after surgery for degenerative cervical myelopathy
title_fullStr Virtual reality-based training to augment recovery of hand dexterity after surgery for degenerative cervical myelopathy
title_full_unstemmed Virtual reality-based training to augment recovery of hand dexterity after surgery for degenerative cervical myelopathy
title_short Virtual reality-based training to augment recovery of hand dexterity after surgery for degenerative cervical myelopathy
title_sort virtual reality based training to augment recovery of hand dexterity after surgery for degenerative cervical myelopathy
topic Degenerative cervical myelopathy
Virtual reality
Hand dexterity
Post-Surgical rehabilitation
url https://doi.org/10.1038/s41598-025-05793-5
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