Comparison of Conventional and Virtual Reality Box and Blocks Tests in Upper Limb Amputees: A Case-Control Study

Previous studies have demonstrated the potential of virtual reality as an effective teaching tool for motor training. Despite the growing interest in this field, only a few studies have determined the validity of the tasks made in virtual environments to real physical environments. This case-control study compares the score of pick and place activity in the real and virtual environment by using the box and blocks test setup on 4 able-bodied and 4 transradial amputees (2 myoelectric prosthetic users and 2 non-prosthetic users). This study integrates the traditional Box and Blocks Test mechanics into gameplay by using the Leap Motion controller and Oculus Rift headset. The participants were instructed to complete the test in both environments randomly for 10 sessions, with 30 minutes of training in each session. Pearson's correlation interpretation was conducted to investigate the relation between the test's score with the training duration, also the score obtained in the real and virtual environment. Independent samples t-test was also carried out to compare the score from the different test environments. All participants showed a greater percentage change of test score in the virtual version and better performance was achieved with increasing training duration. Both environments were positively correlated. However, there was a significant difference in the test score obtained in the real and virtual environment for able-bodied t(9) = 18.19, p <; 0.05 and myoelectric prosthetic user t(9) = 4.51, p <; 0.05, but not for the non-prosthetic user. This study has demonstrated that two different environments showed significantly comparable results in pick and place tasks by individuals with different abilities.