Virtual reality rehabilitation to enhance functional recovery initiated from the acute phase following cervical cord injury: A case report

Introduction: Virtual reality (VR) rehabilitation has recently been introduced as an innovative rehabilitation technique combining interactive environments with intensive exercise training. This technology has demonstrated benefits in conditions such as stroke and neurodegenerative diseases. However, evidence regarding the application in spinal cord injury (SCI) remains unclear. Early intervention with VR rehabilitation for SCI may promote spontaneous movement and assist recovery with minimal physical burden. We report a case of cervical cord injury in which VR rehabilitation using mediVR KAGURA® was initiated in the acute phase after injury and resulted in excellent recovery. Case Report: The patient was a 75-year-old male. He sustained a cervical cord injury following a bicycle accident (Frankel grade C1). X-ray and magnetic resonance imaging revealed instability at the C3/4 level and intramedullary signal changes in his cervical spine. He underwent posterior fixation surgery on the day of injury. Stabilization of his cervical spine was achieved, but he suffered from severe muscle weakness, sensory impairment, and marked trunk ataxia. VR rehabilitation using mediVR KAGURA® was started under the supervision of a physical therapist from 1 week postoperatively. The rehabilitation using mediVR KAGURA® was carried out 2–3 times/week, for 20–30 min/day. He performed the program in a sitting position, which encourages active use of the upper limbs and trunk, providing multisensory feedback. He achieved independent sitting within 1 week of starting rehabilitation using mediVR KAGURA® and was able to walk with a walker by the 2nd week. He achieved independence in activities of daily living by 4 months postoperatively, and he was discharged home. At 1 year postoperatively, he had slight residual numbness in the fingertips but lives without any limitations in daily activities. No adverse events occurred during the course of treatment. Conclusion: This case demonstrated that VR rehabilitation using mediVR KAGURA® could be performed safely and effectively in a patient with cervical cord injury. Early initiation of rehabilitation with mediVR KAGURA® may facilitate voluntary limb activity and enhance functional recovery. Keywords: Virtual reality, rehabilitation, spinal cord injury, mediVR KAGURA®, somato-cognitive coordination therapy.