A Virtual Reality Platform to Facilitate Training on Treatment of Lower Limb Spasticity With OnabotulinumtoxinA

Research Objectives: To assess the benefits of a virtual reality (VR)–based training platform

Design: A VR-based platform employing an immersive experience with haptic technology was designed to provide training on the use of onabotulinumtoxinA for lower limb spasticity (LLS) to increase treatment consistency and enhance knowledge and injection competency.1-5 In a pilot program (December 2020–August 2021), participants underwent one-on-one training on lower limb anatomy and injection guidance, then assessed the platform by completing pre- and post-training surveys.

Setting: Twenty-one US-based academic centers

Participants: Medical trainees

Interventions: Not applicable

Main Outcome Measures: Knowledge gap on the treatment of LLS using pre–VR-training and post–VR-training surveys

Results: Six medical students, 124 residents, and 10 fellows completed pre−VR-training surveys; 111 completed post−VR-training surveys. Average learning time per VR session was ~43 minutes. The percentage of participants who were very comfortable with localization of lower limb muscles increased from 8% pre−VR-training to 14% post−VR-training. Percentages of participants identifying all correct responses almost doubled from pre−VR-training to post−VR-training when asked about possible functions of the flexor digitorum longus (12% vs 22%) and what muscles to consider injecting in a hypothetical poststroke patient (21% vs 40%). Pre−VR-training, 46% and 34% of participants indicated that a VR-based training tool would be very or extremely useful, respectively; post−VR-training responses were 33% and 52%, respectively. Top features participants found beneficial were the realistic feel of needle insertion/removal (82%) and the ability to use injection guidance (79%).

Conclusions: Preliminary results suggest medical trainees have incomplete baseline knowledge and the potential need for additional training experience, for which VR may be useful. VR training duration and additional interventions to optimize training need to be defined.

Author(s) Disclosures: EM: Speaker: AbbVie. SAD: Investigator: AbbVie; Consultant: Allergan (an AbbVie company). AE: Consultant: Allergan, (an AbbVie company), Ipsen, Merz; Research grants: Allergan (an AbbVie company), Ipsen. GEF: Consultant for, research grants from: Allergan (an AbbVie company), Ipsen, Merz. MV-G: Consultant/Speaker: AbbVie, Ipsen, Merz. KI, ACB, GP: Employee: AbbVie. AB: Employee: AbbVie at study conduct. NK: Consultant/Speaker: AbbVie.