by Glasser Mayrsohn S*, Romeo A* and Mayrsohn B†:
*Metropolitan Physical and Occupational Therapy, Great Neck, NY.
†University of Central Florida College of Medicine/Director of Metro Innovation.
Clinical Case Presentations
Background: There have been significant advances in virtual reality gaming consoles over the past decade. These virtual reality games have grown to include motion capture technology that can track a user’s ROM, arm speed, and accuracy. These values, among others, can be assessed over time in order to monitor progress and encourage patient participation. These virtual reality games have been utilized in clinical settings in previous studies and have shown promise. MIRA Rehab is currently developing a therapeutic game platform, based on clinical exercises that are fit for specific patients. This case series will explore 2 cases in which the MIRA platform was used in an outpatient physical therapy practice in conjunction with physical therapy treatments.
Purpose: The purpose of this case study is to explore the therapeutic effects of the clinically based virtual rehabilitation gaming platform MIRA developed by MIRA Rehab as measured by ROM, pain score, and functional outcomes.
Case Description: 2 patients were given the MIRA gaming platform as an intervention from the onset of physical therapy.
Case 1: The first patient was a 3 year old patient referred to as “EC” who was s/p type III supracondylar humerus fracture. Pt was treated with ORIF 03-08-15, hardware and cast removed 03-31-15, evaluated 04-06-15
| Motion | AROM | PROM | MMT |
| Elbow Extension | -15 | -8 | 3-/5 |
| Elbow Flexion | 115 | 118 | 3-/5 |
| Pronation | 70 | 80 | 3-/5 |
| Supination | 70 | 80 | 3-/5 |
- Functional Status: unable to perform the following: Catching/Throwing a large ball, throwing ball into a box, throwing overhand within 3 feet of target, build tower using 9 cubes
- Patient participated in MIRA program 10 minutes per session from evaluation on 04-06-15 to discharge on 06-26-15.
- Patient returned to full participation in ADL’s and achieved return of strength and ROM.
Case 2: The second patient “LM”, an 8 year old, was s/p L elbow fx. sustained 09-30-14 from a fall from a bicycle, placed in a cast immediately for several weeks.
| Motion | ROM | MMT |
| Elbow Flexion | 95 pain | 2+/5 |
| Elbow Extension | -45 pain | 2+/5 |
| Supination | 80 | 3-/5 |
| Pronation | 80 | 3-/5 |
- Functional Activity Status: unable to perform Throwing and Recreational Sports, moderate limitation for Lifting, and severe limitation for Dressing and Self Care.
- MIRA Treatment 15 minutes over duration of treatment
- Patient discharged 8 weeks with full ROM and the ability to perform all ADL’s pain free.
Outcomes: Both patients achieved all goals including full ROM, strength, flexibility as well as the ability to perform all ADL’s.
Discussion: Both patients in the case study met all goals set forth in the initial evaluation. During treatment, patients were given the MIRA Rehab platform. Both patients demonstrated decreased kinesphobia using the injured upper extremity. Patient 1 and 2 also achieved increased AROM using MIRA vs. traditional exercises such as elbow curls and ball toss.
About the authors
Sherrie Glasser Mayrsohn, MSPT
Owner and Director of Metropolitan Physical Therapy
Sherrie Glasser, PT, MS is a widely known clinician and expert in orthopedic, sports and geriatric physical therapy and has more than three decades of experience in clinical research and treating patients. Ms. Glasser is an active member of ASSET (American Society for Shoulder & Elbow Therapists) and AIPT (American Independent Physical Therapists), the American Physical Therapy Association and the Northeast Women’s Health Study Group. Sherrie is a certified medical professional with Titleist Performance Institute (TPI), providing golf fitness. Sherrie has great passion treating the geriatric population, incorporating senior wellness, golf fitness, fall prevention, as well as pelvic floor dysfunction for men and women. Ms. Glasser has lectured extensively at numerous conferences, sports medicine and senior living centers, and has worked in the training and rehabilitation of semi-professional and professional athletes.
Anthony Romeo, DPT, OCS, CSCS
Anthony is a board certified orthopedic specialist as well as a certified strength and conditioning specialist. His passion is working with runners, orthopedics, sports, and vestibular patients. He obtained his Bachelor’s in Exercise Science and Doctorate in Physical Therapy from Sacred Heart University.
Expertise: Orthopedic Specialist, TMJ, Strength and Conditioning Certified Specialist, ART Certified
Brian Mayrsohn is a 4th year medical student at UCF College of Medicine. He graduated from Vanderbilt University with a B.A. in Medicine, Health & Society where he co-founded a student organization called Healthy Head Start—an organization that inspires healthy living among Nashville’s youth using fun and interactive nutrition and wellness initiatives. He followed his passion for nutrition to Columbia University where he received an MS. Following Columbia he served as Director of Business Development for Metro Physical and Aquatic Therapy where he led the development of a physical therapy EMR system and the design and construction of wellness center. In medical school he co-founded Healthcare Innovations, where he challenges healthcare professionals to think differently about medical practice and encourages cross-disciplinary collaboration and entrepreneurship. Currently, his research evaluates mobile health games’ effectiveness in driving behavior change, and he has written several chapters on games for health in a new HIMSS book called mHealth Innovation: Best Practices From The Mobile Frontiers. As a clinician, he plans to utilize sensors, health games, and mobile technology to tailor medicine to his patients. Follow him on Twitter @bmayrsohn.