This is a descriptive study assessing the feasibility of using VR rehabilitation with unilateral (or bilateral) impairment of the arm, wrist and or hand resulting in reduced range of motion, dexterity, and/or strength of the hand.

The purpose of this study is to determine the feasibility of using a virtual reality program to monitor and encourage compliance with musculoskeletal home exercise programs. It hypothesizes that the treatment will display improved compliance, range of motion, and general function for individuals with upper extremity musculoskeletal deficits.

The primary objectives are to: 1. Describe participant compliance with an immersive game-based virtual reality (VR) rehabilitation device for delivering at-home occupational therapy exercises for the wrist and hand in individuals with motor impairments. 2. Describe and compare functional outcomes among participants before and after completing at-home rehabilitation using the VR system.

These objective outcomes will be measured through various standardized tests completed by qualified study team members.

Inclusion Criteria:

• DoD Beneficiary
• Exhibiting musculoskeletal impairment requiring continued at-home rehabilitation
• Cleared by research or clinical medical provider for participation
• Participant no longer has active range of motion movement restrictions. They may still have weight bearing restrictions but nothing that will preclude them from moving their hand and digits to their maximum ability.
• Ability to keep hand and arm in the field of view of the VR scene
• Must have demonstrated the ability for the Oculus to track all hand and wrist motions of interest (during an initial screening at baseline)
• Ability to independently don and doff the VR headset, plus start the app (verified in the Occupational Therapy/Physical Therapy clinic)
• Age range between 18-65
• Demonstrate the ability to tolerate wearing the VR headset

Exclusion Criteria:

• History of photo-induced seizures
• History of motion sickness when using VR equipment (especially vestibular effects such as nausea, dizziness, etc.)
• Partial amputations of the arm being assessed (including missing digits as they may not enable tracking by the VR)