JMIR Publications

ABSTRACT

Background:

Many essential walking activities in daily life, for example, crossing a street, are challenging to practice in conventional therapeutic settings. Virtual environments (VE) delivered through a virtual reality head-mounted display (VR-HMDs) would allow training such activities in a safe and attractive environment. Furthermore, the game-like character and the high degree of immersion in such applications might help maintain or increase children’s motivation and active participation during the rehabilitation process.

Objective:

This study aimed to investigate the usability, user experience, and acceptability of an immersive VE experienced through a VR-HMD to train everyday life walking activities in pediatric neurorehabilitation.

Methods:

In a cross-sectional study, 21 youths (median age 12.1 years, range 6.8-17.7 years) with a neuromotor impairment undergoing inpatient or outpatient neurorehabilitation tested a VE, experienced through the VR-HMD Oculus Quest. The participants, accompanied by their physiotherapists, moved freely around a 4.4 by 10-meter large VE, displaying a magical forest and featuring various gamified everyday activities in different game designs. Using their hands, represented in the VE, the participants could interact with the virtual objects placed throughout the VE and trigger visual and auditory feedback. Symptoms of cybersickness were checked, and usability, user experience, and acceptability were evaluated using customized questionnaires with a visual analog scale for the youths and a 5-point Likert scale for their therapists.

Results:

None of the participants reported any signs of cybersickness after 20 minutes of HMD exposure time. They rated comfort (median 10/ out of 10) and movement ability (10/10) with the VR-HMD as high. The VE had a realistic appearance (8/10) for the majority, and the participants had a strong feeling of spatial presence in the VE (9.5/10). They enjoyed exploring the virtual world (10/10) and liked this new therapy approach a lot (10/10). Therapists’ acceptance of the VR-HMD was high (4/5). Five patients needed more support than usual, mainly for supervision, when moving around with the VR-HMD. Otherwise, therapists felt that the VR-HMD hardly affected their patients’ movement behavior (4.75/5), while it seemed to increase their level of therapy engagement (4/5) compared to conventional physiotherapy sessions.

Conclusions:

This study demonstrates the usability of an immersive VE delivered through a VR-HMD to engage youths in the training of everyday walking activities. The participants’ and therapists’ positive ratings on user experience and acceptance further support the promising application of this technology as a future therapeutic tool in pediatric neurorehabilitation.