Accepted for/Published in: JMIR Serious Games
Date Submitted: Jun 12, 2023
Date Accepted: Nov 7, 2024
Stroke patients’ perceptions of an immersive virtual reality exercise system for upper-limb rehabilitation: A questionnaire and interview study
ABSTRACT
Background:
Since significant resources have been allocated to develop virtual reality (VR)-based rehabilitation exercise programs for post-stroke motor rehabilitation, it is important to understand how stroke patients perceive these technology-driven approaches, as their perceptions can determine acceptance and adherence.
Objective:
This study was aimed at examining stroke patients’ perceptions of an immersive VR-based exercise system developed to deliver shoulder, elbow, forearm, wrist, and reaching exercises.
Methods:
A questionnaire was used to assess stroke inpatients’ (n = 21; mean time from stroke onset: 37.2 days; Brunnstrom stage of stroke recovery for the arm: 3−5) perceived usefulness of, ease of use of, attitude toward, intrinsic motivation for, and intention to using the exercise system. The measurement items were rated on a 7-point Likert scale ranging from 1 (very strongly disagree) to 7 (very strongly agree), with higher values indicating more positive perceptions. Descriptive statistics were employed to summarize the responses. Moreover, we conducted semi-structured interviews, which were audio-recorded and transcribed, and subjected to content analysis to identify thematic patterns.
Results:
The questionnaire results revealed that the patients’ perceptions of the exercise system were positive (mean ratings > 6, median ratings = 6 or 7). The content analysis revealed six positive themes from 73 statements about the exercise system, namely: ease of use, usefulness, enjoyment, motivation, accessibility, and game design. Conversely, 15 statements reflected negative perceptions, which were clustered into three themes: difficulty in handling VR devices, discomforting experiences when using VR devices, and monotony.
Conclusions:
Integrating VR technology into post-stroke functional exercises holds significant promise based on patient interests. However, patient preferences and adaptability must be considered to promote the technology’s success. VR-guided exercises should be user-friendly, health-promoting, engaging, and well-designed. Furthermore, addressing challenges such as bulkiness, motion sickness, discomfort, and exercise monotony is crucial for the widespread adoption and diffusion of this technology.
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