Accepted for/Published in: JMIR Serious Games
Date Submitted: Jun 24, 2025
Open Peer Review Period: Jun 24, 2025 - Aug 19, 2025
Date Accepted: Dec 29, 2025
(closed for review but you can still tweet)
Feasibility and User Experience during Immersive Virtual Reality-based Rehabilitation in Patients with Stroke: Single-Arm Pretest-Posttest Pilot Study
ABSTRACT
Background:
Immersive Virtual Reality (VR) is promising in stroke rehabilitation; however, existing work often lacks a structured assessment of user experience over a long period.
Objective:
To assess user experience in patients with stroke before and after a training period of 4 weeks, in which they used a VR application to train upper limb and cognitive functions
Methods:
Thirty-two chronic or post-acute patients with stroke were enrolled. They all performed 4 weeks of training, performing exercises in the Virtual Supermarket for Stroke (VSS). The VSS had a series of features allowing for the customization of the level of difficulty to make the task more and more challenging throughout the trial. We assessed subjective outcomes after the first and the last session. Clinical scales were also administered at the baseline and at the end of the treatment.
Results:
Flow (4.56, iqr: 0.68 up to 5), sense of presence, and affective state-related variables were satisfactory after the first session. No severe symptoms of cybersickness occurred (SSQ-TS: 11.22, iqr: 20.57). At the end of the intervention program, we did not record any significant differences in any subjective variable. Regarding clinical outcomes, we recorded a significant improvement in balance (Berg Balance Scale PRE: 30, iqr: 31.8; POST: 33.5, iqr: 30), upper limb motor functions (Motricity Index PRE: 45, iqr: 53.75; POST: 46.0, iqr: 45; Box and Block PRE: 0, iqr: 11.5, POST: 0, iqr: 28), and functional mobility (Time Up and Go PRE: 18, iqr: 21.25; POST: 14, iqr: 17).
Conclusions:
The positive experience, possibly mediated by the ease of use and the customized level of challenge, was preserved through the 4 weeks of training. Clinical scales suggested that the VSS also allowed the training of executive functions and promoted neuroplasticity, even in chronic patients. Further studies with larger samples are needed to confirm these results. Clinical Trial: not applicable
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