JMIR Publications

ABSTRACT

Background:

Virtual reality (VR) technology is increasingly applied in neurorehabilitation. However, limited evidence exists on how to design patient-centered VR rehabilitation systems for stroke survivors.

Objective:

o explore stroke survivors’ experiences and unmet needs during traditional rehabilitation and to examine their perspectives on VR-based rehabilitation, providing a scientific foundation for the development of patient-centered VR rehabilitation systems.

Methods:

A qualitative study was conducted at the China Rehabilitation Research Center, Beijing, China, between January and July 2025. Adult patients with a clinical diagnosis of stroke within the past 18 months were invited to participate in face-to-face interviews. Data were collected through face-to-face semi-structured interviews, complemented by a short questionnaire on sociodemographic, clinical, and technology-use characteristics. All interviews were audio-recorded, transcribed verbatim, and analyzed using a thematic approach, and thematic saturation determined sample size.

Results:

Twenty-one stroke survivors (mean age, 52.7 [SD, 17.3] years; 17 men) were included. Six major themes were identified. Three reflected rehabilitation experiences and needs: changes following stroke (physical impairments, psychological impact); challenges in traditional rehabilitation (monotony of training, burdensome rehabilitation routines, limited home rehabilitation); and unmet needs for better recovery (desire for better approaches, need for rehabilitation knowledge, demand for stronger support). The other three reflected perspectives on VR: attitudes toward VR rehabilitation (perceived benefits, skepticism and lack of interest); recommendations for serious game design (diversified game types, customized training contents, functional suggestions); and suggested features of VR systems (access to personal health records, remote rehabilitation support, safety monitoring alerts, technical support).

Conclusions:

Stroke survivors face multiple challenges in traditional rehabilitation, which vary across different stages of recovery. Personalization, safety, and social support are essential considerations for VR rehabilitation, and patient voices should be integrated throughout the system development process.