Currently submitted to: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Dec 4, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Feasibility & Usability of a Biophilic Virtual Reality Rehabilitation System for Stroke Recovery: A Pilot Study With Healthy Adults
ABSTRACT
Background:
Stroke rehabilitation requires interventions that are emotionally engaging, adaptable and tolerable interventions. Virtual Reality (VR) offers promise in these aspects, yet many systems lack therapeutic relevance, modularity and emotional depth. This study introduces a Biophilic Virtual Reality Rehabilitation (BVRR) system, a nature-based VR prototype designed to support both cognitive and motor recovery through modular tasks and therapist-controlled pacing while providing an emotionally resonant environment.
Objective:
To evaluate the feasibility, usability, tolerability and emotional engagement of a Biophilic Virtual Reality Rehabilitation (BVRR) system in healthy adults providing a baseline for potential further testing in a clinical environment with stroke survivors.
Methods:
A single group feasibility study was conducted with healthy adult participants utilising a standing VR session. Participants engaged with biophilic tasks designed to simulate activities relevant to stroke recovery. Quantitative usability metrics included System Usability Scale (SUS), NASA-TLX, Simulator Sickness Questionnaire (SSQ), Igroup Presence Questionnaire (IPQ), Borg RPE and visual analogue scales (VAS).
Results:
Results indicated high usability (mean SUS = 77.5), low cognitive and physical workload, minimal simulator sickness and strong emotional engagement. Participants maintained a preference towards the biophilic environment over the neutral counterpart.
Conclusions:
These findings support the feasibility of BVRR for stroke rehabilitation and creates a foundation for further research and development into the system’s potential for use within a clinical setting
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Copyright
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