Abstract

Stroke is the leading cause of serious, long-term disability in the United States. Exercise and activity in the chronic phase of stroke have shown to be beneficial in achieving and maintaining improvements in motor and ADL function. Interactive video games and virtual reality (VR) have also shown to be effective in improving motor function following stroke. We developed a prototype VR rehabilitation tool called Mystic Isle that uses the Microsoft Kinect sensor and a standard PC. The purpose of this case series was to explore the usability of Mystic Isle as a 5-week intervention to improve performance of client identified activities for adults (>21 years) with chronic stroke (>6 months post) in the home setting. Three participants with chronic stroke completed the five week intervention. Outcomes were measured at baseline, immediately pre-intervention (after a 2 week delay from baseline), and immediately post-intervention. The intervention was conducted in each participant’s home. The results of the Canadian Occupational Performance Measure at baseline guided the choice of the virtual tasks for the intervention. The participants were instructed to complete 4 hours each week. The primary outcome was usability and feasibility of the intervention measured with the Game Experience Questionnaire, the System Usability Questionnaire, and a semi-structured interview. Primary outcome data were analyzed using a mixed methods grounded theory approach. Secondary outcomes included motor impairment, quality of life and occupational performance measured using standard clinical measures. Two of the three participants had very positive responses to the intervention and use of the VR tool in the home setting. All three participants demonstrated improvements in quality of life from pre- to post-intervention and improvements in motor function were scattered across participants. All participants expressed the desire to use the system in the future if improvements were made to increase the usability of the system for the home setting. They also spoke about how they attempted to integrate the game into their daily routine or schedule. A major barrier to use for all participants was a busy day that left them too fatigued to interact with the system and complete the intervention.

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