The VRehab System: A Low-Cost Mobile Virtual Reality System for Post-Stroke Upper Limb Rehabilitation for Medically Underserved Populations

Abstract

Stroke disparities are widespread in both developed and underdeveloped countries, with a disproportionate burden placed on individuals who live in rural areas, those of lower socioeconomic status, and those with inadequate or absent medical insurance. Underserved individuals are often unable to access post-stroke rehabilitation services due to their high out-of-pocket costs, difficulty with transportation, and/or the lack of stroke rehabilitation providers in their geographical area. After a stroke, patients exhibit upper limb problems, such as hemiparesis, hemiplegia, loss of sensation, pain and spasticity, and ataxia. Although it is recommended that patients undergo physical rehabilitation for limb impairments, patients with moderate to severe impairments do respond well to conventional physical therapy programs, are less likely to regain upper limb function, and consume substantial hospital and clinic resources, compared to stroke patients with mild to moderate upper limb impairments. These issues have motivated researchers to develop Virtual Reality (VR) applications that have the potential to combat the distinctive challenges that medically underserved stroke patients' face. In this project, we introduce the VRehab system: a low-cost, portable, flexible, and interactive VR system for stroke rehabilitation. VR system user expectations were examined via online survey, while walkthrough and semi-structured interviews were conducted to evaluate the usability of the VRehab system. Overall, the results of the online survey (n = 73) indicated that individuals thought that a VR system should be priced between $100-300, take no more than 10 minutes to set up, and contain sports content. Usability testing revealed that while the system was quick and easy to setup, and featured engaging game content, further refinement was required in order to enhance the usability and acceptability of the platform for users. Future directions for research are discussed including clinical trials in which the effectiveness of the VRehab system to improve upper limb motor function in medically underserved stroke patients is examined.