User-Centered Virtual Environment for Poststroke Motor Rehabilitation

The use of virtual reality in the rehabilitation of lost or diminished functions after a stroke has been shown to be an innovative means in motor recovery. However, there are still several design challenges to increment the efficiency of these systems. This paper presents the development and evaluation of a nonimmersive three-dimensional virtual environment for poststroke rehabilitation of elbow flexion-extension movements, which considers the therapist as a direct user and the patient as a secondary user. The development of virtual environment was supported by the criteria of a team of specialists in physical and occupational therapy, following the philosophy of user-centered design through three iterations, and incorporating tasks based on the activities of daily living of the Barthel scale. Tests were carried out with healthy users and a patient with a diagnosis of stroke, using the system usability scale (SUS) test and a flow status questionnaire, respectively. Average satisfaction of user group without diagnosis was 79.6 out of 100 points. On the other hand, according to mean values observed with the patient, dimensions of control sense (6.33) and positive emotional experience (6.66) reflect an "optimal" experience, which indicates an enjoyment of virtual tasks despite the effort made to fulfill them.