A low-cost virtual reality stroke rehabilitation system: breaking down barriers to treatment

PurposeStroke is a leading cause of disability worldwide with improved treatments leading to higher survival rates and a greater demand for post-stroke rehabilitation. Technological rehabilitation solutions show promise to meet this growing need, but for maximum impact they must be accessible and affordable. To inform the development of low-cost virtual reality (VR) rehabilitation systems, here we assess the feasibility of motor amplification, an effective stroke treatment solution, on a low-cost controller-free system. DesignWe developed the REVIVE system, a VR stroke rehabilitation system operating on the standalone Meta Quest line of Head Mounted Displays which are wireless, low cost, and require no external hardware. Hand tracking, voice recognition and an automated motor amplification algorithm enable accessible engagement for users with a range of physical and cognitive abilities. An animated coach in the virtual environment guides users through gamified exercises which simulate activities of daily living and functional movements. We tested the system with 60 healthy young adults in a simulated stroke rehabilitation session, with a primary goal of validating the feasibility of the controller-free amplification feature. FindingsUsers reported minimal visually induced motion sickness even when experiencing the visuomotor perturbation generated by amplification, and more positive attitudes toward VR technology after the experience. Additionally, we provide a normative dataset for several REVIVE tasks to serve as a healthy baseline for future clinical applications. ValueOur findings suggest that this affordable consumer-grade system, suitable for home or clinical use, has considerable potential to improve access to post-stroke rehabilitation services.