Virtual Reality–Based Neurorehabilitation Support Tool for People With Cognitive Impairments Resulting From an Acquired Brain Injury: Usability and Feasibility Study

Abstract

Acquired brain injury (ABI) is a prominent cause of disability globally, with virtual reality (VR) emerging as a promising aid in neurorehabilitation. Nonetheless, the diversity among VR interventions can result in inconsistent outcomes and pose challenges in determining efficacy. Recent reviews offer best practice recommendations for designing and implementing therapeutic VR interventions to evaluate the acceptance of fully immersive VR interventions. This study aims to evaluate the usability and feasibility of a co-designed VR-based neurorehabilitation support tool by conducting multiple proof-of-concept trials in a sample of patients with ABI within a hospital setting. A single session deploying custom immersive serious games to train cognitive functions using a new-generation head-mounted display was conducted among a sample of inpatients with ABI. Structured questionnaires were administered at the end of the session to evaluate the usability of the system and the intervention, participants’ familiarity with the technology, and any adverse effects related to cybersickness. Additionally, the training duration while wearing the headset and the demographic characteristics of the participants were considered. A total of 20 patients with ABI participated in a 1-hour proof-of-concept trial. The mean usability score was 37 (SD 2.6) out of 40, the technology familiarity level was 9.2 (SD 2.9) out of 12, and the Simulator Sickness Questionnaire total score was 1.3 (SD 2). On average, participants wore the headset for approximately 25.6 (SD 4.7) minutes during the intervention. There were no substantial differences in usability and technology familiarity levels based on patients’ etiology or age, with no notable symptoms of cybersickness reported. Significantly strong correlations were noted between cybersickness symptoms and various usability categories, including exposure, motivation, interactivity, task specificity, and immersion aspects. Further, there was a significant association between the intervention time and the number of tasks performed (P<.001). Furthermore, patients who derived enjoyment from VR sessions expressed a heightened interest in incorporating VR into their daily neurorehabilitation practice (P<.001). Moreover, oculomotor issues were found to be highly sensitive to the onset of disorientation sickness symptoms (P<.001). Through a collaborative approach, this study showcases the usability and feasibility of a VR-based support tool for cognitive rehabilitation among inpatients with ABI. Key components of such interventions encompass a multidisciplinary array of immersive experiences integrating neurorehabilitation principles and serious games techniques.