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

Abstract

Stroke is a leading cause of disability worldwide. Following a stroke, high doses of intensive motor rehabilitation provide maximal benefit. Barriers to realizing recommended levels of rehabilitation therapy include cost, physical access, and clinical resource availability. Virtual Reality (VR) offers a potential solution to overcome these challenges and enable home-based, self-directed therapy. Here we present a low-cost system utilizing the off-the-shelf Meta Quest 2 headset running custom software to deliver immersive rehabilitation exercises. The system employs movement amplification to partially reduce motor deficits and enable more engaging task completion. It leverages recent advances in VR technology, including hand tracking, voice recognition, and an AI-driven virtual coach, to create a more accessible environment for users with no prior VR experience. We tested the system in 60 able-bodied participants to assess feasibility for eventual clinical use. Participants completed three VR tasks with 30 participants receiving motor amplification. We measured motion sickness levels and attitudes towards the technology, while generating a set of normative motor performance data. Results showed no significant effect of amplification on motor performance, indicating that the small amplification factors applied in this healthy sample did not markedly impact task outcomes. User attitudes towards VR improved after the experience and minimal motion sickness was reported. This study suggests that low-cost VR systems may serve as a feasible option to increase post-stroke motor rehabilitation. Further study is needed to test the system in older adults and in stroke patients to determine feasibility in a more representative clinical setting.