Development and evaluation of a mixed reality system for health education on neck stiffness and soreness

Abstract

Mobile phones are indispensable in daily life, especially among university students, yet their prolonged use has been linked to postural problems such as neck stiffness and soreness - conditions that may reflect more serious underlying health issues. Concurrently, a global shortage of nursing personnel is challenging healthcare systems, emphasizing the need for innovative educational tools that alleviate the workload of nursing professionals. This research develops and evaluates a mixed-reality (MR) system using Microsoft HoloLens to offer health education on neck health. The system's usability and user satisfaction are assessed through subjective scales and qualitative feedback to determine its effectiveness versus traditional educational materials.

Twenty participants were randomly assigned to two groups: an MR-based HoloLens group and a traditional leaflet group (10 participants each). Both groups received identical health education content on neck stiffness and soreness. Participants completed a 9-item knowledge test and semi-structured interviews to assess comprehension and to help gather system usability feedback. The HoloLens group further evaluated the system using the System Usability Scale (SUS) and the Questionnaire for User Interaction Satisfaction (QUIS).

While knowledge acquisition scores are comparable between the groups, the HoloLens group exhibits significantly higher levels of engagement and stronger intent to pursue further health education. The MR system obtains a mean SUS score of 76, denoting “Good” usability and a grade B rating. QUIS responses indicate high satisfaction levels across usability constructs. Qualitative feedback highlights the immersive and interactive design of the HoloLens system, which fosters engagement and motivates users by connecting educational content to personal relevance and curiosity. These findings demonstrate the potential of MR technologies to transform health education by bridging the gap between static information delivery and dynamic learner engagement, ultimately supporting improved comprehension and sustained interest in health topics.