Influence of Demographic and Clinical Factors on Perceived Usability, Presence, Flow, Competence, Pleasant and Unpleasant Sensations, and Utility During Interaction with Virtual Reality Games for Motor and Cognitive Rehabilitation: An Observational Study in Patients with Stroke and Traumatic Brain Injury.

Abstract

Objective: User experience plays a crucial role in the interaction with virtual reality systems, especially in rehabilitation games for patients with brain injuries, who often face cognitive and motor challenges. User experience influences factors such as acceptance, engagement, and, importantly, the effectiveness of the intervention, all of which are key to achieving optimal recovery outcomes. While previous studies have examined the experiences of neurological populations, they have often focused on a single construct and used instruments that include irrelevant or confounding items. The objective of this study was to assess the perceived usability, presence, flow, competence, pleasant and unpleasant sensations, and utility of non-immersive virtual reality-based rehabilitation games targeting motor and cognitive functions in patients with stroke and traumatic brain injury. Materials and Methods: Thirty adults with stroke or traumatic brain injury interacted with three non-immersive virtual reality games targeting motor and cognitive skills, and then completed standardized instruments assessing the above constructs. Results: The results revealed high usability, strong presence, and a positive flow experience. Participants also reported high levels of competence and pleasant sensations, with low levels of unpleasant sensations, indicating a generally favorable user experience. Utility was positively perceived. Analysis of demographic and clinical factors showed no significant impact of sex on most constructs, although women reported higher flow and enjoyment. Etiology, however, had a significant effect, with patients with traumatic brain injury reporting more positive experiences across all constructs compared to patients with stroke. Neither age nor time since injury significantly influenced the results. These findings highlight the importance of understanding specific user experience constructs and the influence of demographic and clinical factors in designing effective and engaging virtual reality rehabilitation games.