Development and evaluation of a virtual reality rehab program for stroke patients

Thesis Abstract

Stroke remains a leading cause of long-term disability worldwide, with conventional rehabilitation approaches often limited by patient engagement and resource constraints. This study addresses the urgent need for innovative rehabilitation interventions by developing a tailored virtual reality (VR) rehab program designed to enhance motor recovery and functional independence among stroke survivors. The primary aim is to evaluate the efficacy, feasibility, and user experience of the VR intervention in comparison to traditional therapy modalities. Specifically, the study seeks to determine the impact of the VR program on motor function, activities of daily living, and patient motivation, as well as to explore user perceptions and adherence factors influencing its implementation. Employing a mixed-methods research design, the study integrates quantitative and qualitative approaches to provide comprehensive insights into the program’s effectiveness and contextual acceptability. The quantitative component adopts a randomized controlled trial (RCT) involving 120 adult stroke patients within three to six months post-stroke, recruited from tertiary rehabilitation centers. Participants are randomly assigned to either the experimental group receiving VR-based therapy or the control group undergoing conventional physiotherapy. The VR program is developed based on principles from the Motor Relearning Program and rooted in the Theory of Self-Determination, emphasizing autonomy, competence, and relatedness to foster motivation. Data collection utilizes validated instruments, including the Fugl-Meyer Assessment for motor function, the Barthel Index for activities of daily living, and the Intrinsic Motivation Inventory to assess motivation levels. Additionally, semi-structured interviews are conducted with 20 participants and 10 physiotherapists to gather qualitative insights into user experiences. Data analysis involves repeated-measures ANOVA to compare pre- and post-intervention scores within and between groups, complemented by regression analysis to identify predictors of motor recovery and adherence. Thematic analysis of interview transcripts is employed to elucidate contextual factors influencing the acceptability and usability of the VR system, guided by the Consolidated Framework for Implementation Research (CFIR). Rigorous validity and reliability testing of the intervention and instruments precede data collection, ensuring the robustness of findings. Ethical approval is obtained from relevant institutional review boards, with participants providing informed consent. Expected findings suggest that the VR rehabilitation program will significantly improve motor outcomes and functional independence compared to conventional therapy, with higher motivation and engagement levels observed among participants in the experimental group. The qualitative component is anticipated to reveal critical facilitators and barriers to VR adoption, including technological usability, patient motivation, and resource considerations. These findings are expected to fill existing gaps in literature regarding immersive VR applications in stroke rehabilitation, particularly emphasizing context-specific implementation factors and theoretical integration. This study empirically contributes to existing knowledge by demonstrating the potential of VR technology to transform stroke rehabilitation paradigms, offering evidence-based insights into its clinical efficacy and user-centered design principles. The integration of the Motor Relearning Model and Self-Determination Theory provides a theoretical framework for optimizing intervention engagement and effectiveness. The research concludes with recommendations for integrating VR rehabilitation into routine clinical practice, emphasizing training, resource allocation, and patient-centered customization. Additionally, it advocates for further longitudinal studies to assess the sustainability of functional gains and to explore scalability across different healthcare settings. Ultimately, this study advances post-stroke rehabilitation practices by establishing an empirically supported, technologically enhanced intervention that prioritizes patient motivation, functional recovery, and health system efficiency.