Immersive Virtual Reality and Robotics for Upper Extremity Rehabilitation

Stroke patients often experience upper limb impairments that restrict their mobility and daily activities. Physical therapy (PT) is the most effective method to improve impairments, but low patient adherence and participation in PT exercises pose significant challenges. To overcome these barriers, a combination of virtual reality (VR) and robotics in PT is promising. However, few systems effectively integrate VR with robotics, especially for upper limb rehabilitation. Additionally, traditional VR rehabilitation primarily focuses on hand movements rather than joint movements of the limb. This work introduces a new virtual rehabilitation solution that combines VR with KinArm robotics and a wearable elbow sensor to measure elbow joint movements. The framework also enhances the capabilities of a traditional robotic device (KinArm) used for motor dysfunction assessment and rehabilitation. A preliminary study with non-clinical participants (n = 16) was conducted to evaluate the effectiveness and usability of the proposed VR framework. We used a two-way repeated measures experimental design where participants performed two tasks (Circle and Diamond) with two conditions (VR and VR KinArm). We found no main effect of the conditions for task completion time. However, there were significant differences in both the normalized number of mistakes and recorded elbow joint angles (captured as resistance change values from the wearable sensor) between the Circle and Diamond tasks. Additionally, we report the system usability, task load, and presence in the proposed VR framework. This system demonstrates the potential advantages of an immersive, multi-sensory approach and provides future avenues for research in developing more cost-effective, tailored, and personalized upper limb solutions for home therapy applications.