Technical Feasibility of the implementation of an intensive upper-limb rehabilitation system (NeuroVirt) intervention for stroke survivors

Background 80% of stroke survivors have upper limb (UL) disability. NeuroVirt is a portable immersive virtual reality (VR) platform that is designed to encourage high-repetition and high-quality UL movement training. The aim of the study is to investigate the technical feasibility, and the useability and acceptability of NeuroVirt. Methods 8 adults with a stroke (≥ 3-months) completed the study. Participants used the device at home for up to two 1-hour sessions each day, 6 days a week, for 6 weeks. Participants also received a 15-minute weekly telephone call. Technical feasibility was measured by the percentage of Wi-Fi disconnections, data push failures, and mean scene frames per second (fps). Usability and acceptability were explored through interview feedback and analysed with a thematic inductive analysis approach. We also recorded the number of movement repetitions per session as an indication of compliance. Results From 12 participants enrolled in the study, 8 (67%) participants started the NeuroVirt exercise program and were included in the study analysis. Results indicated good Wi-Fi stability with 1(1.51%) disconnection out of 198 sessions, 1 (0.09%) push attempt failed out of 1052 data pushes and no data loss. An overall mean of 67.5 (2.27) fps during a session. Data from the interviews suggested that participants found NeuroVirt acceptable and indicated improvements in function. Participants completed on average 3.5 (1.3) sessions per week and performed on average 338.2 (172.7) movement repetitions per session. Conclusion NeuroVirt had no data loss and consistent Wi-Fi stability. The frame rate was above the minimum industry standards of 60-fps required to prevent motion sickness. Preliminary useability and acceptability results showed that a Home-based NeuroVirt program for stroke survivors with UL impairments was both, feasible and well accepted. Trial registration: registration number ISRCTN46051085; prospectively registered the 24/02/2023.