Evaluating Safety and Usability of Robot-Aided Telerehabilitation System for Upper-limb Therapy

Background Robot-assisted telerehabilitation (RAT) is an emerging field that integrates digital health technologies with robotics to deliver remote therapy, offering significant potential to overcome geographical and accessibility barriers in stroke rehabilitation. This approach holds great promise for enhancing upper limb (UL) recovery in stroke survivors. This study aims to assess the safety and usability of a new tele-rehabilitation system that uses the desktop-mounted rehabilitation (DMRbotV3) device and the HoloLens 2, designed to assist stroke survivors with UL dysfunction in performing therapy. Methods Six individuals with chronic stroke (onset ≥ 3 months) and six occupational therapists (OTs) participated in a single-session usability study. They interacted with the DMRbotV3 robotic device to perform structured passive and active therapeutic exercises within mixed-reality (MR) environments powered by the HoloLens 2 platform. Safety, usability, and user experience were assessed using the System Usability Scale (SUS), a customized gamification and satisfaction questionnaire, an experience evaluation survey, and follow-up interviews. Results The DMRbotV3 system was deemed secure, as evidenced by all twelve participants successfully completing the study without any adverse events. Usability evaluations showed a high level of user satisfaction, with a mean (SD) SUS score of 86.7 (8.5)%. The participants provided positive and constructive feedback on the integration of MR with HoloLens 2, which was determined to substantially increase their engagement and motivation during the exercises. Additional feedback emphasized the system’s ease of use, the need for a variety of handle designs, and the importance of simplifying certain exercise games. Conclusion The study demonstrated that the DMRbotV3 system integrated with HoloLens 2 is a safe, feasible, and well-accepted approach for UL rehabilitation in post-stroke individuals. This approach, by enabling more frequent and comprehensive self-administered practice in-home or remote settings, has the potential to enhance telerehabilitation outcomes and support functional recovery in stroke survivors.