A Multisession Evaluation of a Collaborative Virtual Environment for Arm Rehabilitation

In recent years, several multi-user virtual environments (VEs) have been developed to promote motivation and exercise intensity in motor rehabilitation. While competitive VEs have been extensively evaluated, collaborative and competitive rehabilitation VEs have seen relatively little study. Therefore, this article presents an evaluation of a VE for post-stroke arm rehabilitation that mimics everyday kitchen tasks and can be used either solo or collaboratively. Twenty subacute stroke survivors exercised with the VE for four sessions, with the first and third sessions involving solo exercise and the other two involving collaborative exercise. Exercise intensity was measured using inertial sensors while motivation was measured with questionnaires. Results showed high motivation and exercise intensity over all four sessions, and 11 of 20 participants preferred collaborative over solo exercise while only 4 preferred solo exercise. However, there were no differences in motivation, exercise duration, or exercise intensity between solo and collaborative sessions. Thus, we cannot currently claim that collaborative exercises are beneficial for upper limb rehabilitation. Future studies should evaluate other collaborative VE designs in different settings (e.g., at home) and with different participant pairs (e.g., patient-unimpaired) to find effective ways to utilize collaborative exercises in motor rehabilitation.