User Experience of a Virtual Reality-Based Treadmill for Children With a Chronic Disease Affecting Physical Health:...

For children with chronic conditions affecting physical health and who require long-term care, the use of a connected treadmill for gait training as part of a home program can be a way to promote motivation in rehabilitation. Furthermore, the device must be evaluated by all user groups to ensure that its development best meets the rehabilitation needs of children.

The study aimed to assess the user experience of a connected treadmill called Amy-with both immersive and nonimmersive virtual reality-among children with a chronic disease impacting physical health, as well as their parents and therapists, to explore the feasibility and potential of such a device for home-based rehabilitation in this population.

Children with cerebral palsy, neuromuscular diseases, or obesity, along with one of their parents and rehabilitation therapists, were recruited. The study involved evaluating preexisting Amy solutions and collecting user experience feedback from participants with questionnaires. Amy solutions consisted of immersive virtual reality (using a virtual reality headset) and nonimmersive (tablet-based) games, both controlled through body movements on a treadmill conceived to train walking and balance. Questionnaires were the short version of the User Experience Questionnaire; the Usability Metric for User Experience; the Virtual Reality Sickness Questionnaire; a customized questionnaire evaluating comfort, fun, sense of presence and immersion; and a customized questionnaire evaluating parent's perception.

Twenty-eight children, 28 parents, and 18 therapists participated in the study. Compared with User Experience Questionnaire benchmark data, the overall results with immersive and nonimmersive virtual reality in all participants were in the range of 10% best results or in the "excellent" category. The mean (95% CI) scores for each group of participants, with nonimmersive and immersive virtual reality, were as follows: 1.9 (1.6-2.2) and 2.1 (1.6-2.5) for children, 2.0 (1.7-2.2) and 2.3 (2.0-2.5) for parents, and 1.4 (1.1-1.7) and 1.4 (1.1-1.7) for therapists, respectively. User experience was significantly better for children and parents than for therapists (P adjusted .001). From the Usability Metric for User Experience, participants rated the Amy treadmill's usability as "good to excellent" on the System Usability Scale, regardless of whether immersive virtual reality was used. Immersive virtual reality was well tolerated by children. Children experienced immersive virtual reality positively in terms of comfort, immersion, presence, and fun. Parents' acceptability of the connected treadmill was positively assessed.

This study is, to our knowledge, the first to assess the user experience of a playful treadmill-based virtual environment controller in children with chronic conditions affecting physical health in a user-centered and multidisciplinary team-based approach. This initial test demonstrates promising potential for using the connected treadmill as a rehabilitation tool. Therapists may need improvements to better meet their expectations, highlighting the importance of further iterations to align technological features and practical clinical context.