Exploring Usability and User Engagement in Fully Immersive Virtual Reality Systems for Upper Limb Stroke...

Fully immersive virtual reality (FIVR) systems are emerging as innovative tools for upper limb stroke rehabilitation. These systems provide immersive, interactive environments that foster motivation, engagement, and functional recovery. This scoping review examines the usability of FIVR systems for upper limb rehabilitation among stroke survivors, focusing on evaluation methods, patient and therapist experiences, and barriers to adoption.

The review followed PRISMA-ScR guidelines. A systematic search of PubMed, IEEE Xplore, and Scopus identified 20 eligible studies. Data were extracted on study design, participant demographics, VR system characteristics, software, task type, game/task elements, usability evaluation methods, and key findings.

The findings demonstrate generally positive benefits in terms of usability and engagement, with participants indicating both motivation and enjoyment during FIVR interventions. However, there was considerable variability in assessment methods, including both quantitative and qualitative approaches, as well as in hardware, software, interaction methods and no standardized framework. Common challenges included mild side effects (e.g., dizziness), technical complexity, and the need to adapt to patients' varying abilities. Such limitations highlight gaps in the standardization and replicability of usability assessment across studies.

FIVR systems offer potential as supplements to conventional therapy, providing engaging and personalized rehabilitation experiences. Improving usability assessment through standardized frameworks, addressing technical and accessibility barriers, and ensuring the adaptability of interventions to individual patient needs are critical to optimizing effectiveness and supporting broader clinical adoption.