Development of a virtual reality-based intervention for community walking post stroke: an integrated knowledge translation approach

Abstract

Purpose

To develop a virtual reality (VR) based intervention targeting community walking requirements.

Methods

Two focus groups each involving 7 clinicians allowed exploring optimal features, needed support and perceived favorable/unfavorable factors associated with the use of the VR-based intervention from the clinicians’ perspective. Three stroke survivors and 2 clinicians further interacted with the intervention and filled questionnaires related to acceptability and favorable/unfavorable perceptions on the VR intervention. Stroke participants additionally rated their perceived effort (NASA Tax Load Index), presence (Slater-Usoh-Steed) and cybersickness (Simulator Sickness Questionnaire).

Results

Results identified optimal features (patient eligibility criteria, task complexity), needed support (training, human assistance), as well as favorable (cognitive stimulation, engagement, representativeness of therapeutic goals) and unfavorable factors (misalignment with a natural walking pattern, client suitability, generalization to real-life) associated with the intervention. Acceptability scores following the interaction with the tool were 28 and 42 (max 56) for clinicians and ranged from 43 to 52 for stroke participants. Stroke participants reported moderate perceptions of effort (range:20-33/max:60), high levels of presence (29-42/42) and minimal cybersickness (0-3/64).

Conclusion

Findings collected in the early development phase of the VR intervention will allow addressing favorable/unfavorable factors and incorporating desired optimal features, prior to conducting effectiveness and implementation studies.

IMPLICATIONS FOR REHABILITATION

• This study presents the development process of a new virtual reality (VR) intervention for community walking and participation in stroke survivors.

• Results from the focus group and hands-on pilot trial suggest that the VR intervention is feasible and accepted by clinicians and stroke survivors.

• Addressing favorable/unfavorable factors and incorporating features desired by clinicians in the development of the VR tool should promote its eventual implementation in clinical setting.

Keywords:

• Cerebrovascular accident
• mobility
• omnidirectional treadmill
• rehabilitation
• virtual reality

Acknowledgements

The authors would like to thank the participants and clinicians involved in this study as well as the Stéphanie Laurin, stroke program manager of the Jewish Rehabilitation Hospital.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability Statement

Data will be made available upon request.

Additional information

Funding

This study was supported by the Canadian Institutes of Health Research (CIHR, Grant # PJT-148917). ADB and MB were recipients of a doctoral fellowship from the Fonds de recherche du Québec – Santé (FRQS).