Virtual Reality applied to Post-Stroke Rehabilitation: design and development of the NeuroRehab VR Software

ABSTRACT Objective To describe the design and development of NeuroRehab VR, a fully immersive, specific and gamified virtual reality (VR) software aimed at improving the quality of life and reducing disability in post-stroke patients. Methods A public-private collaborative research project was carried out between 2022 and 2024 by a multidisciplinary and multicenter team comprising neurologists, rehabilitation specialists, physiotherapists, exercise and sport sciences professionals and members of the company Dynamics VR Rehab, including engineers, developers, computer programmers, game designers, and digital artists. The project was structured into three phases: preproduction, production, and postproduction, with periodic focus group meetings and testing sessions with patients in the subacute phase of stroke held every one to two months. Results In the Preproduction phase, the multidisciplinary team discussed the initial concepts and, using the SCRUM methodology together with feedback from pilot patients, developed the software design. In this process, three thematic environments (i.e., home, nature, and science fiction) were established, along with five activity types targeting upper limb rehabilitation: fine motor skills, gross motor skills, balance, rhythmic movements, and movement speed. The software incorporated fully immersive VR, advanced hand tracking technology, and adaptive gamification elements. During the Production phase, these components were implemented and consolidated into a functional prototype. Finally, in the post-production phase, several adjustments were made after identifying minor issues, with the aim of improving activity responsiveness and refining the user experience for both patients and clinicians. Conclusion NeuroRehab VR represents a promising tool to be integrated into post-stroke rehabilitation programs and is being tested though a clinical trial. Moreover, this public-private, multidisciplinary, and multicenter collaboration model constitutes an effective framework for the design and development of technologically driven solutions applicable to clinical rehabilitation settings.