  Stroke patients often experience upper limb impairments that restrict their
mobility and daily activities. Physical therapy (PT) is the most effective
method to improve impairments, but low patient adherence and participation in
PT exercises pose significant challenges. To overcome these barriers, a
combination of virtual reality (VR) and robotics in PT is promising. However,
few systems effectively integrate VR with robotics, especially for upper limb
rehabilitation. This work introduces a new virtual rehabilitation solution that
combines VR with robotics and a wearable sensor to analyze elbow joint
movements. The framework also enhances the capabilities of a traditional
robotic device (KinArm) used for motor dysfunction assessment and
rehabilitation. A pilot user study (n = 16) was conducted to evaluate the
effectiveness and usability of the proposed VR framework. We used a two-way
repeated measures experimental design where participants performed two tasks
(Circle and Diamond) with two conditions (VR and VR KinArm). We observed no
significant differences in the main effect of conditions for task completion
time. However, there were significant differences in both the normalized number
of mistakes and recorded elbow joint angles (captured as resistance change
values from the wearable sleeve sensor) between the Circle and Diamond tasks.
Additionally, we report the system usability, task load, and presence in the
proposed VR framework. This system demonstrates the potential advantages of an
immersive, multi-sensory approach and provides future avenues for research in
developing more cost-effective, tailored, and personalized upper limb solutions
for home therapy applications.
