Experience of an upper limb training program with a non-immersive virtual reality system in patients after stroke: a qualitative study

Abstract

Objectives The YouGrabber (YG) is a new virtual reality training system that focuses on unilateral and bimanual activities. This nested study was part of a larger multicentre randomised controlled trial and explored experiences of people with chronic stroke during a 4 week intensive upper limb training with YG. Design: A qualitative design using semi-structured, face-to-face interviews. A phenomenological descriptive approach was used, with data coded, categorized and summarized using a thematic analysis. Topics investigated included: the experience of YG training, perceived impact of YG training on arm function, and the role of the treating therapist. Results: Five people were interviewed (1 female, age range 55-75yrs, 1-6yrs poststroke). Seven main themes were identified: (1) general experience, (2) expectations, (3) feedback, (4) arm function, (5) physiotherapist's role, (6) fatigue, (7) motivation. Key experiences reported included feelings of motivation and satisfaction, with positive factors identified as challenge, competition, fun and effort. The YG training appeared to trigger greater effort, however fatigue was experienced at the end of the training. Overall, patients described positive changes in upper limb motor function and activity level, e.g. automatic arm use. While the opportunity for self-practice was appreciated, input from the therapist at the start of the intervention was deemed important for safety and confidence. Conclusions: Reported experiences were mostly positive and the participants were motivated to practice intensively. They enjoyed the challenging component of the games.