A novel intervention for upper limb rehabilitation in people with stroke combining myoelectric pattern recognition, virtual reality, and serious gaming: a qualitative study

Disabil Rehabil. 2025 Jul;47(15):3930-3937. doi: 10.1080/09638288.2024.2434643. Epub 2024 Dec 3.

Abstract

Purpose: To explore the perceptions and experiences of people with stroke participating in a novel upper limb intervention, combining myoelectric pattern recognition (MPR), virtual reality (VR), and serious gaming.

Material and methods: Six individuals with chronic stroke and moderate to severe upper limb impairment were interviewed after 18 training sessions delivered over 6 weeks (total average practice time of 21 h). The semi-structured interviews were transcribed and analyzed with qualitative content analysis.

Results: The overarching theme that emerged from the interviews, "Many factors come into play to make it work," included three categories: "The Player - training was rewarding and demanding at the same time," "The Program - a fun way to exercise, but there is more to it," and "The Supporter - a partner hard to replace."

Conclusion: Participants perceived the training as motivating, valuable, and different from their previous rehabilitations. Increased use and awareness of their arm and hand in daily life activities were described as positive. Synchronization between the real and virtual arms, game difficulty level, user interface, electrode placement, and potential independent home use were described as challenges. These findings offer valuable insights for future development and implementation of MPR-driven technologies in stroke rehabilitation.

Keywords: Qualitative content analysis; myoelectric pattern recognition; rehabilitation; stroke; surface electromyography (sEMG); upper limb function; virtual reality.

Plain language summary

Surface electromyography-driven interventions are promising approaches to promote upper limb function after strokeA novel intervention combining myoelectric pattern recognition, virtual reality, and gaming may improve awareness and daily use of the paretic arm.Visualization of real-time motor control of the paretic arm added value to the training.End-user experiences and perceptions are essential for developing appropriate rehabilitation interventions.

MeSH terms

  • Activities of Daily Living
  • Adult
  • Aged
  • Electromyography
  • Exercise Therapy / methods
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Qualitative Research
  • Stroke / physiopathology
  • Stroke Rehabilitation* / methods
  • Upper Extremity* / physiopathology
  • Video Games*
  • Virtual Reality*