Upper limb rehabilitation system based on virtual reality for breast cancer patients: Development and usability study

Abstract

Background Functional exercise is crucial for breast cancer patients after surgery, and the use of virtual reality technology to assist patients with postoperative upper limb functional rehabilitation has gradually attracted the attention of researchers. However, the usability of the developed rehabilitation system is still unknown to a large extent. The purpose of this study was to develop a virtual reality upper limb rehabilitation system for patients after breast cancer surgery and to explore its usability. Methods We built a multidisciplinary team based on virtual reality and human-computer interaction technology and designed and developed an upper limb function rehabilitation system for breast cancer patients after surgery. Breast cancer patients were recruited from a grade III-a general hospital in Changchun city for the experiment. We used the System Usability Scale to evaluate the system availability, the Presence Questionnaire scale to measure the immersive virtual reality scene, and the Simulator Sickness Questionnaire subjective measurement scale for simulator sickness symptoms. Results This upper limb rehabilitation system hardware consisted of Head-mounted Display, a control handle and notebook computers. The software consisted of rehabilitation exercises and game modules. A total of 15 patients were tested on this system, all of whom were female. The mean age was 54.73±7.78 years, and no patients were excluded from the experiment because of adverse reactions such as dizziness and vomiting. The System Usability Scale score was 90.50±5.69, the Presence Questionnaire score was 113.40±9.58, the Simulator Sickness Questionnaire-nausea score was 0.93±1.16, the Simulator Sickness Questionnaire-oculomotor score was 0.80±1.27, the Simulator Sickness Questionnaire-disorientation score was 0.80±1.27, and the Simulator Sickness Questionnaire total score was 2.53±3.40. Conclusions This study fills in the blanks regarding the upper limb rehabilitation of breast cancer patients based on virtual reality technology system usability research. As the starting point of research in the future, we will improve the system’s function and design strictly randomized controlled trials, using larger samples in the promotion, to evaluate its application in breast cancer patients with upper limbs and other physiological functions and the feasibility and effects of rehabilitation.

Opportunities and challenges of virtual reality-based interventions for patients with breast cancer: a systematic review

“…Chirico et al in their study reported cybersickness symptoms using the Virtual Reality Symptom Questionnaire (VRSQ) [58]. Their findings showed that except for [33,41] User resistance because of first exposure to the VR [19,41] Quality of visual image [33] Weakness of learning ability [41] Need for familiarization stage to use of VR [19] Adverse effects of medication on the effective use of VR [37] Cost of the equipment [20] Study-related Small sample size [30,33,34,37,[41][42][43] Study design [7,31,32,36,38,42] Single study site [33][34][35]42] Lack of generalizability [20,41,42] Risk of bias [7,36,42] Lack of standardized measurement tools [30,35] The intervention was used only once with each patient [7,35] Lack of blinding [7] Investigating short-term effects [7] Short duration of the study [38] Non-compliance of patients [43] Insufficient data collection [41] Patient unwillingness to complete questionnaires…”

“…Study designs in most of the studies were before-after (N = 5) (19,(29)(30)(31)(32), cross-over (N = 5) [33][34][35][36][37], and RCT (N = 4) [7,20,38,39]. Other study designs in reviewed articles were cross-sectional [40], experimental design [41], quasi-experimental [42] and quasi-randomized clinical trials [43], each with one study. All participants were adult patients with breast cancer.…”

“…The intervention duration varied from 7 to 90 min. Figure 2 shows six studies from the United States [30,[33][34][35][36][37], four from Italy [7,31,40,44], and one from Australia [42], Brazil [29], China [41], Egypt [43], France [19], Jordan [20], Poland [32], and Turkey [38].…”

Effect of a telehealth-based exercise intervention on the physical activity of patients with breast cancer: A systematic review and meta-analysis

“… 71 With the booming technology, we can explore more emerging technologies for telehealth applications, such as virtual reality and interactive voice response systems. 72 , 73 Given the limited number of included studies and non-uniform outcome indicators, our study did not perform subgroup analysis that would allow us to determine the effective form of intervention. This inadequacy must be refined in future studies.…”

From Augmented to Virtual Reality in Plastic Surgery: Blazing the Trail to a New Frontier

“…2 3 Zhou et al and Tokgöz et al describe cost-effective therapeutic regimens that rely on VR. 2 3 Dunn et al successfully used VR in the treatment of phantom limb pain as an alternative to traditional mirror therapy. By simulating the amputated limb, the patient was able to reconcile their visual and proprioceptive representations of the limb.…”