Virtual Reality (VR) has been utilized for several applications and has shown great potential for rehabilitation, especially for home therapy. However, these systems solely rely on information from VR hand controllers, which do not fully capture the individual movement of the joints. In this paper, we propose a creative VR therapy exergame for upper extremity rehabilitation using multi-dimensional reaching tasks while simultaneously capturing hand movement from the VR controllers and elbow joint movement from a flexible carbon nanotube sleeve. We conducted a preliminary study with non-clinical participants (n = 12, 7 F). In a 2x2 within-subjects study (orientation (vertical, horizontal) x configuration (flat, curved)), we evaluated the effectiveness and enjoyment of the exergame in different study conditions. The results show that there was a statistically significant difference in terms of task completion time between the two orientations. However, no significant differences were found in the number of mistakes in both orientation and configuration of the virtual exergame. This can lead to customizing therapy while maintaining the same level of intensity. That is, if a patient has restricted lower limb mobility and requires to be seated, they can use the orientations interchangeably. The results of resistance change generated from the carbon nanotube sleeve revealed that the flat configuration in the vertical orientation induced more elbow stretches than the other conditions. Finally, we reported the subjective measures based on questionnaires for usability and user experience in different study conditions. In conclusion, the proposed VR exergame has the potential as a multimodal sensory tool for personalized upper extremity home-based therapy and telerehabilitation.

翻译：虚拟现实（VR）已在多种应用中被采用，并展现出在康复领域的巨大潜力，尤其适用于家庭治疗。然而，这些系统仅依赖VR手部控制器的信息，无法完全捕捉关节的独立运动。本文提出一种创新的VR治疗运动游戏，利用多维伸展任务实现上肢康复，同时通过VR控制器捕捉手部运动，并通过柔性碳纳米管套筒捕捉肘关节运动。我们与12名非临床参与者（其中7名女性）进行了初步研究。在2×2受试者内设计研究（方向：垂直、水平；布局：平面、弯曲）中，我们评估了运动游戏在不同实验条件下的有效性和愉悦度。结果表明，两种方向在任务完成时间方面存在统计学显著差异。然而，在虚拟运动游戏的方向和布局上，错误次数未发现显著差异。这提示可在保持相同强度水平的前提下实现个性化治疗，即患者若下肢活动受限需保持坐姿，可互换使用不同方向。碳纳米管套筒产生的电阻变化结果显示，垂直方向的平面布局比其他条件诱导了更多的肘部伸展。最后，我们根据问卷报告了不同实验条件下的可用性和用户体验主观测量结果。结论表明，所提出的VR运动游戏有望成为个性化上肢家庭治疗和远程康复的多模态感知工具。