Patient satisfaction and tolerance of virtual reality rehabilitation in subacute ischemic stroke: a pilot study

Sarka Banikova^1,2,3Alice Najsrova²István Szegedi^2,4,5Kateřina Vitová¹Iva Fiedorová^1,3Jana Trdá⁶Ondrej Volny^2,4*

• ¹Department of Rehabilitation and Sports Medicine, University Hospital Ostrava, Ostrava, Czechia
• ²Centre for Clinical Neurosciences, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
• ³Department of Rehabilitation and Sports Medicine, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
• ⁴Department of Neurology, University Hospital Ostrava, Ostrava, Czechia
• ⁵Department of Neurology, University of Debrecen, Debrecen, Debrecen, Hungary
• ⁶VR LIFE Ltd., Ostrava, Czechia

Background: Virtual reality (VR) rehabilitation represents a promising technological approach in post-stroke neurorehabilitation, offering immersive, engaging therapy environments. However, limited data exist on patient satisfaction and tolerance in clinical practice, particularly during the subacute phase of stroke recovery. Objective: To evaluate patient satisfaction and tolerance of VR rehabilitation in patients with subacute ischemic stroke and assess physiotherapist perceptions of treatment outcomes compared to conventional rehabilitation. Methods: A prospective pilot study was conducted from January 1-December 31, 2024, at University Hospital Ostrava, Czech Republic. Patients in the subacute phase of ischemic stroke (≤2 weeks post-stroke) underwent VR rehabilitation using the MDR-certified VR Vitalis® Pro system. Patient satisfaction was measured using the User Satisfaction Evaluation Questionnaire (USEQ). Physiotherapists assessed treatment outcomes on a 5-point scale compared to conventional rehabilitation. Vital signs were monitored pre- and post-intervention. Results: Nineteen patients (mean age 67.7 ± 11.2 years, 52.6% female) completed VR rehabilitation. The mean USEQ satisfaction score was 25.0 ± 6.8 points (range 7-30). High satisfaction (≥25 points) was achieved in 68.4% of patients, with only 5.3% reporting low satisfaction. Individual question analysis revealed highest ratings for information clarity (4.63 ± 0.96) and perceived rehabilitation benefit (4.37 ± 1.12), with 63.2% reporting no discomfort. Physiotherapists rated 31.6% of patients as showing better outcomes than expected with conventional therapy, while 52.6% showed similar outcomes. No serious adverse events were recorded. Conclusions: VR rehabilitation demonstrated high patient satisfaction and excellent tolerance in subacute stroke patients. Individual USEQ analysis revealed strong acceptance for system clarity and rehabilitation benefit. These findings support VR rehabilitation feasibility in clinical stroke care.