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ORIGINAL RESEARCH article

Front. Rehabil. Sci.

Sec. Translational Research in Rehabilitation

Usability and Expert Validation of a Virtual Reality System for Post-Mastectomy Rehabilitation

Provisionally accepted
Giulia BongiornoGiulia Bongiorno1Ilaria AlbiIlaria Albi2Tommaso CoianizTommaso Coianiz2Helena BiancuzziHelena Biancuzzi3Francesca Dal MasFrancesca Dal Mas4Daniele VidiDaniele Vidi2Luca MiceliLuca Miceli5*
  • 1"Friuli Riabilitazione" rehabilitation center, Roveredo in Piano (PN), Italy
  • 2Universita degli Studi di Udine, Udine, Italy
  • 3Universita Ca' Foscari Dipartimento di Economia, Venice, Italy
  • 4Universita Ca' Foscari, Venice, Italy
  • 5CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy, Aviano, Italy

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Introduction: Virtual reality (VR) is proposed as a support (and potential alternative) to traditional rehabilitation after breast cancer surgery, with expected effects on pain, anxiety, fatigue, and recovery of shoulder ROM (range of movement). The study aims to test a VR system that integrates body illusion, gamification, and distraction, evaluating its usability, user experience, and comfort for clinical use. Methods: The study was conducted on 31 healthy subjects (28 physiotherapy students, 3 physiotherapists). The software includes a shoulder ROM calibration phase and a training phase involving a VR tennis game, with adjustable parameters and automatic performance recording. SSQ, SUS, UEQ, CRS, and a question on the adequacy of playing speed were administered. A descriptive analysis (mean, standard deviation) and a qualitative analysis of the open-ended responses were conducted. Results: SSQ: very low average symptoms (minimal discomfort). SUS: good perceived usability (easy, integrated, safe). UEQ: Overall positive experience (clarity, modernity, pleasantness); concerns regarding predictability/slowness. CRS: High tolerability and low anxiety/harm; higher "attachment." Regarding speed: 15 "Yes" votes to making it faster, 16 "No" votes (divided opinions). Discussion: The VR system is well tolerated, usable, and has a favorable user experience in healthy subjects, indicating promising clinical transferability for shoulder rehabilitation after breast surgery. Dynamics and predictability (adaptive speed/levels) remain to be optimized, and the software needs to be validated on patients and experienced physiotherapists in dedicated studies.

Keywords: breast cancer, physical activity, Shoulder rehabilitation, Tennis, virtual reality

Received: 04 Oct 2025; Accepted: 17 Dec 2025.

Copyright: © 2025 Bongiorno, Albi, Coianiz, Biancuzzi, Dal Mas, Vidi and Miceli. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Luca Miceli

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material