Comparative Evaluation of Non-immersive and Immersive Approaches for Upper Limb Rehabilitation: A Performance and Usability Study

Emerging technologies have recently played a critical role in enhancing the upper extremity rehabilitation process, serving as an adjunct to the traditional therapeutic treatments that patients receive. Ideally, these technologies should facilitate accurate tracking of hand movements, collect data on patient performance during functional tasks, and provide an objective view of potential patient progress. While wearable and mechanical devices offer superior accuracy in capturing measurements, the physical limitations of patients require the introduction of hands-free solutions. This research explores hands-free hand tracking technologies in the Box and Block Test (BBT). It compares them to the actual test performed at the Hospital Nacional de Parapléjicos (Toledo, Spain). The study analyses the kinematics in order to evaluate the performance of the therapeutic exercises in three different environments: a technology-free physical environment, a non-immersive virtual space and a fully immersive virtual scenario. This evaluation includes a functional analysis based on the precision of the movements and the goals achieved to complete the therapy. In addition, the clinical study employs a comprehensive questionnaire to evaluate usability, user interaction, presence, and potential VR-induced effects. The results show a remarkable similarity between therapies delivered in traditional, technology-free environments and those delivered in virtual reality-based scenarios.