Mixed Reality–Driven Rehabilitation Using a Robotic Exoskeleton and an Immersive Game-Based Interface

Abstract

Stroke is a major cause of long-term disability worldwide and frequently leads to lasting motor deficits that severely compromise upper-limb function and diminish patients’ independence. The World Health Organization reports that every year millions of people live through a stroke but are left with permanent impairments that demand ongoing rehabilitation. However, access to intensive, individualized treatment is often constrained by social, economic, and technological factors, as well as poor adherence to repetitive training routines. To address these issues, this work introduces an interactive Mixed Reality (MR) rehabilitation system aimed at supporting upper-limb motor recovery while enhancing patient motivation. The system targets right-hand bidigital pinch training and offers two complementary operating modes: (i) an assisted therapy mode using a Bluetooth-controlled robotic exoskeleton, which guides users through prescribed therapeutic movements and exercise sequences; and (ii) an immersive, game-like mode that situates rehabilitation tasks within Activities of Daily Living (ADL) contexts. The platform was implemented in Unity and deployed on the Meta Quest 3S headset, delivering real-time visual feedback via an interactive human–computer interface. The system was evaluated through rehabilitation sessions with healthy volunteers, who subsequently assessed their experience using standardized tools, including the System Usability Scale (SUS), the Virtual Reality Sick-ness Questionnaire (VRSQ), and the NASA Task Load Index (NASA-TLX). The findings revealed good usability and manageable workload levels, indicating that the proposed MR-based system is a promising and engaging complement to conventional upper-limb rehabilitation approaches.

Keywords: Mixed Reality, Rehabilitation, Robotic exoskeleton, Human–computer interaction, Usability

DOI: 10.54941/ahfe1007286