Recovering through play: Studying the effects of collaborative Virtual Reality serious games for stroke rehabilitation through a human-centered design methodology

Stroke is one of the world’s leading causes of death and disability and can have profound consequences that require effective rehabilitation to support survivors’ recovery and improve their quality of life. Despite their value, traditional rehabilitation methods tend to be repetitive and lack variety, which challenges survivors’ motivation. Additionally, these rehabilitation sessions are usually solitary, leaving survivors to practice exercises alone, which can lead to physical setbacks and social isolation. Such isolation can further reduce enthusiasm for therapy, delay recovery, and affect their mental well-being. This work details an extended version from the International Workshop on eXtended Reality for Industrial and Occupational Supports (XRIOS), conducted at IEEE VR 2025. It proposes a collaborative Virtual Reality (VR) framework that aims to increase survivors’ motivation during rehabilitation. Through its collaborative nature, it can involve multiple users in the same virtual space, from stroke survivors to healthcare professionals, giving them a common goal that they must join forces to accomplish. Various serious games were designed through a series of activities focused on specific gestures related to the rehabilitation of the upper limbs, thus improving physical recovery and mental well-being. The design and development were guided by a human-centered methodology that included survivors and professionals, resulting in a user study with a total of 53 participants, 18 from a rehabilitation center. The results indicate that this collaborative VR tool effectively boosts motivation, social interaction, and engagement while maintaining an accessible and manageable level of physical and mental demand for stroke recovery, underscoring its suitability for stroke recovery. • A collaborative VR framework developed to enhance motivation/engagement in stroke rehabilitation. • The framework supports multi-user interaction, connecting stroke survivors and professionals in shared virtual activities. • Serious games targeting upper limb gestures and cognitive recovery were co-designed with survivors and healthcare professionals. • A user study involving 53 participants, including 18 individuals from a rehabilitation center, was conducted. • Results show improved social interaction, motivation, and rehabilitation engagement, with accessible physical and mental demands.