Users’ and therapists’ perspectives on the design of a virtual reality environment to train prosthesis control: a narrative review and focus group study

Abstract

Abstract Introduction: Virtual Reality (VR) is becoming increasingly popular to learn a complex skill, and hence has been used to train the control of upper limb prostheses. It is however unclear what characteristics a VR environment should have in order to become a usable and effective training environment. Our aim was to develop a framework containing the most important factors to be incorporated when designing a VR environment to train prosthesis control. Methods: A mixed method approach was used. First, a narrative review was conducted to explore factors that should be considered when designing a VR environment for prosthesis control. Second, a preliminary framework, based on these factors, was presented to prosthesis users and therapists via a questionnaire. Participants chose the most important factors to be incorporated in a VR environment. Finally, the results were discussed in focus groups. Results: Forty-nine out of 489 articles, were included. The preliminary framework comprised 62 factors in four domains: feedback, control, exercise and environment. Five prosthesis users and eight therapists participated in three focus groups. A final framework was developed which contained 46 factors in the four domains. End-users considered all domains to be equally important, since domains and factors influence each other. Discussion: Future research should investigate aspects of VR enjoyment, implementation of bimanual training and the development of a testing environment with peer support. Conclusion: The developed framework can be used to guide the design of a VR environment to train prosthesis control. Trial registration: May 1st, 2023, https://doi.org/10.17605/OSF.IO/W6Z39