Open Access Te Herenga Waka-Victoria University of Wellington
thesis_access.pdf (14.62 MB)

Mirror VR: The design of a fully immersive virtual reality game for upper limb rehabilitation post-stroke using mirror therapy

Download (14.62 MB)
posted on 2022-08-01, 01:51 authored by Leniston-Kahsai, Senai

Motor rehabilitation post-stroke requires practice that is high-intensity, repetitive, task-specific, challenging, and goal-oriented to promote neuroplasticity to maximise functional recovery outcomes. There is concern that people with stroke (PwS) are not engaging in sufficient therapy dose to induce significant neuroplastic changes. PwS can utilise motor priming techniques, such as mirror therapy (MT), that are low-cost adjuncts to conventional physical rehabilitation proposed to induce neuroplasticity. However, the repetitive and perceived boring elements of conventional physical therapy exercises are potential reasons for low adherence in home-based independent rehabilitation. Interactive rehabilitation-focused video games have shown initial promise for facilitating engagement in rehabilitation. Virtual reality (VR) games focus on movement and promote increased immersion in virtual environments compared to 2D interfaces. The recent emergence of low-cost and standalone consumer-based VR headsets opens the accessibility of VR to new audiences. VR, in combination with interactive gaming, affords opportunities to extend the visual and proprioceptive feedback employed in MT and use gamification to facilitate engagement in rehabilitation.

This thesis involved the design of a fully immersive VR game based on MT. The research comprised three stages: empathic design through a design thinking workshop, iterative prototyping, and expert review of game design with clinicians. A design thinking workshop involving PwS and stroke rehabilitation experts informed the construction of design criteria for the game. Research through design, using the design criteria, was conducted iteratively. An expert review by clinicians evaluated the potential usability of the game as well as validated the game against our design criteria. VR enhanced the visual illusion employed in mirror therapy and could provide an immersive and novel self-management tool for PwS to positively engage with their rehabilitation. Future directions will include testing how VR could facilitate engagement in rehabilitation through qualitative and quantitative analysis of the user testing with PwS.


Copyright Date


Date of Award



Te Herenga Waka—Victoria University of Wellington

Rights License

Author Retains Copyright

Degree Discipline

Design Innovation; Health Research

Degree Grantor

Te Herenga Waka—Victoria University of Wellington

Degree Level


Degree Name

Master of Design Innovation

ANZSRC Socio-Economic Outcome code

920403 Disability and Functional Capacity; 920502 Health Related to Ageing; 970110 Expanding Knowledge in Technology

ANZSRC Type Of Activity code

Experimental Development

Victoria University of Wellington Item Type

Awarded Research Masters Thesis



Victoria University of Wellington School

School of Design Innovation


Rodríguez Ramírez, Edgar; Robinson, Brian