title: Patient perspectives on virtual reality-based rehabilitation after knee surgery: Importance of level of difficulty.
abstract: This article explored the perspectives of 25 patients regarding virtual reality (VR)-based rehabilitation following knee surgery and identified the important factors that allowed patients to immerse themselves in rehabilitation. Qualitative analysis of data collected via open-ended questionnaire and quantitative analysis of data from physical assessments and surveys were conducted. In the open-ended questionnaire, the majority of participants mentioned level of difficulty as the most common reason for selecting both the most and the least immersive exercise programs. Quantitative analysis showed that participants experienced a high level of flow (3.9 +/- 0.3 out of 5.0) and a high rate of expectation of therapeutic effect (96%) and intention of exercise adherence (96%). Further, participants with more severe pain or physical dysfunction tended to have more positive experiences (e.g., Difficulty-Skill Balance, Clear Goals, and Transformation of Time), leading to high levels of flow during VR-based rehabilitation. In conclusion, VR-based games are potentially acceptable as a motivational rehabilitation tool for patients following knee surgery. However, to best meet patients' needs, it might be useful to equip a VR program with varied levels of difficulty, taking into account the severity of the individual's knee injury. Additionally, severe pain or physical dysfunction might act as an indication rather than a contraindication for VR-based rehabilitation.
authors.forename: Minyoung
authors.initials: M
authors.lastname: Lee
authors.forename: Dongwon
authors.initials: D
authors.lastname: Suh
authors.forename: Jaebum
authors.initials: J
authors.lastname: Son
authors.forename: Jungjin
authors.initials: J
authors.lastname: Kim
authors.forename: Seon-Deok
authors.initials: SD
authors.lastname: Eun
authors.forename: BumChul
authors.initials: B
authors.lastname: Yoon
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000534:rehabilitation*; D005082:Physical Exertion; D004856:Postural Balance; D055070:Resistance Training; D011795:Surveys and Questionnaires; D018910:Video Games / Q000523:psychology; D000076142:Virtual Reality; D015013:Yoga; D055815:Young Adult
keywords: flow experience; knee injury; level of difficulty; motivation; pain; patient perspectives; physical function; physical therapy; rehabilitation; virtual reality