User Experience of Extended Reality Treatment for Visuospatial Neglect Among Patients and Informal Caregivers: Qualitative Interview Study

Abstract

Background: Visuospatial neglect (VSN) is a cognitive disorder following a stroke, where individuals fail to perceive or respond to stimuli on the contralesional side of space. Visual scanning training (VST) is the recommended treatment in clinical guidelines. Objective: This qualitative study explored how patients (N=10) and informal caregivers (N=8) perceived the usability and potential implementation of 3 extended reality (XR)-based serious games to enhance VST-1 in virtual reality and 2 in augmented reality-as tools for VST. These technologies not only enhance patient engagement but also enable detailed data collection to monitor therapeutic progress. Methods: The themes and feedback were compared with themes and feedback from VSN therapists from a previous study: (1) suitability for VSN rehabilitation, (2) applicability, (3) motivation, (4) guidance, (5) versatility, and (6) detailed insights in game performance. Results: Highlights were that patients reported high engagement and enjoyment, with many expressing willingness to use the games in both clinical and home settings. Informal caregivers supported these findings and emphasized the motivational value of the games. Additionally, both groups noted the importance of accessible instructions and technical support. Conclusions: Although XR technology offers potential in neurorehabilitation, a uniform solution may not suit all users. This study showed the importance of including diverse end-user groups in development for usability, acceptance, and implementation. Successful integration of XR in rehabilitation requires customizable features, structured support, and attention to the differing roles of caregivers. Further research is needed to evaluate the clinical effectiveness and optimize patient-tailored applications of XR in VSN treatment.