{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T21:07:47Z","timestamp":1785618467286,"version":"3.56.0"},"reference-count":29,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Technical University of Cluj Napoca"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Virtual reality (VR) technologies have gained increasing attention in the field of physical rehabilitation due to their potential to enhance patient engagement and provide adaptive, feedback-rich environments. In this study, we report on the development and preliminary evaluation of a VR-based rehabilitation application aimed at improving upper extremity function, including muscle strength, endurance, and joint mobility. The application delivers a structured set of interactive exercises designed to support recovery through engaging, gamified tasks with real-time performance feedback and scalable difficulty levels. A pilot usability study was conducted with a cohort of target users to assess the system\u2019s practicality, therapeutic relevance, and user satisfaction. Qualitative data were collected to evaluate usability, effectiveness, and areas for further improvement. Preliminary results suggest that the VR application is usable, accessible, and well-received by users, with high levels of engagement reported throughout the intervention. Participants also provided constructive feedback, emphasizing the potential benefits of incorporating enhanced sensory feedback mechanisms to improve immersion and therapeutic impact. These initial findings support the viability of VR-based rehabilitation tools and provide a foundation for future clinical studies aimed at validating their efficacy in diverse patient populations.<\/jats:p>","DOI":"10.3390\/bioengineering12070726","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T07:42:06Z","timestamp":1751355726000},"page":"726","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Exercises Based on a Non-Immersive Virtual Reality Application for Upper Limb Rehabilitation"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5495-7604","authenticated-orcid":false,"given":"Cosmin-Ilie","family":"Cotia","sequence":"first","affiliation":[{"name":"Faculty of Automotive, Mechatronics and Mechanical Engineering, Technical University of Cluj-Napoca, Bd. Muncii, Nr. 103\u2013105, 400641 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6422-4826","authenticated-orcid":false,"given":"Silviu Dan","family":"Mandru","sequence":"additional","affiliation":[{"name":"Faculty of Automotive, Mechatronics and Mechanical Engineering, Technical University of Cluj-Napoca, Bd. Muncii, Nr. 103\u2013105, 400641 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Miclaus, R., Roman, N., Caloian, S., Mitoiu, B., Suciu, O., Onofrei, R.R., Pavel, E., and Neculau, A. (2020). Non-Immersive Virtual Reality for Post-Stroke Upper Extremity Rehabilitation: A Small Cohort Randomized Trial. Brain Sci., 10.","DOI":"10.3390\/brainsci10090655"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Georgiev, D.D., Georgieva, I., Gong, Z., Nanjappan, V., and Georgiev, G.V. (2021). Virtual Reality for Neurorehabilitation and Cognitive Enhancement. Brain Sci., 11.","DOI":"10.3390\/brainsci11020221"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Riva, G., Ba\u00f1os, R.M., Botella, C., Mantovani, F., and Gaggioli, A. (2016). Transforming Experience: The Potential of Augmented Reality and Virtual Reality for Enhancing Personal and Clinical Change. Front. Psychiatry, 7.","DOI":"10.3389\/fpsyt.2016.00164"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e15635","DOI":"10.2196\/15635","article-title":"Virtual Reality Games and the Role of Body Involvement in Enhancing Positive Emotions and Decreasing Anxiety: Within-Subjects Pilot Study","volume":"8","author":"Pallavicini","year":"2020","journal-title":"JMIR Serious Games"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1007\/s10278-018-0122-7","article-title":"Applying Modern Virtual Reality Technologies to Medical Images and Models","volume":"32","author":"Sutherland","year":"2019","journal-title":"J. Digit. Imaging"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Kenea, C.D., Abessa, T.G., Lamba, D., and Bonnech\u00e8re, B. (2024). Technological Features of Immersive Virtual Reality Systems for Upper Limb Stroke Rehabilitation: A Systematic Review. Sensors, 24.","DOI":"10.3390\/s24113546"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Kenea, C.D., Abessa, T.G., Lamba, D., and Bonnech\u00e8re, B. (2025). AdaptRehab VR: Development of an Immersive Virtual Reality System for Upper Limb Stroke Rehabilitation Designed for Low- and Middle-Income Countries Using a Participatory Co-Creation Approach. Bioengineering, 12.","DOI":"10.3390\/bioengineering12060581"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Garofano, M., Del Sorbo, R., Calabrese, M., Giordano, M., Di Palo, M.P., Bartolomeo, M., Ragusa, C.M., Ungaro, G., Fimiani, G., and Di Spirito, F. (2025). Remote Rehabilitation and Virtual Reality Interventions Using Motion Sensors for Chronic Low Back Pain: A Systematic Review of Biomechanical, Pain, Quality of Life, and Adherence Outcomes. Technologies, 13.","DOI":"10.3390\/technologies13050186"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Czajkowska, U., Popek, M., Pezowicz, C., Le\u015bnik, B., and \u017buk, M. (2025). Squat Kinematics Analysis Using Vicon and Affordable Motion-Capture Solutions. Sensors, 25.","DOI":"10.3390\/s25113294"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Berton, A., Longo, U.G., Candela, V., Fioravanti, S., Giannone, L., Arcangeli, V., Alciati, V., Berton, C., Facchinetti, G., and Marchetti, A. (2020). Virtual Reality, Augmented Reality, Gamification, and Telerehabilitation: Psychological Impact on Orthopedic Patients\u2019 Rehabilitation. J. Clin. Med., 9.","DOI":"10.3390\/jcm9082567"},{"key":"ref_11","unstructured":"(2024, December 10). Intel RealSense Depth Camera. Available online: https:\/\/www.intelrealsense.com\/depth-camera-d435i\/."},{"key":"ref_12","unstructured":"(2024, September 05). Nuitrack True 3D Body Tracking. Available online: https:\/\/nuitrack.com\/."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Palacios-Navarro, G., and Hogan, N. (2021). Head-Mounted Display-Based Therapies for Adults Post-Stroke: A Systematic Review and Meta-Analysis. Sensors, 21.","DOI":"10.3390\/s21041111"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Butz, B., Jussen, A., Rafi, A., Lux, G., and Gerken, J. (2022). A Taxonomy for Augmented and Mixed Reality Application to Support Physical Exercises in Medical Rehabilitation. Healthcare, 10.","DOI":"10.3390\/healthcare10040646"},{"key":"ref_15","unstructured":"Moore, K.L., Dalley, A.F., and Agur, A.M.R. (2013). Clinically Oriented Anatomy, Lippincott Williams & Wilkins. [7th ed.]."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Faria, A.L., Cameir\u00e3o, M.S., Couras, J.F., Aguiar, J.R.O., Costa, G.M., and Badia, S.B.I. (2018). Combined Cognitive-Motor Rehabilitation in Virtual Reality Improves Motor Outcomes in Chronic Stroke\u2014A Pilot Study. Front. Psychol., 9.","DOI":"10.3389\/fpsyg.2018.00854"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e17331","DOI":"10.2196\/17331","article-title":"The Role of Virtual Reality in Improving Health Outcomes for Community-Dwelling Older Adults: Systematic Review","volume":"22","author":"Dermody","year":"2020","journal-title":"J. Med. Internet Res."},{"key":"ref_18","first-page":"114","article-title":"Determining what individual SUS scores mean: Adding an adjective rating scale","volume":"4","author":"Bangor","year":"2009","journal-title":"J. Usability Stud."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s12984-020-0652-3","article-title":"Adaptive Conjunctive Cognitive Training (ACCT) in Virtual Reality for Chronic Stroke Patients: A Randomized Controlled Pilot Trial","volume":"17","author":"Maier","year":"2020","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_20","first-page":"1973","article-title":"Prospect for Intelligent Rehabilitation Techniques to Treat Motor Dysfunction","volume":"16","author":"Huo","year":"2021","journal-title":"Neural Regen. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1177\/1545968318820169","article-title":"Effect of Specific Over Non-Specific VR-Based Rehabilitation on Poststroke Motor Recovery: A Systematic Meta-Analysis","volume":"33","author":"Maier","year":"2019","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.gaitpost.2014.07.003","article-title":"Overground versus Self-Paced Treadmill Walking in a Virtual Environment in Children with Cerebral Palsy","volume":"40","author":"Sloot","year":"2014","journal-title":"Gait Posture"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/s10916-018-0905-x","article-title":"Utilising the Intel RealSense Camera for Measuring Health Outcome in Clinical Research","volume":"42","author":"Siena","year":"2018","journal-title":"J. Med. Syst."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1109\/TNSRE.2017.2771272","article-title":"Virtual Activities of Daily Living for Recovery of Upper Extremity Motor Function","volume":"26","author":"Adams","year":"2018","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1186\/s12984-021-00957-6","article-title":"A novel upper-limb tracking system in a virtual environment for stroke rehabilitation","volume":"18","author":"Liu","year":"2021","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Nath, D., Patel, K., Thakur, A., and Sharma, N. (2024). The efficacy of virtual reality for upper limb rehabilitation in stroke patients: a systematic review and meta-analysis. BMC Med. Inform. Decis. Mak., 24.","DOI":"10.1186\/s12911-024-02534-y"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Dordevic, M., Stevanovic, A., Tomic, N., Radulovic, M., and Ostojic, G. (2023). A Comparison of Immersive vs. Non-Immersive Virtual Reality Exercises for the Upper Limb: A Functional Near-Infrared Spectroscopy Pilot Study with Healthy Participants. J. Clin. Med., 12.","DOI":"10.3390\/jcm12185781"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1177\/02692155211066534","article-title":"Effects of virtual reality in improving upper extremity function after stroke: A systematic review and meta-analysis of randomized controlled trials","volume":"36","author":"Jin","year":"2022","journal-title":"Clin. Rehabil."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.apmr.2021.06.024","article-title":"Effect of Virtual Reality-Based Rehabilitation on Upper Limb Motor Function and Daily Living Activities in Patients After Stroke: A Systematic Review and Meta-Analysis","volume":"103","author":"Hao","year":"2022","journal-title":"Arch. Phys. Med. Rehabil."}],"container-title":["Bioengineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-5354\/12\/7\/726\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:02:20Z","timestamp":1760032940000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-5354\/12\/7\/726"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":29,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["bioengineering12070726"],"URL":"https:\/\/doi.org\/10.3390\/bioengineering12070726","relation":{},"ISSN":["2306-5354"],"issn-type":[{"value":"2306-5354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,1]]}}}