A New System for the Remote Configuration and Monitoring of VR Rehabilitation Exercises

Virtual reality (VR) and head-mounted displays (HMDs) are gaining popularity in rehabilitation. However, to be effectively integrated into clinical settings, these systems must offer advanced features such as telerehabilitation support, flexible rehabilitator-patient ratios, and real-time monitoring and interaction with virtual scenarios. To meet these requirements, this paper proposes a new system for the remote configuration and monitoring of VR-HMD rehabilitation exercises, enabling experts to interact with and manage patient-specific virtual scenarios. The system comprises two executables: one on the VR-HMD and another on an external monitoring device controlled by the expert, both coordinated by a shared Network Manager library. The paper evaluates the system by assessing time overhead (the duration when the patient is not actively engaged in rehabilitation) and system performance (including frames per second, network bandwidth usage, and monitoring effectiveness). This evaluation is compared with traditional HMD rehabilitation setups that lack rehabilitator interaction. Additionally, the system is reviewed in terms of development effort (steps and time required to adapt exercises for each monitoring method) and developers’ feedback on usability, functionality, ease of use, and future interest. Evaluation results indicate that the proposed system significantly reduces time overhead—by up to 85%—by minimizing the need to transfer the HMD between patient and rehabilitator. The system maintains performance with only a 2-5% decrease and limits network usage to under 350 kilobytes per second, ensuring fast and accurate monitoring. Developers have rated the system highly for usability and functionality, though ease of use needs improvement, and future interest depends on more streamlined development features and better documentation. Overall, the system enhances VR rehabilitation by facilitating seamless intervention, efficient monitoring, and device compatibility through low-bandwidth solutions and adjustable visual quality, thus improving control, interaction, and effectiveness.