Main themes and sub-themes identified.

Background
Virtual reality (VR) gaming is a promising technology that can be applied in stroke rehabilitation to increase survivors’ social engagement, though its optimal usage and effects on stroke recovery are not fully understood. This qualitative study aimed to investigate stroke survivors’ and caregivers’ perspectives of VR-based gaming rehabilitation modules for supporting post-stroke recovery and social participation.
Methods
Twenty-eight participants (18 stroke survivors and 10 caregivers) were recruited through purposive sampling from acute hospitals in Hong Kong. Two rounds of semi-structured interviews were carried out, with the first round exploring participants’ previous knowledge of VR, views about its relevance to stroke rehabilitation, and expected benefits. The second round of interviews was conducted immediately post-intervention to investigate participants’ experience, satisfaction, and areas for improvement. Resulting data were thematically analysed.
Results
Most participants were female (75%) with secondary education or above (82%). For stroke survivors, the average duration since stroke was 9.39 (SD = 10.48) years and most were first-time survivors (89%). Main themes identified included (1) Shift in attitudes towards VR technology; (2) Perceptions of VR effectiveness; and (3) Practical drawbacks and design recommendations. Participants reported positive experiences with the VR-based gaming modules, including increased confidence in mobility and heightened awareness regarding outdoor safety and accessibility. Despite concerns regarding hygiene and discomfort with gaming equipment, participants found VR gaming to be engaging and conducive to their recovery.
Conclusion
The VR-based gaming modules were well-received by survivors and their caregivers and considered as an appealing and useful method of post-stroke rehabilitation. Improvements in survivors’ attitudes towards VR technology, and self-observed benefits to their physical and psychosocial health, were noted. Areas for optimisation included expansion of game length and contents, options for alternative gaming equipment, and enhanced design elements.