Traditional Rehabilitation Experiences, Unmet Needs, and Perspectives on Virtual Reality-Based Rehabilitation Among Patients With Stroke in China: Qualitative Thematic Analysis and Semistructured Interview Study.

backgroundTraditional stroke rehabilitation is facing challenges, and virtual reality (VR)-based rehabilitation is a promising solution. However, results from studies focusing on VR-based stroke rehabilitation remain inconsistent, largely due to the use of noncustomized interventions in previous trials.

objectiveTo enhance rehabilitation services and inform the development of patient-centered VR rehabilitation systems, this study aimed to (1) explore the experiences and unmet needs of survivors of stroke during current hospital rehabilitation, and (2) examine their perspectives on the use of VR technology in poststroke rehabilitation.

methodsWe conducted a qualitative thematic analysis based on descriptive phenomenology between January and July 2025 at the China Rehabilitation Research Center. Adult patients with a clinical diagnosis of stroke within the past 18 months were eligible. A total of 21 survivors of stroke (mean age, 52.7, SD 17.3 y; men, n=17) were included. Data were collected through face-to-face semistructured interviews, complemented by a short questionnaire on sociodemographic, clinical, and technology-use characteristics. All interviews were audio-recorded, transcribed verbatim, and analyzed using a thematic approach, with thematic saturation used to determine the sample size.

resultsAfter a stroke, patients experience significant physical and psychological changes. On the one hand, the sudden loss of abilities alters their perceived roles within the family and society; on the other hand, the sharp contrast between their desire for recovery and their current recovery limitations creates substantial psychological pressure. Accepting their condition and rebuilding confidence is a long-term process. Traditional rehabilitation is commonly described as burdensome, monotonous, and lacking continuity after discharge. Although patients desire a better rehabilitation approach and improved outcomes, attitudes toward VR-based rehabilitation vary. Some view VR as a convenient tool, while others express no interest or perceived need for technology-based rehabilitation. Patients indicated that serious games should be diversified to meet different individual and training needs, and should incorporate clearer feedback mechanisms, appropriate scoring systems, adjustable difficulty levels, and progressive game chapters. Functional expectations for VR systems included family involvement, access to personal rehabilitation data, telerehabilitation support, safety monitoring, and technical support.

conclusionsStroke rehabilitation services in China require improvement in the appeal of rehabilitation content, patient self-management, and continuity of care. Although patients desire better rehabilitation approaches and outcomes, the effective integration of VR technology must account for factors, such as personal characteristics and preferences, as well as socioeconomic status. Unlike previous studies that primarily examined user experiences with digital technologies or compared rehabilitation outcomes, our research contributes to the literature by linking the challenges and patient needs in conventional rehabilitation with concrete directions for the future design of VR rehabilitation. These insights deepen current understanding of how VR technologies can be meaningfully integrated into stroke care and provide a roadmap for developing patient-centered and culturally responsive VR solutions.