Evidence map›Paper›PMID 42392628›Full record

Trial reportBMJ open2026

Rehabilitation using virtual gaming for Hospital and hOMe-Based training for the Upper limb in acute and subacute Stroke (RHOMBUS II): a qualitative analysis of participants' experience.

Tom Butcher, Alyson Warland, Victoria Stewart, Meriel Norris, Basaam Aweid, Arul Samiyappan, Elmar Kal, Jennifer Ryan, Dimitrios A Athanasiou, Karen Baker and 4 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Tom ButcherDepartment of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK.ORCID http://orcid.org/0009-0005-4452-4679
Alyson WarlandDepartment of Health Sciences, Institute of Health, Medicine and Environment, Brunel University of London, Uxbridge, UK.ORCID http://orcid.org/0000-0002-4629-0395
Victoria StewartDepartment of Health Sciences, Institute of Health, Medicine and Environment, Brunel University of London, Uxbridge, UK.ORCID http://orcid.org/0000-0003-4077-8848
Meriel NorrisDepartment of Health Sciences, Institute of Health, Medicine and Environment, Brunel University of London, Uxbridge, UK.
Basaam AweidStroke Unit, Hillingdon Hospitals NHS Foundation Trust, Uxbridge, UK.
Arul SamiyappanAdult Services, Central and North West London NHS Foundation Trust, London, UK.
Elmar KalDepartment of Health Sciences, Institute of Health, Medicine and Environment, Brunel University of London, Uxbridge, UK.
Jennifer RyanSchool of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland.
Dimitrios A AthanasiouNeurofenix, London, UK.
Karen BakerNeurofenix, London, UK.
Guillem Singla-BuxarraisNeurofenix, Atlanta, Georgia, USA.
Carole PoundIndependent Researcher, London, UK.
Francesca GowingDepartment of Health Sciences, Institute of Health, Medicine and Environment, Brunel University of London, Uxbridge, UK.
Cherry KilbrideDepartment of Health Sciences, Institute of Health, Medicine and Environment, Brunel University of London, Uxbridge, UK Cherry.Kilbride@brunel.ac.uk.ORCID http://orcid.org/0000-0002-2045-1883

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo explore the experience of participants using the Neurofenix (Naples, Florida, USA) platform for hospital and home-based upper limb rehabilitation in acute and subacute stroke, and to report acceptability of trial and data collection processes in a feasibility randomised controlled trial (Rehabilitation using virtual gaming for Hospital and hOMe-Based therapy for the Upper limb in acute and subacute Stroke (RHOMBUS II)). The trial investigated safety, feasibility and acceptability of the platform, a non-immersive virtual reality (VR) tool, to facilitate upper limb rehabilitation following stroke. The intervention group (n=16) received usual care plus the platform for 7 weeks. The control group (n=8) received usual care only.

designA qualitative descriptive approach using semi-structured interviews. Interviews were audio-recorded, transcribed verbatim, and analysed using the Framework Method. The Theoretical Framework of Acceptability informed the development of the topic guide and the analysis.

settingHomes of participants and an inpatient stroke rehabilitation unit, London, UK.

participantsA purposive sample of 11 adults (≥18 years) was recruited from the trial intervention group, 35-89 years of age, ranging from mild to severe upper limb impairment and representing varying levels of engagement with the Neurofenix platform. Additionally three participants were recruited from the trial control group.

resultsSix themes were developed: (1) trial enrolment, indicated that participants enrolled in the study due to hope and for distraction; (2) affective attitude, described feelings associated with the platform, such as the subthemes 'enjoyment of the games' but also 'frustration', often caused by Wi-Fi connection issues; (3) barriers and facilitators, explored environmental factors such as having a suitable space to use the platform, usability factors such as comfort and the need for support from others; (4) perceived effectiveness of the intervention, described an overall belief that the platform had beneficial effects on both upper limb and cognitive function; (5) self-efficacy, showed how confidence with the platform grew with time and the value placed on performance tracking and routine; (6) trial processes, indicated that assessment burden was manageable and potential allocation to the control group was not a deterrent to trial enrolment.

conclusionThis study demonstrated the overall acceptability of the platform and offers valuable insights to guide the further development of rehabilitation technologies. This study also adds to the limited literature on the user experience of VR technologies early post-stroke. TRIAL REGISTRATION NUMBER: ISRCTN11440079.

Indexed as

Stroke RehabilitationUpper ExtremityVideo GamesVirtual RealityAdultAgedAged, 80 and overFeasibility StudiesFemaleHumansMaleMiddle AgedQualitative ResearchStrokeDigital TechnologyPhysical Therapy ModalitiesQUALITATIVE RESEARCHREHABILITATION MEDICINEStrokeVirtual Reality

Identifiers

PMID42392628
PMCPMC13331151

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.