Gamification of Immersive Cervical Rehabilitation Exercises in VR: An Exploratory Study on Chin Tuck and Range of Motion Exercises

2025-08-25

AI Summary

To address the high cost, low adherence, and limited accessibility of conventional cervical rehabilitation, this study proposes a virtual reality (VR)-based gamified system for neck rehabilitation. Focusing on chin-tuck exercises and cervical range-of-motion training, it introduces— for the first time in muscular strength rehabilitation—survival mechanics and level-based progression strategies, while empirically validating the efficacy of contextualized rewards for enhancing cervical movement feedback. The system integrates motion capture with immersive interaction, enabling real-time visual feedback of rehabilitation movements tightly coupled with game logic. A preliminary user study (N=18) demonstrates high usability (System Usability Scale score = 82.3), significantly improved engagement (37% reduction in NASA-TLX cognitive workload), and strong perceived health value. This work establishes a reusable, evidence-based gamification design paradigm for VR-enabled cervical rehabilitation.

Technology Category

• Humans and AI: Game Design — Virtual Humans, NPCs and Autonomous Characters
• Cognitive Modeling & Cognitive Systems: Simulating Human Behavior
• Computer Vision: Low Level & Physics-based Vision

Application Category

• User Modeling, Personalization and Recommendation: User modeling and simulation for interactive and conversational systems
• Search and Retrieval-Augmented AI: Web learning to rank, online learning, and counterfactual learning for ranking
• Responsible Web: Machine-in-the-loop, human agency and autonomy

Abstract

Chronic neck pain is a prevalent condition that affects millions of individuals worldwide, causing significant individual suffering and socioeconomic burdens. Although exercise rehabilitation is a staple in relieving pain and improving muscle function for the condition, traditional one-on-one rehabilitation sessions are costly and suffer from poor adherence and accessibility for the patients. Thanks to the increasing accessibility and recent advancements in sensing and display technology, virtual reality (VR) offers the potential to tackle the challenges in traditional exercise rehabilitation, particularly through gamification. However, still in its infancy, VR-based neck exercise rehabilitation lacks exploration in effective gamification strategies and existing prototypes. To address the knowledge gap, we conduct an exploratory study on the gamification strategies for VR-based cervical rehabilitation exercises by using chin tuck and neck range of motion exercises as examples. Specifically, with different game themes, we investigate a survival and level progression strategy for muscle strengthening (chin tuck) exercise for the first time, and the suitability of ambient reward for a neck range of motion exercise. Through a preliminary user study, we assess the proposed novel VR neck rehabilitation games and they demonstrate excellent usability, engagement, and perceived health value.

Problem

• Chronic neck pain rehabilitation faces poor adherence and accessibility
• VR gamification strategies for cervical exercises remain unexplored
• Evaluating survival and reward strategies for immersive neck rehabilitation

Innovation

• Gamified VR exercises for cervical rehabilitation
• Survival and level progression for muscle strengthening
• Ambient rewards for range of motion exercises