Date of Award

Spring 6-5-2026

Document Type

Thesis (Undergraduate)

Department

Computer Science

First Advisor

Elizabeth Murnane

Abstract

Physical therapy is a central component of rehabilitation for musculoskeletal conditions, yet adherence to prescribed treatment remains persistently poor. Jack et al. identified pain, boredom, and insufficient feedback as key barriers to treatment adherence in physiotherapy outpatient settings,¹ and Rucinski et al. confirmed that non-adherence rates in orthopaedic populations remain between 50 and 70%, with patients who disengage facing elevated risk of reoperation, progressive functional decline, and poor clinical outcomes.² According to the World Health Organization, approximately 1.71 billion people globally live with musculoskeletal conditions,³ with shoulder pain specifically carrying a community prevalence ranging from 0.67 to 55.2% worldwide and incidence rates between 7.7 and 62 per 1000 persons per year.⁴ Despite evidence that exercise therapy improves function and reduces pain, patients frequently disengage before completing rehabilitation. The primary drivers of this disengagement are pain during exercise, boredom from repetitive movement, and the absence of real-time feedback on movement quality.

Virtual reality has emerged as a promising intervention to address this gap: research shows VR can reduce perceived pain by shifting attentional resources away from nociceptive signals,⁵ and recent work exploring VR exergames with practicing physical therapists found that clinicians were optimistic about VR’s motivational potential, while identifying corrective feedback and clinical specificity as critical unmet needs.⁶

This thesis designs and evaluates RehabVR, a Meta Quest VR system with two exercise scenes targeting upper-body rehabilitation, intended for use within supervised physical therapy sessions. The design process involved needfinding interviews with inpatient physical therapists and a VR rehabilitation technology developer, alongside a literature review spanning rehabilitation science, behavior change theory, and immersive human-computer interaction. A prototype was developed in Unity using the Meta XR SDK, incorporating gamified exercise mechanics, real-time movement guidance, and adaptive feedback. A user study with five experienced clinical staff members at the Dartmouth Hitchcock Medical Center Physical Therapy Clinic  and eight patient volunteers evaluated interaction clarity, clinical validity, and patient engagement during use. Preliminary results suggest that immersive, goal-oriented environments reduce conscious attention to repetition and support sustained therapeutic movement, pointing toward VR’s potential as a clinically integrated complement to supervised rehabilitation.

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