Augmented reality for hand function rehabilitation: Assessing perceptions of feasibility and meaningfulness among individuals with cervical spinal cord injury

Augmented reality for hand function rehabilitation: Assessing perceptions of feasibility and meaningfulness among individuals with cervical spinal cord injury | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Augmented reality for hand function rehabilitation: Assessing perceptions of feasibility and meaningfulness among individuals with cervical spinal cord injury Damian M. Manzone, Olga Taran, Hardeep Singh, Cesar Marquez-Chin, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8683353/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 14 You are reading this latest preprint version Abstract Background: Creating high-quality, home-based rehabilitation tools is integral for hand function recovery among individuals living with cervical spinal cord injury (cSCI). Specifically, the effectiveness of home-based exercises is limited by compliance issues and a lack of guidance and performance feedback. Using augmented reality (AR) headsets can provide a solution because the technology can specifically track hand postures while interacting with real objects and in the real environment. Thus, the current study sought to 1) develop an AR application that provided grasping guidance and feedback and 2) assess its perceived feasibility and meaningfulness among individuals with cSCI. Methods: 15 individuals with cSCI (AIS: A-D, Neurological Level of Injury: C3-C7) tried a custom AR rehabilitation application while performing hand exercises with real objects in a clinical setting. The application was designed to track joints, provide visual guidance of object-specific grasping postures, and provide visual and score-based feedback. After trying the system, participants completed structured questionnaires (i.e., the System Usability Scale and one custom questionnaire) and one 30-minute semi-structured interview to assess perceived meaningfulness and feasibility of the system in the context of home-based rehabilitation. The questionnaires were analysed descriptively and the qualitative interviews were analysed using thematic and summative content analyses. Results: From the questionnaires, participants had an overall positive perception of the application and perceived the system as usable with a mean System Usability Scale score of 76/100. Further, the thematic analysis revealed two main themes: Perceived Therapeutic Value (subthemes: removing rehabilitation barriers, quality of the guidance and feedback, motivation) and Building a Usable and Tailored Experience (subthemes: feasibility considerations, suggestions and refinement). Conclusions: Overall, individuals with cSCI perceived that the AR system provided useful grasping guidance and feedback and was meaningful towards their rehabilitation. Further, individuals with cSCI provided suggestions to increase the usability and meaningfulness of the application which will be incorporated in future iterations of the system. Thus, the current study demonstrates the potential to increase the dosage of high-quality, home-based rehabilitation for individuals with cSCI. augmented reality spinal cord injury rehabilitation hand function wearable technology Full Text Additional Declarations No competing interests reported. Supplementary Files ARfeasibilitysupplimentarymaterial.docx Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 18 Mar, 2026 Reviews received at journal 10 Mar, 2026 Reviews received at journal 04 Mar, 2026 Reviews received at journal 24 Feb, 2026 Reviews received at journal 20 Feb, 2026 Reviewers agreed at journal 13 Feb, 2026 Reviewers agreed at journal 10 Feb, 2026 Reviewers agreed at journal 09 Feb, 2026 Reviewers agreed at journal 09 Feb, 2026 Reviewers agreed at journal 08 Feb, 2026 Reviewers invited by journal 08 Feb, 2026 Editor assigned by journal 26 Jan, 2026 Submission checks completed at journal 26 Jan, 2026 First submitted to journal 23 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8683353","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":580726277,"identity":"9c25d1c0-c685-4870-a4c7-d7cd492fe299","order_by":0,"name":"Damian M. 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Specifically, the effectiveness of home-based exercises is limited by compliance issues and a lack of guidance and performance feedback. Using augmented reality (AR) headsets can provide a solution because the technology can specifically track hand postures while interacting with real objects and in the real environment. Thus, the current study sought to 1) develop an AR application that provided grasping guidance and feedback and 2) assess its perceived feasibility and meaningfulness among individuals with cSCI.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003e15 individuals with cSCI (AIS: A-D, Neurological Level of Injury: C3-C7) tried a custom AR rehabilitation application while performing hand exercises with real objects in a clinical setting. The application was designed to track joints, provide visual guidance of object-specific grasping postures, and provide visual and score-based feedback. After trying the system, participants completed structured questionnaires (i.e., the System Usability Scale and one custom questionnaire) and one 30-minute semi-structured interview to assess perceived meaningfulness and feasibility of the system in the context of home-based rehabilitation. The questionnaires were analysed descriptively and the qualitative interviews were analysed using thematic and summative content analyses.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eFrom the questionnaires, participants had an overall positive perception of the application and perceived the system as usable with a mean System Usability Scale score of 76/100. Further, the thematic analysis revealed two main themes: Perceived Therapeutic Value (subthemes: removing rehabilitation barriers, quality of the guidance and feedback, motivation) and Building a Usable and Tailored Experience (subthemes: feasibility considerations, suggestions and refinement).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eOverall, individuals with cSCI perceived that the AR system provided useful grasping guidance and feedback and was meaningful towards their rehabilitation. Further, individuals with cSCI provided suggestions to increase the usability and meaningfulness of the application which will be incorporated in future iterations of the system. Thus, the current study demonstrates the potential to increase the dosage of high-quality, home-based rehabilitation for individuals with cSCI.\u003c/p\u003e","manuscriptTitle":"Augmented reality for hand function rehabilitation: Assessing perceptions of feasibility and meaningfulness among individuals with cervical spinal cord injury","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-04 06:56:30","doi":"10.21203/rs.3.rs-8683353/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-18T10:12:53+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-11T03:33:45+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-04T21:12:12+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-24T14:33:17+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-20T05:13:32+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"150957607308876811497118417984705066586","date":"2026-02-14T04:19:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"325344933486962602776353189374712552456","date":"2026-02-10T20:37:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"57318558785116543628300636412259460790","date":"2026-02-09T12:40:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"220945757639669979654059086147812788941","date":"2026-02-09T10:14:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"203372275576762325087973241141985991763","date":"2026-02-08T16:18:40+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-02-08T13:08:01+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-26T12:24:26+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-26T12:22:33+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of NeuroEngineering and Rehabilitation","date":"2026-01-24T02:52:42+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-neuroengineering-and-rehabilitation","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jner","sideBox":"Learn more about [Journal of NeuroEngineering and Rehabilitation](http://jneuroengrehab.biomedcentral.com/)","snPcode":"12984","submissionUrl":"https://submission.nature.com/new-submission/12984/3","title":"Journal of NeuroEngineering and Rehabilitation","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c56918c9-9c55-4eb9-a598-0f84348cf5c6","owner":[],"postedDate":"February 4th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-19T21:23:16+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-04 06:56:30","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8683353","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8683353","identity":"rs-8683353","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}