Authors: Brennan, A¹., Blackburn, N²., Rankin, D¹., McCreadie, K¹., Charles, T³., Condell, J¹

Affiliations: ¹ School of Computing, Engineering and Intelligent Systems, Ulster University, Derry/Londonderry, Northern Ireland, UK. ² School of Health Sciences, Ulster University, Derry/Londonderry, Northern Ireland, UK. ³ School of Arts and Humanities, Ulster University, Derry/Londonderry, Northern Ireland, UK

Background/ Introduction: In 2022, 2.3 million women were diagnosed with breast cancer worldwide. Treatment includes chemotherapy, radiotherapy, and surgery. Following surgery, many experience shoulder pain and stiffness. Physiotherapy is prescribed; however, poor adherence can result in incomplete rehabilitation, and reduced shoulder Range of Motion (RoM), which impacts quality of life. In our previous study, Extended Reality (XR) rehabilitation showed promise in improving engagement and user experience in physiotherapy settings through immersive environments and feedback mechanisms. However, limited research was conducted with this patient group on the effectiveness of this intervention. This study aims to further our work, evaluating the feasibility, usability, and preliminary efficacy of an XR-assisted exercise intervention for post-surgery breast cancer patients.

Material & Methods: A total of 10 participants will be recruited and allocated to two groups. The control group will perform upper-body physiotherapy exercises via video guidance on a computer monitor. The experimental group will participate in a custom-developed XR-based exercise intervention using a Meta Quest 3, performing the same exercise programme within an immersive environment. The XR intervention will incorporate gamification elements, including scoring, real-time visual/auditory feedback, and progress tracking to support engagement/adherence. Both groups will complete matched exercise sessions over an 8-week intervention. The XR system incorporates a pose estimation model trained on a dataset of annotated upper-body rehabilitation movements from healthy participants, enabling real-time performance feedback without large clinical datasets.

Results: Primary outcomes are feasibility and shoulder RoM; secondary outcomes include pain, fatigue, quality of life, usability, and patient engagement. Data will be collected at baseline, midpoint, and post-intervention, enabling individual and between-group comparisons using quantitative and qualitative approaches.

Conclusion: This feasibility study will evaluate patient engagement and adherence in an XR intervention compared to a control group. Findings will inform the feasibility and development of XR-based rehabilitation tools for this patient population.