Hospitalized older adults' experiences of virtual reality-based group exercise therapy with cycle ergometers: An early feasibility study

Sedentary behavior among hospitalized older adults is a well-described challenge that can increase the risk of loss of function and mortality. Therefore, it is important to encourage physical activity (PA) during hospitalization. Exertion Games (exergames) have repeatedly been suggested as a tool to encourage and sustain motivation in rehabilitation programs. This article presents early findings from a convergent parallel mixed methods study that explored whether social presence and PA could be combined through the novel use of immersive virtual reality technology in a feasible group exercise constellation. Inpatients (n=10, 50% female, 80.3±8.2 years) were invited to participate in a bi-weekly VR group session. Most participants (62%) responded that it was a good experience to a large/great extent, which they would like to use repeatedly (76%). The technology was easy for untrained healthcare professionals and had minimal adverse events for the participants. However, a major finding illustrates that the enclosing immersiveness of the headset hindered conversation during exercise sessions. The exclusion of sight likely had a negative effect on forming relations between the participants, which conversely caused the participants to experience a lack of cohesion and relatedness with the other participants. VR-mediated group therapy may be a promising solution to existing physiotherapy practices since it may incorporate basic psychological needs. However, to optimize for social interaction, future systems will need to afford a higher degree of social presence, e.g., through avatar embodiment in a shared virtual environment, to support older adults' autonomous motivation for PA through social interaction and novel technologies.