Virtual reality solution to promote adapted physical activity in older adults: outcomes from VR2Care project exploratory study

Vincenzo De Luca^1*Malak Qbilat²Alessandra Cuomo³Antonio Bianco¹Francesca Cesaroni⁴Chiara Lanari⁴Ad Van Berlo⁵Telma Mota⁶Lucia Pannese⁷Michael Brandstötter⁸Matthieu Arendse⁹Vania Mota¹⁰Wilhelmina Van Staalduinen¹¹Hugo Paredes²Guido Iaccarino^12,3Maddalena Illario^1,12

• ¹Department of Public Health, School of Medicine and Surgery, University of Naples Federico II, Naples, Campania, Italy
• ²Institute for Systems and Computer Engineering, Technology and Science (INESC TEC), Porto, Portugal
• ³Department of Clinical Medicine and Surgery, School of Medicine and Surgery, University of Naples Federico II, Naples, Campania, Italy
• ⁴Cooperativa Sociale COOSS Marche Onlus, Ancona, Italy
• ⁵Smart Homes, Eindhoven, Netherlands
• ⁶Altice Labs, Aveiro, Portugal
• ⁷imaginary srl, Milano, Italy
• ⁸cogvis software und consulting gmbh, Wien, Austria
• ⁹Tante Louise, Bergen op Zoom, Netherlands
• ¹⁰Venerável Ordem Terceira de São Francisco do Porto, Porto, Portugal
• ¹¹Academy on Age-Friendly Environments in Europe, Gouda, Netherlands
• ¹²Interdepartmental Research Center For Hypertension and Related Conditions, University of Naples Federico II, Napoli, Italy

Background: Insufficient physical activity is one of the leading risk factors for death worldwide. Regular exercise can improve physical performance and quality of life, reduce the risks of falls and depressive symptoms, and reduce the likelihood of cognitive decline in older adults. Virtual reality (VR) and serious games (SG) are promising tools to improve physical and cognitive functioning. As part of the VR2Care project activities, four pilot sites explored the capabilities of the VR environment in a remote psychomotor training with SG and a hybrid approach with local groups of older adults performing physical activity. Objective: The present study aimed to explore and measure the impact on older adults' quality of life and physical activity of using VR2Care solution and the level of usability, satisfaction and acceptance. Methods: The study is a mixed method study, using qualitative and quantitative surveys to evaluate quality of life and physical activity of older users, and usability, satisfaction and acceptance of the solution. The data collection is a mix of investigator site data entry and users' self-reported data through the solutions or through online and paper-based means. Data were collected at baseline and after a follow-up of 6 weeks. Data are expressed as mean ± standard deviation (SD) unless otherwise stated. Within the group, baseline to end of observation differences were assessed by paired sample t-test. A P = .05 was considered significant. Results: No significant improvements in quality of life and physical activity were found. Little improvement, although not significant, in physical activity was found, comparing the Total MET average value of users who participated in phase I and II, therefore using SmartAL and Rehability. Little improvement, although not significant, in physical activity applies in ≥76 population. Users' feedback on usability, satisfaction and acceptance of VR2Care is generally positive. VR2Care was appreciated mostly for its usefulness in managing physical activity and the capacity to influence the consistency of attending physical activity sessions as prescribed by doctors. Conclusions: Our results suggest that randomized controlled trial will be needed to assess correlations between specific features of the solution and health outcomes.