Immersive virtual reality in residential aged care: mixed-methods study

Care staff, led by a physiotherapist, will implement a six-week group program of immersive virtual reality physical activities for participating residents. The training will be provided by RecoveryVR in a workshop format provided face-to-face over two hours. After the training session, staff will deliver the virtual reality activities which will involve: 1. Orientation session: The two initial 30-40 minute sessions will enable each resident to trial the Pico Neo 3 head-mounted virtual reality display, hand controller, immersive virtual reality experience and a 5-10 minute sample of the physical activities in the program. Residents will have the opportunity to affirm or withdraw their consent to participate in the study. Residents and staff will be observed during this session and will participate in separate reflexive focus group discussions on conclusion to capture responses to the experience of virtual reality, the physical activities and the group session. The service manager will also be interviewed about the program. 2. Virtual reality physical activity program: The program will comprise of 30-40 minute group sessions each week for the subsequent five weeks during which participating residents will each take part in at least one 5-10 minute block of immersive virtual reality physical activities. Residents will be seated and will primarily use the upper extremities. This will be undertaken in two successive groups of five residents. The residents’ view will be streamed onto a monitor so staff can provide support. Residents and staff will be observed and will participate in separate focus groups after each weekly session to reflect on their experience. The physiotherapist will also be interviewed briefly each week. 3. On conclusion of the six-week program: Participants will be interviewed individually using open-ended questions to collect reactions to the program’s content, conduct and therapeutic value, and reflections on the use of immersive virtual reality technology in residential aged care. The virtual reality activities in this study are games and exercises that promote physical activity. They are designed to be accessible and fun. The scenarios will be selected from the following activities: • Games o Upper body - a range of games designed to use the participant’s existing range of motion, reach, and response time. o Sport - popular ball sports that involves trunk rotation and sit-to-stand o Balance - activities that require trunk strength, sitting and standing balance. • Exercise o Trail - videos from various locations that require task specific repetition to play. o Waterway - row, kayak through these videos that requires upper body strength and general endurance. o Gym - use these gym applications to increase strength and upper limb function Stretching - follow along with these videos to stretch out different parts of the body. • Creative o Painting - paint a masterpiece in 3D to increase time on task and includes upper limb range of motion, reach and grasp. o Building - build your own toy town that uses trunk rotation and reach. Adherence will be monitored using a piloted worksheet at each session and include time using the virtual reality, problems with the technology, and time take for potential troubleshooting.