Acceptability, Feasibility, and Effectiveness of Immersive Virtual Technologies to Promote Exercise in Older Adults: A Systematic Review and Meta-Analysis

Abstract

Context: This review aimed to synthesize the literature on the acceptability, feasibility, and effectiveness of immersive virtual technologies to promote physical exercise in older people. Method: We performed a literature review, based on four databases (PubMed, CINAHL, Embase, and Scopus; last search: 30 January 2023). Eligible studies had to use immersive technology with participants aged 60 years and over. The results regarding acceptability, feasibility, and effectiveness of immersive technology-based interventions in older people were extracted. The standardized mean differences were then computed using a random model effect. Results: In total, 54 relevant studies (1853 participants) were identified through search strategies. Concerning the acceptability, most participants reported a pleasant experience and a desire to use the technology again. The average increase in the pre/post Simulator Sickness Questionnaire score was 0.43 in healthy subjects and 3.23 in subjects with neurological disorders, demonstrating this technology’s feasibility. Regarding the effectiveness, our meta-analysis showed a positive effect of the use of virtual reality technology on balance (SMD = 1.05; 95% CI: 0.75–1.36; p < 0.001) and gait outcomes (SMD = 0.7; 95% CI: 0.14–0.80; p < 0.001). However, these results suffered from inconsistency and the number of trials dealing with these outcomes remains low, calling for further studies. Conclusions: Virtual reality seems to be well accepted by older people and its use with this population is feasible. However, more studies are needed to conclude its effectiveness in promoting exercise in older people.

Application and Challenges of the Technology Acceptance Model in Elderly Healthcare: Insights from ChatGPT

“…In elderly healthcare, a positive image may involve perceptions of the technology as reliable, secure, and beneficial for health and well-being. [8,15,30,32,34,35] Facilitating Conditions (FC):…”

“…Subjective Norms (SN) acknowledged the social pressures and influences from family, friends, and healthcare providers, contributing to heightened acceptance [8,32,33]. The construct of Image (IM) underscored the perceived reputation associated with using technology in elderly healthcare, emphasizing reliability, security, and overall well-being benefits [8,15,30,32,34,35]. Facilitating Conditions (FC) assesses the external support available, including technical assistance and access to resources [7,8,36].…”

“…The TAM has served as a valuable framework for assessing the elderly's perception and acceptance of various healthcare technologies. In the realm of telehealth, TAM can be employed to gauge how elderly individuals perceive and embrace remote consultations, monitoring, and virtual care technologies [24,28,34,[37][38][39][40][41][42][43][44][81][82][83][84]. Furthermore, TAM has been proven useful in understanding the factors influencing the adoption of wearable health devices among the elderly, including smartwatches and fitness trackers designed to monitor vital signs and activity levels [28,45,46].…”

“…It is also reported as aiding in comprehending how elderly individuals perceive and adopt assistive technologies, including smart home devices, medication reminders, and other aids that enhance independent living [5,21,26,36,50]. In the domain of rehabilitation, TAM can be employed to explore the acceptance of virtual reality and gamified applications, considering factors like engagement, perceived benefits, and ease of use [34,36,40,[50][51][52][53][54][55]. Additionally, the model is valuable in assessing the elderly's acceptance of AI-driven healthcare support, including health-related chatbots or virtual assistants, and elucidating factors influencing adoption [39,56].…”

Older Adults’ Continuance Intentions for Online Physical Exercise Classes

“…Even older populations appreciated the value of technology, even though they historically used technology less frequently for everyday services and communication due to factors such as digital literacy and internet access. Overall, the increasing use of digital technology in daily activities and assisted living may facilitate a paradigm shift toward successful and healthy aging [6,7] and serve as an alternative to improving older individuals' physical and mental health [8][9][10][11][12][13]. Therefore, it is essential to understand the impact of this digital shift on older adults' health and wellness activities, including physical exercise.…”