Usability Issues of Clinical and Research Applications of Virtual Reality in Older People: A Systematic Review

Abstract

Aging is a condition that may be characterized by a decline in physical, sensory, and mental capacities, while increased morbidity and multimorbidity may be associated with disability. A wide range of clinical conditions (e.g., frailty, mild cognitive impairment, metabolic syndrome) and age-related diseases (e.g., Alzheimer's and Parkinson's disease, cancer, sarcopenia, cardiovascular and respiratory diseases) affect older people. Virtual reality (VR) is a novel and promising tool for assessment and rehabilitation in older people. Usability is a crucial factor that must be considered when designing virtual systems for medicine. We conducted a systematic review with Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) guidelines concerning the usability of VR clinical systems in aging and provided suggestions to structure usability piloting. Findings show that different populations of older people have been recruited to mainly assess usability of non-immersive VR, with particular attention paid to motor/physical rehabilitation. Mixed approach (qualitative and quantitative tools together) is the preferred methodology; technology acceptance models are the most applied theoretical frameworks, however senior adapted models are the best within this context. Despite minor interaction issues and bugs, virtual systems are rated as usable and feasible. We encourage usability and user experience pilot studies to ameliorate interaction and improve acceptance and use of VR clinical applications in older people with the aid of suggestions (VR-USOP) provided by our analysis.

Effectiveness of an Innovative Cognitive Treatment and Telerehabilitation on Subjects With Mild Cognitive Impairment: A Multicenter, Randomized, Active-Controlled Study

“…The current findings show a significant improvement in memory, language and visuo-constructional abilities after the end of face-to-face cognitive VRRS treatment compared to face-to-face cognitive treatment as usual. Our findings are in line with previous studies that described the usefulness of face-to-face virtual reality rehabilitation protocols aimed at improving memory and executive functioning in older participants with mild cognitive difficulties ( Liao et al, 2019 ; Moreno et al, 2019 ; Tuena et al, 2020 ) as well as previous studies of effective cognitive treatments to prevent and slow the progression of MCI ( Belleville, 2008 ).…”

Effects of exposure to immersive videos and photo slideshows of forest and urban environments

“…For people with limited access to nature (e.g., elderly in nursing homes, hospital patients, or jail inmates), already the visual representation of nature can relieve stress and improve emotional well-being 22 , 35 – 39 . Many studies in environmental psychology have used conventional photos to compare natural and urban environments or to demonstrate the positive effects of nature photos 5 , 6 , 40 , 41 .…”

A Virtual Reality-Based Cognitive Telerehabilitation System for Use in the COVID-19 Pandemic

“…Evidently, it will be necessary to include spaced retrieval tasks that demand a little more attention and effort in order to find contrastable evidence. Similarly, a usability evaluation will have to be taken into account, as this is critical when working with users who have specific needs [65]. This evaluation should be performed in the design stages of the application, considering the execution time, level of immersion, comfort and possible adverse side effects on the participant.…”