One of the pillars which underpins active aging is found in the performance of physical activity. While adherence to physical activity programs has traditionally been low in older people, immersive virtual reality (IVR) could provide an alternative and complementary training mode. A randomized clinical trial was conducted to explore the feasibility and effects of a 10-week IVR exergame program on physical functions of 24 institutionalized older adults who were allocated to an experimental group (EG n = 13; 85.08 ± 8.48 years) and control group (CG n = 11; 84.82 ± 8.10 years). The IVR intervention was feasible, with no adverse effects being reported (no Simulator Sickness Questionnaire symptoms; low negative experience scores on the Game Experience Questionnaire < 0.34/4), no dropouts, high adherence, and good post-gaming usability (System Usability Scale > 73.96%). The EG showed significant improvements: Tinetti scores for balance (1.84 ± 1.06; p < 0.001), gait (1.00 ± 1.08; p < 0.001), total score (2.84 ± 1.67; p < 0.001), and handgrip (4.96 ± 4.22; p < 0.001) (pre–post assessment). The CG showed significantly worsened compared to the EG: Five times sit-to-stand test, Tinetti scores for balance, gait, and total score, and the Timed Up and Go test total score (post-assessment). The findings show that the IVR intervention is a feasible method to approach a personalized exercise program and an effective way by which to improve physical function in the target population.

Parkinson’s disease (PD) is a neurological disorder that usually appears in the 6th decade of life and affects up to 2% of older people (65 years and older). Its therapeutic management is complex and includes not only pharmacological therapies but also physiotherapy. Exercise therapies have shown good results in disease management in terms of rehabilitation and/or maintenance of physical and functional capacities, which is important in PD. Virtual reality (VR) could promote physical activity in this population. We explore whether a commercial wearable head-mounted display (HMD) and the selected VR exergame could be suitable for people with mild–moderate PD. In all, 32 patients (78.1% men; 71.50 ± 11.80 years) were a part of the study. Outcomes were evaluated using the Simulator Sickness Questionnaire (SSQ), the System Usability Scale (SUS), the Game Experience Questionnaire (GEQ post-game module), an ad hoc satisfaction questionnaire, and perceived effort. A total of 60 sessions were completed safely (without adverse effects (no SSQ symptoms) and with low scores in the negative experiences of the GEQ (0.01–0.09/4)), satisfaction opinions were positive (88% considered the training “good” or “very good”), and the average usability of the wearable HMD was good (75.16/100). Our outcomes support the feasibility of a boxing exergame combined with a wearable commercial HMD as a suitable physical activity for PD and its applicability in different environments due to its safety, usability, low cost, and small size. Future research is needed focusing on postural instability, because it seems to be a symptom that could have an impact on the success of exergaming programs aimed at PD.

Life expectancy has increased in recent years. Physical activity has been postulated as a key element in active aging strategies. However, adherence to physical exercise programs has traditionally been low among the elderly, and the current situation of the COVID-19 pandemic has added extra impediments. Immersive virtual reality (IVR) devices could motivate this population to practice exercise. This study aimed to analyse the use of IVR exergames as a tool to facilitate physical exercise in older people. Four healthy older adults (males, 65–77 years) participated in the study. They carried out two exergaming sessions with HTC Vive Pro^TM. Outcomes were evaluated using the Simulator Sickness Questionnaire (SSQ), System Usability Scale (SUS), Game Experience Questionnaire (GEQ post-game module), an ad hoc satisfaction questionnaire, and perceived effort. All participants completed the sessions without adverse effects, with no SSQ symptoms reported. SUS scores were high in both sessions (SUS > 85/100). Post-game GEQ scores were 3.08–3.41/4 (positive experiences) and 0.08–0.16/4 (negative experiences). Opinions showed high levels of satisfaction with the experience. Exergaming programs, based on commercial head-mounted displays, are a feasible alternative to traditional senior exercise, and could be a solution to the current situation that has arisen from the impact of the COVID-19 pandemic.

Physical exercise has been recognized as an important strategy in the promotion of healthy aging. Positive effects on older adults’ motor ability are brought about by engaging their motor skills and promoting sensorimotor learning and cortical plasticity. These processes could be increased with the use of immersive virtual reality (IVR) technology, since the multisensory stimulation is greater. The aim of this study was to explore the usability and balance effects of an IVR exercise program in community-dwelling nonagenarian people. A sample of 12 women were allocated to an experimental group (EG n = 6; 91.67 ± 1.63 years) and a control group (CG n = 6; 90.83 ± 2.64 years). For 10 weeks, the EG used a commercial IVR exergame three times a week. All the sample completed the program without adverse effects (without Simulator Sickness Questionnaire symptoms). Post-gaming usability was good (System Usability Scale 78.33). The EG improved some balance parameters significantly (Tinetti test: balance (10.97 %; Sig = 0.017), gait (9.23%; Sig = 0.047) and total score (10.20%; Sig = 0.014) and maintained total TUG test times (−0.45%)). There were significant differences between groups (Tinetti test: balance (Sig = 0.004) and total score (Sig = 0.0032)). We successfully demonstrated that IVR training is feasible and is an effective and personalized method to enhance balance and to reduce the risk of falls in community-dwelling nonagenarian women.

La Realidad Virtual (RV) es una herramienta cada vez más presente en la valoración y tratamiento del paciente neurológico. Sin embargo, en ocasiones, la exposición a entornos inmersivos puede desencadenar efectos adversos. Detectar las posibles complicaciones de su uso se antoja fundamental para dotar de seguridad a sus aplicaciones terapéuticas. El objetivo de este trabajo ha sido realizar una traducción y adaptación transcultural del cuestionario Simulator Sickness Questionnaire (SSQ), empleado para valorar el cybersickness o sintomatología adversa asociada al uso de la RV, de cara a minimizar riesgos vinculados a su uso en población española. Se llevó a cabo una traducción, retrotraducción y adaptación del instrumento original y una validación de contenido y equivalencia semántica del cuestionario a través de la opinión de expertos, llegando a una versión preliminar evaluada en un ensayo piloto con 54 participantes. Tras la obtención de la versión preliminar en español, el análisis de validez de contenido mostró valores elevados (índice de validez de contenido ³ 0.89; valores de kappa ³ 0.89). 42 de los 54 participantes en el estudio (78%) entendieron el total de la equivalencia semántica planteada y el 100% de la muestra comprendió 13 de los 16 ítems adaptados (81%). El proceso de traducción y adaptación transcultural al castellano del SSQ llevado a cabo, ha dado como resultado una versión equivalente al cuestionario original, presentando una elevada concordancia semántica que facilitará el desarrollo de futuros estudios en población española sobre la sintomatología adversa que pudiera generar la RV. Virtual Reality (VR) uses is growing in the assessment and treatment of neurological patients. However, immersive environments exposure can trigger adverse effects. Checking the possible complications of its use is essential to provide security to therapeutic approaches. The aim of this work has been to carry out a translation and cross-cultural adaptation of the Simulator Sickness Questionnaire (SSQ), used to assess cybersickness or adverse symptoms associated with VR, with the aim to decrease risks in the Spanish population. Forward-translation, back-translation and cross-cultural adaptation of the original questionnaire was carried out. Content validation and semantic equivalence was assessed by an expert panel, leading to a preliminary version evaluated in a pilot trial with 54 participants. After obtaining the preliminary version in Spanish, the content validity analysis showed high values (content validity index ³ 0.89 and kappa values ³ 0.89). 42 of the 54 participants (78%) understood the total semantic equivalence raised and 100% of the sample understood 13 of the 16 adapted items (81%). The translation and cross-cultural adaptation into Spanish of the SSQ was carried out in this study, showed an equivalent version to the original questionnaire, presenting a high semantic concordance and facilitating the development of future studies in the Spanish population on the adverse symptoms that VR could generate.