Virtual reality (VR)-based rehabilitation is a growing technological field, which gradually becomes integrated into existing programs. However, technology has to support human behavior and -needs, including social relatedness, to achieve health-related outcomes. Elderly people have high risk of loneliness, and VR has technological affinity for natural social interaction. Previous studies have relied on competitiveness rather than collaborative elements, but research shows that competitiveness can lead to (feelings of) stress and aggressive behavior in some individuals. This article presents a mixed methods study to gather end-user feedback on a social VR scenario that encourages inter-player collaboration on a virtual tandem bike. Outpatients ( $$n=11$$n = 11 , 64% males, $$60\pm 11$$60 ± 11 years) were invited to participate with a co-player (friend or family). Participants biked on average 10.7 (± 3) minutes with a mean speed of 14.8 kmph (± 5.8). The results indicate potential and feasibility for the collaborative social biking application. Participants reported excellent usability-scores (85 ± 5), high intrinsic motivation in all categories: enjoyment (6.5 ± 0.5), effort/importance (6.4 ± 0.3), relatedness (6.3 ± 0.7) and minimal increase in symptoms of nausea, oculomotor and disorientation. Furthermore, participants found the social aspect enjoyable, agreed that collaboration eased tasks and that they lost track of exercise duration. Interpersonal interaction between participants varied, but was mostly positively rated valence, even if the sense of copresence was limited by physical constraints and avatar representation. Most participants expressed that they would use the program again, but future studies should explore how to improve location and appearance of the virtual coactor, as well as implement additional tasks.

Virtual reality (VR) has been shown to function well as an assistive technology to physical therapy for elderly users. Elderly users are a unique user group in this field, due to their characteristics and demands. They are also a user group that can definitely benefit from VR technology, which is unfortunately a perspective that seems elude the VR community. This study explores how augmenting a manuped exercise (chair-based exercise bike), using an interactive screen-based virtual environment (VE), can change the exercise experience for retirement home residents. It is the first study in a series of studies, initiating an investigation into how to use VR to augment conventional exercise experiences, specifically for the retirement home resident audience. In a larger scope, the ambition is longterm to use VR technology to increase motivation with retirement home residents, to uphold a regular exercise routine. The results showed that a majority of subjects reported to support the VE augmentation and preferred the VE based exercise experience to the conventional exercise. This supports VR as an assisting technology for physical therapy, and suggests the potentiality VE augmented exercises, tailored for retirement home residents.

Virtual technology and immersive experiences are not very often associated with older adults. Recent studies suggest that exercise augmentation using flat screen-based virtual environments, which allow nursing home residents to experience virtual places different from the nursing home, can increase the intrinsic motivation of nursing home residents. In this paper, we increase the immersive properties of such augmentation through an Oculus Rift Head Mounted Display, to evaluate the effect on the older adults' sense of presence, if it has any relation to the level of intrinsic motivation to exercise, and an effect of the exercise user experience. A small sample size makes this a feasibility study. Results suggest HMD displays for immersive VR experiences applicable to nursing home users but not the particular exercise purpose.

For most nursing home residents, regular physical exercise is a necessity to keep standard motor-function and strength. Meanwhile, many nursing home residents do not pursue this actively. This paper examines if augmenting a conventional chair-based bike exercise, with a suite of four recreational virtual environments, will increase the intrinsic motivation with a group of nursing home residents. After 4-months of availability, results suggest that the augmentation has increased the intrinsic motivation to exercise, by comparing results from before and after, using measurement scales from the Intrinsic Motivation Inventory.

The aim of this study was to investigate the potential of mixed-reality systems to virtually manipulate the eating experience and facilitate increased food intake among older participants. Social isolation is often associated with undernourishment among older adults receiving care services. Mixed-reality systems that blend real elements and a virtual world can conveniently allow older adults to eat a meal in their home while experiencing having a conversation with friends through virtual avatars in a virtual environment. A within-subjects study on thirty older participants investigated whether the mixed-reality illusion of eating in a living room with and without familiar others contributed positively to the meal experience and increased energy intake. The results did not display any significant changes in energy intake but highlighted that the virtual living room had a more energetic and pleasant atmosphere and that meals eaten in the virtual room were perceived to be of a higher quality compared to meals eaten in the real lab environment. Eating while engaging in avatar-based social interactions with three remotely located friends resulted in lower sensations of being alone and positive mood changes. A discussion of the reasons for the absence of increases in energy intake is included.

We present the prototype of a wireless tracker developed to improve functionality and experience of biking systems using virtual reality (VR) for augmentation. VR has shown promise as an assistive technology to promote physical activity for older adult users. In previous studies, nursing home participants' intrinsic motivation to exercise has shown to increase when using VR to augment their biking exercise routine. The presented VR augmentation system previously used a wired Arduino UNO microcontroller, with magnets and Hall effect sensors to track the pedaling behavior of users. The prototype for a pedaling-tracking device that we present in this paper improves the real-time synchronization of proprioceptive and visual feedback to user actions along with an increased ease-of-use and flexibility, which can suggest future directions in VR technologies for various applications in both domestic and professional setups. The new prototype presented is currently deployed for initial testing in two rehabilitation centers for older adults in Frederiksberg, Denmark.