Implementation of Virtual Reality Motivated Physical Activity via Omnidirectional Treadmill in a Supported Living Facility for Older Adults: A Mixed-Methods Evaluation.

Title of the Paper

Implementation of Physical Activity Using a Virtual Reality-Based Omnidirectional Treadmill in Assisted Living Facilities for Older Adults: A Mixed-Methods Evaluation

Paper Information

• Subject Area: Virtual Reality, Healthy Aging, Physical Activity, and Social Well-being
• Keywords: Elderly Social Care, Physical Activity, Virtual Reality, Technological Innovation, Mental Health, Assisted Living Facilities

Research Background and Problems

• What problems or challenges did the authors identify?

  • With the intensification of global aging, the demand for healthcare resources is increasing.
  • Physical decline in older adults leads to reduced mobility and prolonged sedentary behavior.
  • Social isolation and loneliness are prevalent among older adults, especially in care facilities.
  • Although virtual reality (VR) technology has garnered attention in healthy aging, most studies focus on healthy older adults, with limited research on those with physical or psychological impairments.
  • VR technology has rarely been studied in long-term applications within assisted living environments.

• Why is this problem important?

  • Physical activity is crucial for preventing falls, delaying cognitive decline, and improving overall health.
  • Increasing participation in physical activity is essential to reduce older adults' dependence on healthcare and social care resources.
  • Exploring technological solutions to compensate for the lack of physical activity in real-world environments and providing new forms of social connections and cultural experiences through VR is vital.

• Research Motivation and Related Work

  • The necessity of enhancing physical activity and mental health for older adults and the urgent need to develop suitable technologies for these groups.
  • The authors referenced previous short-term VR exercise experiments with older adults, finding that these studies involved overly healthy samples, failing to reflect the potential role of VR for a more diverse and older population.
  • Current VR studies on fall prevention (e.g., virtual dance and motion-sensing games) show potential for improving balance but require further validation.

Solutions

• What methods or solutions did the authors propose?

  • Proposed a dual-device study using the MOTUS Adventure omnidirectional treadmill (a standing VR interface) and the MOTUS Relieve static VR video system (a static immersive experience).
  • Recruited older adults in assisted living facilities for a 6-week mixed-methods evaluation.
  • Introduced quantitative tests to assess participants' physical functions and collected qualitative data through logs, resident focus groups, and staff interviews to understand user experience and device feasibility.

• What is innovative about this solution?

  • The first application of an omnidirectional treadmill for older residents in assisted living facilities.
  • Collected feedback, user experiences, and usage barriers in a long-term context, addressing the gap in existing short-term studies.
  • Balanced physical activity with VR exploration experiences, designing a solution that includes both the "active" treadmill and the "static" immersive viewing experience.

• What are the implementation steps and key technologies used?

  • Participants were randomly assigned to test the two VR devices.
  • Collected data on participants' physical health and activity levels, including fall risk assessments and standard fitness tests (e.g., sit-to-stand test, two-minute step test, 2.45-meter timed up-and-go test).
  • Combined user logs, focus group discussions, and interviews to systematically analyze technology usability, advantages, disadvantages, and improvement suggestions.
  • Used NVivo 12 for qualitative data analysis to ensure reliability.

Research Findings

• What specific findings were achieved?

  • Technical Feasibility: The study found that most residents, including a 103-year-old participant, could safely use the MOTUS Adventure omnidirectional treadmill, albeit with supervision. The chair-based VR experience was easier to use and suitable for participants with more limited physical abilities.
  • User Feedback: Older adults generally felt that VR technology provided a virtual travel experience "beyond four walls," with positive impacts on mental and physical health, particularly when visiting cultural sites and natural landscapes.
  • Physical Activity: Most residents participating in the treadmill program reported increased physical activity, describing sensations similar to "real exercise."

• What are the advantages compared to existing solutions?

  • The innovative design combines virtual exploration with physical activity, overcoming the limitations of static leisure VR experiences.
  • Greater focus on the needs of frailer older adults, clarifying the relationship between physical activity and VR applicability.
  • Practical insights into the barriers to technology use were gained through implementation in real assisted living facilities.

• What were the experimental or evaluation results?

  • Residents engaged more frequently with the MOTUS Relieve (14 interactions) static experience, though many also tried the standing VR treadmill (16 interactions).
  • Average fitness test scores indicated that this group had significantly lower activity levels than independently living older adults, supporting the need for assistive technology designed with these limitations in mind.
  • Familiarity with the devices improved over time. Despite minor negative experiences such as slight dizziness, the majority of feedback was positive.

• Limitations and Future Directions

  • Limitations:

    • Small sample size and short study duration made it difficult to quantify actual medical outcomes.
    • Participants were not yet fully independent in using the devices, requiring additional technical support and guidance.
    • Feedback indicated that some virtual content was overly simplistic or unrealistic, limiting immersion.
    • Physical space requirements and cost issues restricted broader application in care environments.

  • Future Directions:

    • Increase sample size and study duration to validate the quantitative benefits of the treadmill on health and activity levels.
    • Combine behavioral change interventions to explore the drivers of VR technology use, enhancing older adults' confidence in using the technology independently.
    • Develop more realistic and detailed cultural and natural content.
    • Optimize device portability, such as developing a foldable treadmill.
    • Explore safer "seated treadmills" as an alternative for residents with more severe physical limitations.

Conclusion

This study provides empirical support for the potential of virtual reality to enhance physical activity among older adults while revealing the barriers and future improvement directions for implementing this technology in social care environments. Future research should focus on optimizing technology design and promotion strategies under policy support to validate the long-term impact of this technology on healthy aging.