Pòster presentat pel doctor José Ferrer, metge d'Innovació i Projectes, a la "A Metaverse for the Good Conference", celebrada el 9 i el 10 d'abril de 2024 al Centre de Cultura Contemporània de Barcelona.

1. Real-Life VR Integration for Mild Cognitive Impairment Rehabilitation
Authors:
José Ferrer Costa, Medical Doctor, Innovation and projects. Badalona Serveis Assistencials, Spain.
Contact: jfcosta@bsa.cat
Maria-José Ciudad (ORCID: 0000-0002-4431-7136), Neuropsychologist, Badalona Serveis Assistencials, Spain
Maribel González Abad - Nurse assistant, Badalona Serveis Assistencials, Spain.
José Luis Rodríguez García - Nurse, Badalona Serveis Assistencials, Spain.
Julisa Cortes - IES Health intern for the Liberal Arts & Business program.
Results
Patients´ Engagement and Satisfaction:
● An overwhelming 90.48% of participants felt comfortable using the VR system, and 76.19% expressed a strong desire to use the program frequently,
showcasing high user satisfaction and acceptance.
● The majority found VR exercises more entertaining than traditional methods, with 50% agreeing or strongly agreeing, highlighting VR's potential as a more
engaging cognitive stimulation tool. The complexity of the program was not a significant barrier, with a majority of participants reporting they found the
program either agreeable or neutral in terms of complexity (figure 8).
System Usability and Acceptability by the patients:
● While some participants perceived the VR headset as heavy, the study's tailored content, developed following guidelines to reduce side effects, was
effective—indicated by the high comfort levels reported.
● Notably, despite reports of discomfort, the majority did not have to discontinue the VR experience, suggesting successful mitigation strategies were in place
(Figure 9).
Professional Evaluation: Usability and Impact on Patient Care Quality
● Usability: Professionals unanimously praised the VR program's user-friendly interface, highlighting its ease of integration into daily clinical practice. While
acknowledging a learning curve for some patients, it was considered manageable, pointing to the program's straightforward design and relevance to clinical
settings (Figure 10).
● Impact on Patient Engagement: Healthcare professionals observed an enhanced patient engagement with VR sessions compared to conventional methods. The
immersive VR environment minimized distractions and discouraged skipping challenging tasks, leading to higher levels of active involvement and immersion.
This contrasts with the lesser engagement seen with computer or paper-based tasks, where patients showed more distractibility.
● Effectiveness in Cognitive Stimulation and Social Interaction: Professionals reported improvements in participants' mood, cognitive engagement, and
willingness to engage in therapeutic activities. The use of 360-degree videos, in particular, was seen as beneficial for fostering socialization and making group
sessions more impactful and relatable.
Introduction
The aging population is increasingly confronted with the challenge of mild cognitive impairment, a condition
that often precedes more severe dementia types (1, 2). Despite the effectiveness of traditional cognitive
therapies, they frequently fall short in terms of engagement and accessibility (3, 4). This pilot study,
conducted at the Intermediate Care Center El Carme in Badalona, Spain, explores the usability and
acceptability of Virtual Reality and Augmented Reality as innovative interventions for seniors with MCI.
In collaboration with Reality Telling, we have developed a customized VR program comprising interactive
cognitive exercises (Figures 1-4 and immersive 360-degree videos (Figures 5 and 6). These exercises aim to
enhance memory, executive function, and attention through engaging in daily life tasks, while the videos
provide virtual tours to promote social interaction and emotional engagement. The assessment of this
intervention's impact on cognitive functions, conducted using standardized scales, will be detailed in a
forthcoming publication, focusing this presentation on the practical application and user experience of VR
and AR in cognitive rehabilitation.
A Metaverse for the Good Conference, 9-10th April 2024
En col·laboració amb:
Figures 1-4: VR cognitive exercises: Patients seated and standing, engaging in interactive content.
Discussion
Pilot Study Insights:
Our study demonstrates a significant shift towards using VR and AR for MCI treatment, indicating a more effective engagement method for seniors compared to
traditional techniques. Customized VR content, tailored to seniors' cognitive levels and designed to minimize side effects, has seen broad acceptance among users
and therapists, highlighting VR's potential for personalized cognitive rehabilitation.
User-Centered Design and Safety:
Iterative content refinement, driven by users and professionals´ feedback, underscores our dedication to safety and experience, adapting the VR environment
accordingly. These adjustments ensure the safety and immersion of seniors, showing the dynamic adaptability of VR/AR in meeting user needs.
Preference and Practicality:
The transition from traditional methods to VR indicates a clear preference for immersive experiences that minimize distractions. The choice between VR and AR is
dictated by the nature of the task, with AR recommended for movement-involved activities for safety, and VR for focus-intensive tasks.
Future Directions:
Ongoing research aims to further evaluate VR's therapeutic effectiveness, with an emphasis on accessibility and customization for diverse cognitive needs. This
initiative marks a significant step towards a more engaging, personalized cognitive care model, promoting the continuous innovation and integration of immersive
technology in healthcare.
Acknowledgments
We extend our heartfelt thanks to Reality Telling for their invaluable collaboration in developing the VR program that stands at the heart of this study. Special
gratitude is also due to the Àrea Metropolitana de Barcelona (AMB) for their financial support through a grant for innovative social and technological
entrepreneurship initiatives.
Figures 5 and 6: 360 video VR session: Exploring Badalona's seaside virtually
Figures 6 and 7: Initial VR supermarket task design posed safety concerns for seniors bending down. Responsive redesign
introduced a basket on a table, enhancing safety and immersion, showcasing VR's adaptability for senior-friendly therapeutic
environments
Figure 8: Participants' Usability Evaluation
Figure 9: VR Headset Comfort Feedback
Figure 10: Professionals' System Usability Assessment
Materials and methods
The pilot, registered under ClinicalTrials.gov ID NCT06155721, enrolled 45 senior participants with MCI to assess the
impact of VR on various cognitive functions. The intervention involved 8 VR sessions using Meta Quest 2 headsets,
integrating hand-tracking technology for immersive interaction. The study was designed to capture detailed daily
feedback from both patients and therapists, allowing for the continuous adjustment and improvement of the virtual
content created.
This process allowed the continuous adaptation of VR and AR content to meet user needs effectively, emphasizing safety
and engagement (Figures 6 and 7). Final feedback was analyzed using the SUS and qualitative comments, providing a
comprehensive evaluation of the VR program's complexity, entertainment value, and overall comfort. The findings from
this feedback were instrumental in refining the VR intervention, demonstrating the value of a patient-centered and
iterative design process in clinical VR applications.
This pilot study received principal support from
Badalona Serveis Assistencials, with additional funding
from a digital content grant to Reality Telling by Àrea
Metropolitana de Barcelona (AMB)