Feasibility and Immediate Effects of Dynamic Exercise Using Mixed Reality for Balance Improvement in Older Adults and Individuals With Neurologic Disorders

Objective To investigate the feasibility and immediate effects of dynamic exercise using mixed reality (MR), a technology that allows real-time interaction between physical surroundings and computer-generated virtual objects, in older adults and individuals with Parkinson’s disease and stroke. Design Prospective single-arm intervention study. Setting Rehabilitation ward in the hospital. Participants Thirty-one participants, including 10 community-dwelling older adults without neurologic or neuromuscular disorders (4 women; mean age, 70.4 y; SD, 3.0), 11 outpatients with Parkinson’s disease (4 women; mean age, 68.4 y; SD, 7.6), and 10 individuals with a stroke (3 women; mean age, 62.8 y; SD, 16.2) in a subacute rehabilitation ward were recruited. Interventions Participants performed MR-based exercise for approximately 20 minutes. Main Outcome Measures After exercise, participants rated their level of simulator sickness using the Simulator Sickness Questionnaire (SSQ). They further rated their enjoyment, continuation, exercise effectiveness, and fatigue using a Numerical Rating Scale. The Timed Up and Go test and Functional Reach Test were performed both before and after the exercise. Results The median SSQ-nausea, SSQ-oculomotor, SSQ-disorientation, and SSQ-total scores were 9.5, 7.6, 0.0, and 7.5, respectively, indicating a low likelihood of simulator sickness. The median Numerical Rating Scale scores for enjoyment, continuation, effectiveness, and fatigue were 8.0, 8.0, 7.5, and 2.0, respectively. The Timed Up and Go test in individuals with stroke and Functional Reach Test in older adults showed significant improvement after exercise ( P <.05). Conclusions Dynamic exercises with MR may be sufficiently feasible to perform balance exercises with less risk of simulator sickness, offering the potential to improve balance ability.