Effects of Immersive Virtual Reality and/or Multicomponent Physical Exercise on Cognitive and Functional Performance in Hospitalized Older Patients With Severe Functional Dependency: Study Protocol for a Randomized Clinical Trial

This study will be conducted in a Spanish tertiary hospital to investigate the impact of a cognitive stimulation intervention through immersive virtual reality (IVR) on hospitalized older adults with severe functional dependency. The study will also examine the combined effect of a multicomponent exercise intervention (ME) with IVR. A total of 212 acute patients will be enrolled in the Acute Geriatric Unit of the hospital, meeting specific inclusion criteria related to age, stability in cardiopulmonary, respiratory, and neurological systems, expected length of stay, and ability to communicate and collaborate with the research team. Patients will be randomly assigned to a control group or one of three intervention groups: IVR, ME, or IVR + ME.

The interventions for the IVR and ME groups will involve watching 3D videos of Spanish landscapes and undergoing progressive upper and lower extremity exercises, respectively. The IVR + ME group will receive both interventions, while the control group will receive usual care. Primary outcome measures include cognitive tests, strength assessments, and balance and mobility evaluations. Secondary outcome measures include mood, quality of life, functional performance, delirium assessments, and length of hospital stay.

The study will take place in the Acute Geriatric Unit (AGU) of a tertiary hospital in Pamplona, Navarra, Spain, and will adhere to standard clinical trial guidelines. Eligibility criteria include medical inpatients admitted to the AGU between January 2024 and March 2025, with specific inclusion and exclusion criteria. The study aims to evaluate the impact of the interventions on cognitive and physical function among hospitalized older adults with severe functional dependency, with the goal of enhancing their well-being and care during hospitalization.

The research team anticipates that the interventions will positively influence cognitive function, physical performance, mood, quality of life, isometric strength, and acceptance of virtual reality technology among participants. The study's comprehensive approach encompasses various assessments to provide a holistic evaluation of the interventions' effectiveness in improving outcomes for hospitalized older adults with severe functional dependency.

Overall, this study represents a significant effort to understand how innovative interventions such as cognitive stimulation through IVR and multicomponent physical exercise could positively impact the health outcomes and quality of life of hospitalized older adults with severe functional dependency. The study's findings are expected to provide valuable insights for healthcare providers, researchers, and policymakers seeking to optimize care for this population.