Feasibility, Acceptability, and Tolerability of Fully-Immersive Virtual Reality Use Among Individuals with Neurological Conditions: A Mixed Methods Study.

Introduction: Virtual reality (VR) offers a multidimensional simulated reality built with digital formats and can be characterized as semi-immersive (single projection screen) or fully-immersive (head-mounted display). Although VR is an emerging intervention for the rehabilitation of individuals with neurological disorders, research on fully-immersive technologies and the patient experience is limited. Purpose: To evaluate the feasibility, acceptability, and tolerability of using off-the-shelf, fully-immersive VR with adults following neurological impairment. Methods: Mixed-methods study including 18 participants with a mean standard deviation (SD) age of 67.11 (12.12) years, asked to complete 20 minutes of dynamic rhythm-based VR activity in sitting. Outcomes included the pre- and postactivity VR Sickness Questionnaire (VRSQ), physiological data (maximum heart rate and Borg Rating of Perceived Exertion [RPE]), the User Satisfaction Evaluation Questionnaire (USEQ), and a structured interview. Quantitative analysis consisted of descriptive and inferential statistics. VRSQ scores were compared using a Wilcoxon signed-rank test. Qualitative analysis consisted of thematic analysis of interviews. Results: Median interquartile range (IQR) pre- and postactivity VRSQ scores were 7.50 (0-19.58) and 7.92 (0-19.38), respectively. Differences in scores were not statistically significant (Z = 0, P = 1.00). The median USEQ score was 27.50 (25.00-28.25). The mean percentage of maximal heart rate achieved was 63 (10) %, with a median RPE score of 10.50 (8.25-12.75). Qualitative analysis revealed themes of enjoyment and beneficial therapeutic challenges as facilitators of VR use. Conclusion: A single session of fully-immersive off-the-shelf VR yielded promising integrated findings related to the feasibility, acceptability, and tolerability of this type of intervention for a sample of individuals with a variety of neurological conditions.