Multicomponent exercise with virtual reality for preventing functional decline in hospitalized older adults: a randomized, three-arm, parallel clinical trial.

BACKGROUND

Acute hospitalization often triggers functional decline in older adults. While multicomponent exercise programs (MEP) are effective, the role of immersive Virtual Reality (VR) remains underexplored in acute geriatric wards. This study evaluated the efficacy of a VR-enhanced MEP program compared with conventional MEP and usual care (UC).

METHODS

Randomized, three-arm, parallel clinical trial in an acute geriatric ward. Patients aged ≥75 years were randomized to receive 1) MEP, 2) MEP-VR, or 3) UC. The primary outcome was the change in functional capacity, as measured by the Short Physical Performance Battery (SPPB). Secondary outcomes included the Timed Up and Go (TUG) test, cognitive status (MMSE), Barthel Index, Quality of Life (EuroQol-5D-5L), and muscle strength.

RESULTS

A total of 156 participants were enrolled (mean age, 86.4 [SD 5.2] years). Regarding the primary outcome, MEP was significantly more effective than MEP-VR. The between-group difference in SPPB was 1.04 points (95% CI: 0.33, 1.75) for MEP vs. UC and 0.13 points (95% CI: -0.64, 0.89) for MEP-VR vs. UC. Direct comparison showed MEP-VR performed lower than MEP (-0.91 points; 95% CI: -1.67, -0.16). Regarding cognitive function, between-group analysis showed superior improvements in both intervention arms versus control, with MEP-VR demonstrating a significant advantage (+1.90 points; 95% CI: 0.76, 3.04) and MEP showing an improvement of +1.23 points (95% CI: 0.18, 2.28) versus UC; direct comparison between MEP-VR and MEP yielded a non-significant difference of +0.67 points (95% CI: -0.46, 1.80). Adherence was high, with no serious adverse events related to VR.

CONCLUSIONS

Conventional MEP remains the most effective intervention for improving physical function. Further studies are required to confirm the comparative effectiveness of VR integration for cognitive benefits in holistic geriatric care.