Acceptability & Tolerability of Virtual Reality Sessions in Acute Geriatric Ward
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Published:
Dec 23, 2025
Keywords:
Virtual Reality, VRAGMENT, Geriatric, Cognitive, Acute Ward
Main Article Content
Abstract
Introduction: Virtual Reality (VR) could improve mental and physical condition. However, limited studies have been conducted on VR utilization for the elderly in acute wards. This study aimed to evaluate the acceptability and tolerability of a VR Prototype called VRAGMENT in the acute geriatric ward, as well as the acceptance correlation with cognitive function.
Methods: In this cross-sectional study, thirty-two subjects were recruited consecutively. Their satisfaction and complaints during and after a single VRAGMENT session were recorded using a questionnaire that elaborates the Technology Acceptance Model. VRAGMENT is a VR game programmed based on Instrumental Activities of Daily Living, designed by Universitas Indonesia.
Result: No falls or near falls were reported. No subject reported nausea, boredom, sleepiness, or oculomotor impairments such as dry or red eye, eye strain, blur, or difficulty focusing. Few subjects complained of general discomfort (19%), fatigue (6%), headache (9%), and dizziness (16%). All subjects declared that they were satisfied, enjoyed, and impressed. Most of them (97%) stated that VRAGMENT met their expectations and needs, and would like to recommend it to others. The overall acceptance and perceived ease of learning were significantly correlated with cognitive function.
Conclusion: This study proved that despite their age, cognitive impairment, and acute clinical condition, most subjects could accept and tolerate VRAGMENT sessions. This could be achieved through since VRAGMENT specifically designed for the elderly with cognitive impairment, as well as game protocol adaptation. Following study about the effect on patient outcomes needs to be conducted.
Methods: In this cross-sectional study, thirty-two subjects were recruited consecutively. Their satisfaction and complaints during and after a single VRAGMENT session were recorded using a questionnaire that elaborates the Technology Acceptance Model. VRAGMENT is a VR game programmed based on Instrumental Activities of Daily Living, designed by Universitas Indonesia.
Result: No falls or near falls were reported. No subject reported nausea, boredom, sleepiness, or oculomotor impairments such as dry or red eye, eye strain, blur, or difficulty focusing. Few subjects complained of general discomfort (19%), fatigue (6%), headache (9%), and dizziness (16%). All subjects declared that they were satisfied, enjoyed, and impressed. Most of them (97%) stated that VRAGMENT met their expectations and needs, and would like to recommend it to others. The overall acceptance and perceived ease of learning were significantly correlated with cognitive function.
Conclusion: This study proved that despite their age, cognitive impairment, and acute clinical condition, most subjects could accept and tolerate VRAGMENT sessions. This could be achieved through since VRAGMENT specifically designed for the elderly with cognitive impairment, as well as game protocol adaptation. Following study about the effect on patient outcomes needs to be conducted.
Article Details
How to Cite
Harini, M., Yusuf, P. A., Kusumaningsih, W., Harimurti , K., Nasrun, M. W., Harahap, A. R., Defi, I. R., Widyaningrum, S., Arif, L. S., Pujitresnani, A., & Nugraha, B. (2025). Acceptability & Tolerability of Virtual Reality Sessions in Acute Geriatric Ward. Indonesian Journal of Physical Medicine and Rehabilitation, 14(2), 161 - 169. https://doi.org/10.36803/indojpmr.v14i2.487
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Original Article
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27. Ha J, Park HK. Factors affecting the acceptability of technology in health care among older korean adults with multiple chronic conditions: a cross-sectional study adopting the senior technology acceptance model. Clin Interv Aging. 2020;15:1873–81.
28. Mannheim I, Varlamova M, van Zaalen Y, Wouters EJM. The role of ageism in the acceptance and use of digital technology. J Appl Gerontol. 2023;42:1283–94.
29. Hong SJ, Lui CSM, Hahn J, Moon JY, Kim TG. How old are you really? cognitive age in technology acceptance. Decis Support Syst [Internet]. 2013;56:122–30. Available from: http://dx.doi.org/10.1016/j.dss.2013.05.008
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32. Chang E, Kim HT, Yoo B. Virtual Reality Sickness: A Review of Causes and Measurements. Int J Hum Comput Interact [Internet]. 2020;36(17):1658–82. Available from: https://doi.org/10.1080/10447318.2020.1778351
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34. MacDonald S. Introducing the model of cognitive-communication competence: A model to guide evidence-based communication interventions after brain injury. Brain Inj [Internet]. 2017;31(13–14):1760–80. Available from: https://doi.org/10.1080/02699052.2017.1379613
2. Harini M, Arvianto B. Hospital acquired disabiliy pada bangsal geriatri akut terintegrasi: studi pendahuluan. In: Temu Ilmiah Geriatri Terpadu 2023. Jakarta: PERGEMI; 2023.
3. Chen Y, Almirall-Sánchez A, Mockler D, Adrion E, DomÃnguez-Vivero C, Romero-Ortuño R. Hospital-associated deconditioning: Not only physical, but also cognitive. Int J Geriatr Psychiatry. 2022;37:1–13.
4. Saitoh M, Takahashi Y, Okamura D, Akiho M, Suzuki H, Noguchi N, et al. Prognostic impact of hospital-acquired disability in elderly patients with heart failure. ESC Hear Fail. 2021;8:1767–74.
5. Ellis G, Whitehead MA, Robinson D, O’Neill D, Langhorne P. Comprehensive geriatric assessment for older adults admitted to hospital: meta-analysis of randomised controlled trials. BMJ. 2011;343:1034.
6. Smith TO, Sreekanta A, Walkeden S, Penhale B, Hanson S. Interventions for reducing hospital-associated deconditioning: a systematic review and meta-analysis. Arch Gerontol Geriatr. 2020;90:1–9.
7. Peraturan Menteri Kesehatan Republik Indonesia Nomor 79 Tahun 2014 tentang Penyelenggaraan Pelayanan Geriatri di Rumah Sakit [Internet]. 2014. Available from: https://peraturan.go.id/files/bn1752-2014.pdf
8. Vlake JH, Bommel J Van, Wils EJ, Korevaar TIM, Hellemons ME, Schut AFC, et al. Effect of intensive care unit-specific virtual reality (ICU-VR) to improve psychological well-being and quality of life in COVID-19 ICU survivors: a study protocol for a multicentre, randomized controlled trial. Trials. 2021;22:328.
9. Ioannou A, Papastavrou E, Avraamides MN, Charalambous A. Virtual reality and symptoms management of anxiety, depression, fatigue, and pain: a systematic review. Vol. 6, SAGE Open Nursing. Nicosia: SAGE Publications Inc.; 2020. p. 1–13.
10. Delshad SD, Almario C V., Fuller G, Luong D, Spiegel BMR. Economic analysis of implementing virtual reality therapy for pain among hospitalized patients. npj Digit Med. 2018;1:1–8.
11. Kolbe L, Jaywant A, Gupta A, Vanderlind WM, Jabbour G. Use of virtual reality in the inpatient rehabilitation of COVID-19 patients. Gen Hosp Psychiatry. 2021;71:76–81.
12. Naef AC, Jeitziner MM, Gerber SM, Jenni-Moser B, Müri RM, Jakob SM, et al. Virtual reality stimulation to reduce the incidence of delirium in critically ill patients: study protocol for a randomized clinical trial. Trials. 2021;22:174–85.
13. Pacheco TBF, de Medeiros CSP, de Oliveira VHB, Vieira ER, de Cavalcanti FAC. Effectiveness of exergames for improving mobility and balance in older adults: a systematic review and meta-analysis. Syst Rev. 2020;9:163.
14. Kanyılmaz T, Topuz O, Ardıç FN, Alkan H, Öztekin SNS, Topuz B, et al. Effectiveness of conventional versus virtual reality-based vestibular rehabilitation exercises in elderly patients with dizziness: a randomized controlled study with 6-month follow-Up. Braz J Otorhinolaryngol. 2022;88:41–9.
15. Nuryanto MR, Samatra DPGP, Irfan M, Dinata IMK, Sawitri AAS, Sugijanto. Pemberian latihan virtual reality lebih baik daripada latihan konvensional terhadap peningkatan fungsional tangan pada pasien pasca stroke. Sport Fit J. 2019;7:78–84.
16. de Vries AW, Faber G, Jonkers I, Dieen JH Van, Verschueren SMP. Virtual reality balance training for elderly: similar skiing games elicit different challenges in balance training. Gait Posture. 2018;59:111–6.
17. Gotanda H, Tsugawa Y, Xu H, Reuben DB. Life satisfaction among persons living with dementia and those without dementia. J Am Geriatr Soc. 2023;71(4):1105–16.
18. El-Wahsh S, Monroe P, Kumfor F, Ballard K. Communication Intervention for People with Dementia and Their Communication Partners. In: Low LF, Kate Laver, editors. Dementia Rehabilitation. London: Academic Press Inc.; 2021. p. 35–56.
19. Dadang M, Wahyudi ER, Dwimartutie N, Dinakrisma AA, Wahyuni LK, Wanarani, et al. Panduan praktik klinis (PPK) sindrom imobilisasi geriatri. Jakarta: RSUPN Dr. Cipto Mangunkusumo; 2021.
20. Mahendra I. Penggunaan Technology Acceptance Model (TAM) Dalam Mengevaluasi Penerimaan Pengguna Terhadap Sistem Informasi Pada PT. Ari Jakarta. J Sist Inforasi STMIK Antar Bangsa. 2018;V(2):183–95.
21. Syed-Abdul S, Malwade S, Nursetyo AA, Sood M, Bhatia M, Barsasella D, et al. Virtual reality among the elderly: A usefulness and acceptance study from Taiwan. BMC Geriatr. 2019;19(1):1–10.
22. Ratnasari N, Susanti RD, Harun H. Psychometric Validation of Nursing Student’s Learning Experiences Questionnaire on using Virtual Reality. J Nurs Care. 2023;6(2):113–24.
23. MoCA Test Inc. MoCA Cognition [Internet]. 2024. Available from: https://mocacognition.com/paper/
24. Husein N, Lumempouw S, Ramli Y. Uji Validitas dan Reliabilitas Montreal Cognitive Assessment Versi Indonesia (MoCA-Ina) Untuk Skrining Gangguan Fungsi Kognitif. Neurona [Internet]. 2010;27(4):4–15. Available from: https://arsip.neurona.web.id/paper-detail.do?id=734
25. WHO. ICD-10 Version: 2019 [Internet]. 2025. Available from: https://icd.who.int/browse10/2019/en
26. Lin X, Wang Y, Zhan Z, Wang Q, Xiang D, Li H. Effects of VR technical interaction and acceptance on rural cultural identity: The mediating role of embodied cognition and flow experience. Telemat Informatics Reports [Internet]. 2024;16(April 2023):100170. Available from: https://doi.org/10.1016/j.teler.2024.100170
27. Ha J, Park HK. Factors affecting the acceptability of technology in health care among older korean adults with multiple chronic conditions: a cross-sectional study adopting the senior technology acceptance model. Clin Interv Aging. 2020;15:1873–81.
28. Mannheim I, Varlamova M, van Zaalen Y, Wouters EJM. The role of ageism in the acceptance and use of digital technology. J Appl Gerontol. 2023;42:1283–94.
29. Hong SJ, Lui CSM, Hahn J, Moon JY, Kim TG. How old are you really? cognitive age in technology acceptance. Decis Support Syst [Internet]. 2013;56:122–30. Available from: http://dx.doi.org/10.1016/j.dss.2013.05.008
30. Hopkins RO, Jackson JC. Long-term neurocognitive function after critical illness. Chest [Internet]. 2006;130:869–78. Available from: http://dx.doi.org/10.1378/chest.130.3.869
31. Bernal G, Jung H, Yassı İE, Hidalgo N, Alemu Y, Barnes-Diana T, et al. Unraveling the dynamics of mental and visuospatial workload in virtual reality environments. Computers. 2024;13:1–16.
32. Chang E, Kim HT, Yoo B. Virtual Reality Sickness: A Review of Causes and Measurements. Int J Hum Comput Interact [Internet]. 2020;36(17):1658–82. Available from: https://doi.org/10.1080/10447318.2020.1778351
33. Saredakis D, Szpak A, Birckhead B, Keage HAD, Rizzo A, Loetscher T. Factors associated with virtual reality sickness in head-mounted displays: a systematic review and meta-analysis. Front Hum Neurosci. 2020;14:1–17.
34. MacDonald S. Introducing the model of cognitive-communication competence: A model to guide evidence-based communication interventions after brain injury. Brain Inj [Internet]. 2017;31(13–14):1760–80. Available from: https://doi.org/10.1080/02699052.2017.1379613