Life in Play: A Serious Game in Immersive Virtual Reality for Activities of Daily Living Training in Hospitalized Adults
Prolonged hospitalization and immobility are associated with functional decline, reduced independence in Activities of Daily Living (ADLs), and increased morbidity. Conventional rehabilitation approaches often face challenges related to patient engagement, especially among individuals with psychological or motivational barriers. This study presents the development and validation of Life in Play, an immersive Virtual Reality (VR) serious game designed to support ADL training in hospitalized adult patients. A methodological pilot study was conducted in a hospital ward using a Meta Quest 3 headset, evaluating usability, safety, and acceptability. Usability was assessed using the System Usability Scale (SUS) with 33 physical therapists, yielding a mean score of 82.0 (±8.0), indicating excellent usability. Acceptability and intrinsic motivation were measured using the IMI-TEQ-Br, yielding high Interest/Pleasure (6.33 ± 0.12) and low Pressure/Tension (2.95 ± 0.87), while safety was monitored through hemodynamic parameters and the Simulator Sickness Questionnaire (SSQ), which had a score of 16.52. Five patients completed the intervention. Most sessions were asymptomatic or presented only mild oculomotor symptoms, with one participant discontinuing due to claustrophobia. Repeated exposure resulted in reduced SSQ scores, and correlations were observed between hemodynamic parameters, BORG scale, and SSQ. Overall, the findings suggest that the VR system is usable, safe, and well accepted in the hospital setting, supporting its feasibility as an adjunct tool for ADL rehabilitation.