Participatory design and evaluation of virtual reality games to promote engagement in physical activity for people living with dementia

BACKGROUND: Exercise is a key component of physical health and quality of life for people living with dementia; however, challenges related to dementia symptoms and aging can make it difficult for people living with dementia to engage in exercise. While immersive virtual reality is showing increasing promise for exercise and rehabilitation applications, there is a lack of research regarding its use with people living with dementia. METHODS: Through participatory design with exercise therapists, kinesiologists, and people living with dementia, we designed two virtual reality environments (a farm and a gym) that were implemented on head-mounted displays to support five different upper-body exercises. Virtual reality and comparable human-guided exercises were tested with six people living with dementia. Both qualitative and quantitative measures were used, including reaching distance, distance traversed, and speed as well as feelings of enjoyment, engagement, interest, easiness, comfort, and level of effort. RESULTS: Participants’ subjective responses, motion, and fitness parameters all demonstrated comparable results between virtual reality and human-guided exercises. Therapists’ feedback also supported virtual reality exercise as an appropriate and engaging method for people living with dementia. CONCLUSIONS: Collaborating with experts and people living with dementia throughout the design process resulted in an intuitive and engaging design. The results suggest that head-mounted virtual reality has promising potential to support physical activity for people living with dementia.