Feasibility and safety of mixed reality treadmill walking in older adults: A pilot and feasibility trial
image: An older adult wearing a VR headset while walking on a treadmill (left) and his virtual character mimicking the motion (right).
Credit: Osaka Metropolitan University
Virtual reality (VR) treadmill walking has been recognized for its potential to enhance enjoyment and motivation, although safety concerns limit its use in older adults. Mixed reality (MR), by integrating virtual elements with the real environment, may reduce these risks while maintaining motivational benefits. Through a pilot and feasibility trial, Osaka Metropolitan University researchers examined the practicality of implementing MR treadmill walking in healthy older adults to determine readiness for a definitive randomized controlled trial.
Forty-two community-dwelling older adults were randomized to treadmill walking with MR (MR+) or without MR (MR-). Each participant performed a 10-minute self-paced treadmill walking task. Feasibility outcomes included recruitment, retention, adherence, safety (Simulator Sickness Questionnaire [SSQ]), enjoyment (Physical Activity Enjoyment Scale [PACES]), and exercise intensity (percentage of heart rate reserve [%HRR]).
All 42 participants consented and completed the treadmill session and follow-up assessments. No adverse events or falls occurred. SSQ scores indicated negligible simulator sickness, confirming good tolerability, and PACES scores were significantly higher in MR+ than in MR-. %HRR values reflected moderate exercise intensity in both groups. All prespecified feasibility thresholds were achieved.
MR treadmill walking was found to be safe, tolerable, and enjoyable for older adults, meeting key feasibility criteria and providing a solid basis for progression to a definitive randomized controlled trial to establish clinical efficacy and broader applicability in geriatric rehabilitation.
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