Could an integrated VR-based telerehabilitation platform to support RECOVERY and maintenance of FUNctional abilities be usable and acceptable to older adults with neurological conditions?

Abstract Background: With the increasing prevalence of neurological conditions among older adults, there is a growing need for effective home-based rehabilitation solutions supporting long-term functional recovery while minimizing caregiver burden. Virtual reality (VR)-based interventions have shown promising results in enhancing neuroplasticity and motivation. However, the usability and acceptability of integrated VR telerehabilitation systems in home settings remain underexplored. Objective: This study aimed to evaluate the usability and acceptability of the RecoveryFun system, a prototype integrated VR-based telerehabilitation platform designed to support upper limb functional recovery in older adults with neurological conditions. It also investigated impact on patients’ quality of life, caregiver stress, and healthcare professionals’system perception. Methods: Patients aged over 60 years with neurological conditions and moderate upper limb function were recruited to test the system. The system comprised a VR headset with exergames, a wearable stress monitoring sensor, a caregiver mobile app and a clinician web platform. Usability and acceptability were evaluated with a 4-week pre-post study during which each participant followed an individualized rehabilitation plan of at least two weekly training sessions,supported by a caregiver. Secondary outcomes included functional ability, quality of life and interest to use the system for the patient, while perceived stress and system impact for the caregiver. Results: Sixteen patient–caregiver pairs were enrolled across Italy, Belgium and Switzerland; fourteen completed the study, along with six professionals. Patients reported good usability and high satisfaction with the comfort and ease of use of the system. Caregivers found the system usable and not impacting their routine, with reduced stress levels and perceived benefits in patient motivation. Professionals valued remote individualized rehabilitation, noting some setup and adaptability issues. Conclusions: RecoveryFun demonstrated good usability and acceptability across user groups. With further refinements, it could be a valuable home telerehabilitation solution for older adults with neurological conditions. Trial Registration: ClinicalTrials.gov (NCT06640452), registered on 2024-10-10