Age Does Not Prevent the Acceptance of Virtual Reality in Subacute Stroke Rehabilitation

The intersection of an aging population and technological innovation in healthcare presents significant challenges for rehabilitation medicine. The incidence of cerebrovascular accidents (CVA / stroke) increases with age, and although virtual reality is proving to be a highly promising tool in neurorehabilitation, concerns regarding the "digital illiteracy" of seniors have often led to doubts about its broader applicability in older patients.

This secondary analysis examined whether age actually impacts the acceptance, satisfaction, and tolerance of virtual reality exercises among patients in the early phase post-stroke.

Study Design and Methodology

Researchers compared outcomes across 19 post-ischemic stroke patients divided into two age cohorts:

Younger group (< 70 years): 10 patients, mean age 59.1 years.

Older group (≥ 70 years): 9 patients, mean age 77.3 years.

Both groups underwent exercises using the VR Vitalis® Pro system (focused on hand coordination, fine motor skills, balance, and cognitive training) alongside standard conventional rehabilitation. Satisfaction was evaluated using the internationally recognized User Satisfaction Evaluation Questionnaire (USEQ, score range 6–30 points).

Key Findings

Comparable (and Slightly Higher) Satisfaction in Seniors: Adults aged 70 and older achieved a mean satisfaction score of 25.4 out of 30 points, compared to 24.6 points in the younger group. Statistical analysis confirmed no negative difference in technology acceptance between the age cohorts.

Maximum Score Achieved by an 86-Year-Old Patient: Paradoxically, the highest possible satisfaction score (30 out of 30 points) was awarded by the study’s oldest participant (86 years old), while the lowest rating was given by a 68-year-old patient.

Excellent Tolerance and Safety: Across a total of 80 exercise units, no adverse effects, motion sickness (cybersickness), or premature therapy terminations due to age were recorded.

Clinical Benefits Assessed by Physical Therapists: For 77.8% of seniors over 70, physical therapists rated exercise outcomes with VR as comparable to or better than those achieved through conventional rehabilitation alone.

Recommendations for Clinical Practice

The study's findings unequivocally refute age-based prejudices. Chronological age should never serve as a reason to exclude a patient from virtual reality rehabilitation. Instead of age, healthcare professionals should primarily evaluate the patient's cognitive status, visual capacity, and intrinsic motivation.

Exercises within the VR Vitalis® Pro system are designed to be so intuitive and clear that older patients manage them effortlessly, even without prior experience with modern digital technologies.

Study Authors: A. Najsrová, Š. Baníková, I. Szegedi, K. Vítová, I. Fiedorová, J. Trdá, O. Volný (Center for Clinical Neurosciences, Faculty of Medicine at the University of Ostrava, Ostrava University Hospital, and VR LIFE s.r.o.)

Published in: Česká a slovenská neurologie a neurochirurgie (2025)

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