Virtual Reality Rehabilitation Platform for Mild Cognitive Impairment: A Metaverse Approach

Abstract

Mild Cognitive Impairment (MCI) is increasingly prevalent among elderly populations, necessitating new approaches that support cognitive engagement, social interaction, and remote monitoring. This study presents a Virtual Reality Rehabilitation Platform designed within a metaverse-based framework to enhance usability and accessibility for elderly individuals with cognitive impairment. Unlike conventional VR rehabilitation systems, the proposed platform integrates three key innovations: (1) a metaverse-oriented, multi-user environment that enables avatar-based social interaction, co-presence with therapists, and persistent shared game spaces; (2) an MQTT-based real-time monitoring and control channel that allows therapists to observe gameplay events, adjust sessions, and supervise users remotely with low latency; and (3) deployment and preliminary usability validation with elderly individuals with MCI in a real-world clinical context, demonstrating its feasibility for remote, home-based rehabilitation via high-speed wireless networks, including 5G-ready infrastructure. A total of 18 elderly participants engaged with the platform over a five-week period, using Oculus Quest 2 devices to perform memory, spatial awareness, and interaction-based VR tasks. This study intentionally focuses on evaluating usability, acceptance, and user experience rather than clinical cognitive outcomes; as such, no pre-/post-intervention cognitive assessments were conducted. Quantitative satisfaction surveys, game evaluations, and qualitative focus group findings revealed generally positive user engagement, clear task comprehension, and moderate-to-high satisfaction across VR interaction elements, while also identifying areas for improvement such as device comfort and motion smoothness. The results highlight the potential of metaverse-supported VR rehabilitation as an accessible and socially engaging tool for elderly individuals with cognitive impairment, and they establish a foundation for future studies evaluating clinical efficacy and long-term cognitive benefits.