Early mobilization is a structured protocol designed to facilitate motor recovery in intensive care unit (ICU) patients with ICU-acquired weakness. This process is typically implemented by an interdisciplinary team of nurses, physical therapists, and other healthcare professionals. However, its application is often constrained by the patients' critical conditions, limited mobility, and the challenges of coordinating care within resource-intensive ICU environments. In this study, we developed a patient-centered virtual reality (VR) exergame through an interdisciplinary design process involving clinicians and therapists, tailored to the constraints of critical care. The exergame incorporates progressive mobility levels that mirror early mobilization practices, and includes an embodied avatar to provide guidance and motivation. Using Meta Quest 3 body tracking, the system captures and visualizes patients' movements, thereby providing motivational engagement and quantifiable mobility metrics. We evaluated the exergame in two stages: a dual-user study involving healthy participants and healthcare professionals or students (N = 13), and a subsequent study with cardiothoracic ICU patients (N = 18) to assess feasibility, design validity, and clinical acceptance. Across both studies, participants reported high enjoyment and engagement without discomfort or stress. Furthermore, patients demonstrated increases in movement speed, range of motion, and workspace volume of the upper body across game levels. Physiological monitoring further indicated that the exergame elicited exertion without inducing excessive cardiovascular responses. These findings highlight the feasibility of VR exergames as a clinically acceptable and engaging adjunct to early mobilization in critical care, offering a novel pathway to improve rehabilitation outcomes for ICU patients.

翻译：早期活动是一种旨在促进重症监护病房（ICU）中获得性肌无力患者运动功能恢复的结构化方案。该方案通常由护士、物理治疗师及其他医疗专业人员组成的跨学科团队实施。然而，其应用常受限于患者的危重病情、活动能力受限，以及在资源密集的ICU环境中协调照护的挑战。本研究通过临床医生和治疗师参与的跨学科设计流程，开发了一款适应危重症护理限制条件的、以患者为中心的虚拟现实（VR）运动游戏。该游戏融入了反映早期活动实践的渐进式活动等级，并包含具身化虚拟形象以提供指导和激励。系统利用Meta Quest 3的身体追踪技术捕捉并可视化患者的运动，从而提供激励性互动和可量化的活动度指标。我们分两个阶段评估了该游戏：首先开展了一项包含健康参与者与医疗专业人员或学生（N = 13）的双用户研究，随后对心胸外科ICU患者（N = 18）进行了研究，以评估其可行性、设计有效性和临床接受度。两项研究中的参与者均报告了高度的愉悦感和参与感，且未出现不适或压力。此外，患者在不同游戏等级中表现出上肢运动速度、活动范围和动作空间体积的提升。生理监测进一步表明，该运动游戏能引发适度体能消耗，而未导致过度心血管反应。这些发现凸显了VR运动游戏作为危重症护理中早期活动方案的临床可接受且具吸引力的辅助手段的可行性，为改善ICU患者的康复效果提供了新途径。