Virtual walking system with mood evaluation for individuals with severe mobility impairment: development and feasibility study.

PURPOSE: This study developed a home-based virtual walking (VW) system with integrated symptom tracking and examined its feasibility and usability in a user study with individuals with severe mobility impairment (SMI). MATERIALS AND METHODS: A multidisciplinary, iterative framework guided the system development. Following contextual research, a 10-day single-group longitudinal repeated-measures study was conducted with 11 participants with SMI. Feasibility and usability were primarily assessed through post-study qualitative interviews. Momentary mood was captured using an in-virtual reality (in-VR) two-dimensional (2D) Affect Grid, while embedded single-item ratings tracked anxiety, depressed mood, and pain. Changes were analysed using an adjusted logistic generalised linear mixed model (GLMM) and generalised estimating equations (GEE). RESULTS: Contextual research guided the system design towards enhancing accessibility, ergonomics, and therapeutic engagement. The final VW system featured modules for locomotion, multisensory feedback, and symptom tracking. Qualitative analysis revealed high acceptability, alongside challenges in content variety and hardware ergonomics. GEE models showed significant phase × day interaction effects for single-item depressed mood and anxiety ratings over the session period (all p < 0.01). CONCLUSION: This study supports the feasibility and acceptability of a novel VW system for home-based use by individuals with SMI. Preliminary findings suggest potential for alleviating psychological distress, but large-scale randomised controlled trials are warranted to evaluate clinical effectiveness.