A Virtual Peer Mentor to Enhance Social Presence in VR Rehabilitation for

The adoption of immersive virtual reality (IVR) for gamified rehabilitation is increasing. However, a significant challenge relates to perceptions of virtual environments as empty and isolating, potentially increasing stress, particularly among older users (patients). This paper explores the use of a virtual peer mentor (VPM) in a custom IVR-rehabilitation game to provide guidance and companionship. This game specifically targets patients recovering from acute myocardial infarction (AMI), commonly known as a heart attack. Grounded in social support theory, the VPM provides three types of support: (1) informational support, through pre-exercise narratives detailing a shared medical history; (2) instrumental support, through real-time demonstrations of clinically-validated exercise movements; and (3) emotional support, through positive feedback and encouragement. A within-subjects study involving 30 hospitalized AMI patients (all over 47 years old) evaluated the effectiveness of the VPM-integrated IVR-rehabilitation game. Each participant experienced a baseline (no VPM) and VPM-integrated version of the game on separate days. The results from the Intrinsic Motivation Inventory (IMI) and the social presence module of the Game Experience Questionnaire (GEQ-SPM) show that the VPM resulted in significant increases in engagement, and statistically significant lower pressure/tension. Furthermore, participants exhibited high user acceptance (76.7%) and task-completion rates (98.5%), with minimal cybersickness. The findings demonstrate that a psychologically-grounded VPM can effectively reduce stress in middle- and older-age patients in an IVR rehabilitation setting.