Challenges in developing a new therapeutic exergaming system to promote mobility in ICU patients: an international...

Few digital health interventions are currently used in the rehabilitation of ICU patients, despite growing interest in innovative approaches such as exergaming. We aimed to determine the requirements for a therapeutic exergaming system for use in ICU patients. A cross-sectional survey was developed through iterative feedback from a multidisciplinary panel of ICU professionals. The survey was distributed online among ICU professionals using convenience and snowball sampling. The survey was completed by 106 ICU professionals from 16 different countries across four continents. The willingness to use a therapeutic exergaming system to increase physical activity in ICU patients was high, with a median score of 9 (interquartile range: 7-10) on a 0-10 scale. System features rated as very important or absolutely essential included ease of use (85%), patient enjoyment (85%), increasing the patients' motivation for physical activity and mobility (84%), and the ease of transportation (82%). Respondents emphasized adaptability to physical, cognitive, and sensory impairments, suitability for bedridden patients, and ease of integration within the ICU environment, including hygiene, mobility, and space constraints. Over 80% of respondents (strongly) agreed with most proposed benefits of therapeutic exergaming, including stimulation of active participation (94%), activation of patients with ICU-acquired weakness or prolonged immobilization (91%), distraction from the ICU environment (91%), and improved patient motivation to engage in rehabilitation (82%). This survey identifies key requirements for the development of therapeutic exergaming systems and supports their potential role in ICU mobilization when designed to complement existing rehabilitation practices and the intensive care context.