Immersive Virtual Reality Applied to Therapeutic Physical Exercise in Cellular Therapy

Cell therapy (CT), including hematopoietic stem cell transplantation (HSCT) and advanced CAR T-cell therapies, is used for the treatment of oncohematological and other diseases. HSCT is associated with treatment-related toxicities, including fatigue, muscle weakness, and reduced functional capacity due to intensive conditioning chemotherapy, immunosuppressive treatments, corticosteroids, and complications such as infections or graft-versus-host disease. Emotional symptoms, including anxiety, depression, fear, and frustration, also affect patients' recovery and ability to regain functional independence. Evidence indicates that exercise interventions improve emotional well-being, fatigue, quality of life, physical function, cardiovascular fitness, and muscle mass in patients with hematological malignancies and HSCT recipients. Virtual reality (VR) has emerged as an innovative tool in rehabilitation, supporting patient motivation, exercise guidance, and monitoring. Immersive virtual reality (IVR), through head-mounted displays and multisensory environments, enhances the sense of presence and engagement. Studies suggest that IVR-based exercise programs are feasible, improving functional abilities, quality of life, satisfaction, and adherence. Since 2017, a Therapeutic Exercise program for patients admitted for HSCT has been implemented at Álvaro Cunqueiro Hospital (Vigo) through collaboration between the Physiotherapy Unit and the Hematology Department. Before admission, patients undergo a physical assessment, receive an individualized exercise plan, education, and a therapeutic exercise guide. Based on clinical experience, the team hypothesizes that integrating IVR into therapeutic exercise may improve motivation, adherence, and emotional well-being during hospitalization.

Inclusion Criteria: * Patients aged 18 years or older. * Signed informed consent. * Patients eligible for CT scan at the Alvaro Cunqueiro Hospital. * Patients capable of performing therapeutic exercise independently, based on an objective initial functional assessment. * The clinical investigator, in their professional judgment, determines that the patient can adhere to all study requirements. Exclusion Criteria: * Patients under 18 years of age. * Any medical condition or mental illness that could interfere with understanding HIP and CI. * Patients participating in another clinical trial. * Balance disorders that increase the risk of falls. * Severe visual and/or auditory impairments that prevent participation in the session. * History of vertigo, seizures, or epileptic fits.