The VR platform, Bionautica Trails, was set up as a high-definition flat-screen television, oriented vertically on a stand in front of 1 of 2 treadmills designated for the study (Figure 1). This system was selected over head-mounted VR options for the safety of the patient. Each of the 2 systems was run on an individual computer hard drive and connected to a Bluetooth keyboard with a built-in trackpad. For the purposes of the study, the Bionautica Trails platform was not updated and remained frozen in the version initially used to maintain consistency between participant experience regardless of when they started treatment.

Vertically oriented television screen in front of a treadmill showing an example of Bionautica Trails.

The educational audio files each intervention group patient heard during their treatment were recorded in a deidentified cloud-based server, via Microsoft Azure, to track individual exposure to education and frequency. Patients used on-ear, wireless headphones, connected to the walking trails via Bluetooth, to better immerse themselves and allow other patients to continue exercising without distraction. These were noise reducing but not noise canceling to ensure that patients could communicate properly with nursing staff. Headphones were disinfected using AF3 antibacterial wipes provided by the facility, as per standard infectious disease guidelines.

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