The TERSICORE project: A Virtual Rehabilitation Protocol Based on Creative and Social Games in the Metaverse

A growing body of evidence suggests that VR (Virtual Reality) tasks - particularly those involving artistic expression within social contexts - can significantly enhance rehabilitative outcomes. However, these approaches remain largely underexplored within the field of virtual cognitive rehabilitation. The TERSICORE project introduces an innovative protocol for virtual cognitive rehabilitation that leverages creative and socially interactive games within both immersive and non-immersive metaverse environments. It is structured around four exergames, each developed to address the rehabilitation needs of specific cognitive domains: learning and memory, perceptual motor function executive function, complex attention, and language. A fifth separate environment, a realistic virtual village scenario, is employed as a dynamic assessment tool for pre- and post-intervention evaluation, capturing ecological indicators of cognitive and functional performance. All the exergames include a range of VR tasks: solving logic-based challenges within an escape-room setting, stimulating long-term memories by using reminiscence strategies, enhancing language abilities through semantic feature pathways while participating in collaborative art gallery set up; and restoring color to well-known artworks in a cooperative context. Moreover, such tasks are specifically designed to support multi-user rehabilitation sessions, transitioning from conventional one-on-one therapeutic approaches to a collaborative, group-based model involving both patients and clinicians. These virtual environments are accessible through VR (Virtual Reality) headsets - i.e., immersive modality - or tablet devices - i.e., non-immersive one, enabling their use in both clinical and home-based settings. To conclude, TERSICORE represents a flexible, scalable model for virtual rehabilitation. By integrating multi-user engagement and creative experiences, the protocol aims to enhance patient motivation, increase adherence to rehabilitation programs, ultimately improving clinical outcomes.