Lactate Kinetics After Multimodal Exercise and Adjunctive Virtual Reality Exercise in Hospitalized Geriatric Patients : A Randomized Control Trial

The goal of this clinical trial is to determine whether adding virtual reality exercise to conventional multimodal exercise affects exercise-related lactate kinetics, functional status, frailty, sarcopenia risk, perceived exertion, and health-related quality of life in adults aged 60 years or older who are hospitalized in an acute geriatric ward. The main questions it aims to answer are: 1. are there any difference in post exercise lactate at day 1 and 7 between the two groups? 2. does the lactate concentration reduces after low intensity resistance exercise in subject with high resting lactate? 3. Does virtual reality-assisted multimodal exercise improve functional independence, frailty status, sarcopenia risk, perceived exertion, and health-related quality of life from baseline to Day 7? Researchers will compare participants receiving conventional multimodal exercise plus virtual reality exercise with participants receiving conventional multimodal exercise alone to evaluate the additional effects of the virtual reality intervention. Participants will: * Undergo functional and medical assessments before starting the exercise program. * Receive an individualized conventional multimodal exercise program during hospitalization. * If assigned to the intervention group, perform additional virtual reality exercise using the VRAGMENT program. * Have capillary blood lactate concentrations measured immediately before and after standardized low-intensity resistance exercise on Day 1 and Day 7. * Complete the following assessments at baseline and on Day 7: * Barthel Index to assess functional independence. * Frailty Index-40 (FI-40) to assess frailty. * SARC-F to assess the risk of sarcopenia. * Borg Rating of Perceived Exertion (RPE) Scale to assess perceived exercise intensity. * EQ-5D-5L to assess health-related quality of life. * Have vital signs, exercise tolerance, and adverse events monitored throughout the intervention.