Abstract
Objectives: This cross-sectional, randomly assigned study aimed to assess the influence of immersive virtual reality (VR) on exercise tolerance expressed as the duration of a submaximal exercise test (ET) on a cycle ergometer.Methods: The study enrolled 70 healthy volunteers aged 22–25years. Each participant performed an ET with and without VR. Time- and frequency-domain heart rate variability (HRV) parameters were analyzed for the first 3min (T1), the last 3min (T2), and the time at which the shorter of the two tests terminated (Tiso). In the time domain, a SD of R–R intervals (SDNN) and a root mean square of successive R–R interval differences (RMSSD) in milliseconds were computed. The following spectral components were considered: low frequency (LF), high frequency (HF), total power (TP), and LF/HF ratio. The study was registered in ClinicalTrials.gov (NCT04197024).Results: Compared to standard ET, tests in immersive VR lasted significantly longer (694 vs. 591s, p<0.00001) and were associated with lower HR response across the range of corresponding exercise levels, averaging 5–8 beats/min. In the multiple regression analysis, the ET duration was positively determined by male sex, immersion in VR, and negatively determined by HRT1 and RMSSDT1.Conclusion: Exercising in VR is associated with lower HR which allowed subjects to exercise for a longer time before reaching target heart rate (HR). In addition, the increase in exercise duration was found to be related to an adjustment in autonomic nervous activity at a given work rate favoring parasympathetic predominance.
Highlights
In everyday life, exercise tasks involving maximal exertion are seldom performed and, rather, a submaximal physical activity is preferred with lesser physiologic stress
We aimed to determine whether the implementation of immersive virtual reality during a submaximal exercise task would prolong the time until the target heart rate was achieved; we investigated whether VR was capable of blunting the heart rate response and altering heart rate variability (HRV) associated with the exercise on a cycle ergometer in healthy individuals
It can be seen that heart rate was consistently lower in the virtual reality tests over the full range of work rates
Summary
Exercise tasks involving maximal exertion are seldom performed and, rather, a submaximal physical activity is preferred with lesser physiologic stress. Submaximal exercise tasks can be used to predict peak oxygen uptake (VO2peak), assess functional limitations, assess the ability to perform a rehabilitation program, or estimate the outcome of interventions. Interventions are commonly sought that allow submaximal training to be performed in less stressful circumstances in order to achieve a better exercise tolerance. After an effective training program, high-intensity tasks may be performed with lower levels of pulmonary ventilation, oxygen uptake, and heart rate (HR; Casaburi et al, 1987a,b). Stationary cycling is an exercise method unfamiliar to many people, and endurance is highly dependent on patient motivation. A method of increasing patient motivation may be to perform exercises in a virtual reality (VR) environment (Tekerlek et al, 2017)
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