Virtual Reality Exergames Research Articles

Move, React, Repeat! The Role of Continuous Cues in Immersive Exergames

Immersive virtual reality (VR) exergames blend playful environments with physical activities. In such games, providing continuous cues, i.e., real-time indications of how the movements are being performed, can guide players and improve the execution of movements. However, research about how continuous cues impact player performance and experience in VR exergames remains sparse. To this end, we conducted a within-participants study (N=32) with four conditions: (i) no, (ii) audio, (iii) visual, and (iv) audiovisual cueing. The results show that both unimodal and bimodal cueing improve the player experience without causing cybersickness, while bimodal cueing improves pose accuracy. We provide three main design implications for VR exergames: (i) considering the granularity of cues, (ii) exploring different continuous cue designs, and (iii) underlining the use of continuous cues in other immersive experiences.

That's the way I (dis-)like it! - Effect of Gamer Types and Competitiveness in VR Exergaming

In response to growing global concerns surrounding sedentary lifestyles among adults, the imperative to motivate physical activity has driven the exploration of Virtual Reality (VR) exergames as a promising solution. Personality traits, particularly competitiveness, can play a pivotal role in influencing individuals' motivation to engage in either competitive or non-competitive versions of the same exergame. While existing studies have primarily focused on sports-related competitive orientations, they have overlooked the potential gain in information from gaming-related personality traits. This research addresses this gap by using a modified gaming-related competitiveness questionnaire and evaluating a VR cycling exergame featuring solo, self-competition and virtual opponent cycling conditions in a controlled user study with 38 participants. Empirical findings reveal a notable difference in self-rated competitiveness between the two domains of sports and gaming, and significant correlations between some gamer-types and motivation. These findings highlight the importance of these personality types during exergaming and their potential efficacy for personalisation to increase motivation.

Exercise intensity of virtual reality exergaming modulates the responses to executive function and affective response in sedentary young adults: A randomized, controlled crossover feasibility study

Virtual reality (VR) exergaming is a novel strategy to encourage physical activity and boost emotional well-being. However, its effects on executive function (EF) are not fully understood. This study assessed the immediate and retention effects of immersive VR exergaming, at varying exercise intensities, on EF and affect among sedentary college students. Thirty participants (mean age = 22.2±2.5 years; 18 females) underwent 15-minute sessions of moderate-intensity (MI), high-intensity (HI), and active-control intensity (AC) VR exergaming in a counterbalanced order. EF was evaluated using the Flanker, Task-switching, and N-back tasks before, immediately after, and 30 minutes post-intervention. Emotional valence and arousal were measured by the Feeling Scale and Felt Arousal Scale, respectively. Inverse efficiency score (IES) results indicated that inhibitory control was higher following both MI and HI exergaming compared to AC (p < 0.05), with improvements sustained for 30 minutes. HI VR exergaming showed the greatest improvement (p = 0.048). Both HI and MI also exhibited higher working memory capacity than AC (p < 0.05), with HI performing better (p = 0.039). No significant differences in task-switching performance were observed among the groups (p > 0.05). Emotional valence and arousal were significantly elevated immediately after and sustained for 30 minutes following MI and HI exergaming (p < 0.05). This study demonstrates the cognitive and affective benefits of MI and HI VR exergaming in young adults, with HI VR exergaming showing longer-lasting improvements. These findings suggest that immersive VR exergaming can enhance both physical and cognitive health, potentially improving academic performance and daily functionality in collegiate populations.

Comparison of Virtual Reality Exergames and Nature Videos on Attentional Performance: A Single-Session Study.

This study aimed to investigate the acute effects of a single session of a VR exergame (Beat Saber) and a VR nature video (Ireland 4K) on attentional performance, using the Flanker and Attentional Blink (AB) tasks. The objective was to assess whether these VR interventions could enhance attentional control, as measured by improvements in response times and accuracy. A total of 39 psychology students, aged 19-25, were randomly assigned to one of three groups: VR exergame, VR nature video, or control. Participants completed the Flanker and AB tasks before and after the intervention. A repeated measures design was employed to analyze changes in response times and accuracy across pre- and post-test sessions. The study revealed significant improvements in response times and accuracy across all groups in the post-test measures, indicating a strong training effect. In the AB task, shorter stimulus onset asynchrony (SOA) led to decreased accuracy and slower response times, emphasizing the difficulty in processing closely spaced targets. The interaction between Type and Group in response times for target stimuli suggested that the intervention types differentially influenced processing speed in specific conditions. The findings suggest that while brief VR interventions did not produce significant differences between groups, the training effect observed highlights the influence of task-specific factors such as SOA and target presence. Further research is needed to explore whether longer or repeated VR sessions, as well as the optimization of task-specific parameters, might lead to more pronounced cognitive benefits.

Effectiveness of Technological Interventions for Older Adults With Parkinson Disease: Systematic Review.

Among the older population, Parkinson disease (PD) stands out as a leading contributor to disability. Clinically, the foremost objectives in managing PD involve proactively delaying and preventing disability. Understanding the pivotal role of gait and balance in daily functionality holds substantial clinical significance, signaling imminent disability and prompting a reevaluation of management approaches. A key priority lies in identifying novel and effective interventions for symptoms that substantially contribute to disability. This paper presents a systematic review that critically examines the existing body of literature on the use of technology in the rehabilitation of older patients with PD. By synthesizing current evidence, we aim to provide insights into the state of the field, identify gaps in knowledge, and offer recommendations for future research and clinical practice. A systematic review of the literature was conducted in September 2023 analyzing manuscripts and papers of the last 5 years from the PubMed, Scopus, Embase, Web of Science, and CINAHL databases following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 14 papers were included. The inclusion criteria are as follows: (1) randomized controlled trial, (2) PD in people aged 65 years and older, and (3) use of technology in the rehabilitation training in the older population. A large portion of effective interventions relies on the incorporation of technology, particularly through virtual reality exergames. This technology appears to have effects not only on the cognitive aspect but also on the physical domain. The analysis of the results clearly indicates that, in terms of gait and balance performance, the technological intervention outperforms the traditional approach, irrespective of the specific technology employed. This systematic review seeks to shed light on the evolving landscape of technology-assisted rehabilitation for older individuals with PD. As we delve into the available evidence, we will assess the extent to which technology can serve as a valuable adjunct to conventional therapy, offering new avenues for optimized care and improved outcomes in this growing patient demographic. As we sift through the existing evidence, our goal is to evaluate the potential of technology as a valuable supplement to traditional therapy, presenting fresh opportunities for enhanced care and better outcomes in this expanding patient demographic.

Balance Board or Motion Capture? A Meta-Analysis Exploring the Effectiveness of Commercially Available Virtual Reality Exergaming in Enhancing Balance and Functional Mobility Among the Elderly.

Force platforms and motion capture are commonly used as feedback mechanisms in exergaming; nevertheless, their therapeutic effectiveness may vary. Therefore, the primary objective of this study was to evaluate the effectiveness of commercially available virtual reality (VR) exergaming systems on balance and functional mobility, with a supplementary analysis considering the administered dose of exergaming. The search was conducted in five databases. Commercially available exergaming platforms were classified into two categories: VR exergaming with a balance board (including Wii Balance Board) and motion capture (including Xbox Kinect). Two categories of control interventions (treatment as usual [TAU] and no treatment [NT]) were extracted. The meta-analysis was performed separately for static, dynamic, and proactive balance outcomes and for the aggregated results of all included outcomes with subgroup analysis of lower, moderate, and higher doses. In total, 28 studies with 1457 participants were included. Both exergaming systems were particularly effective in improving the single leg stance outcome. VR exergaming with motion capture was found to be more effective than TAU with a standardized mean difference (SMD) of 0.48 (P = 0.006) and NT (SMD = 0.86; P = 0.02). In conclusion, commercially available VR exergaming with a motion capture feedback mechanism has demonstrated effectiveness as an intervention for balance training when compared with NT. Specifically, high doses (above 134 minutes per week) appear to be more beneficial for healthy older adults. Moreover, the findings provide some weak evidence supporting the effectiveness of VR exergaming with a balance board for improving functional mobility, particularly when compared with NT.

Active Virtual Reality Games: Comparing Energy Expenditure, Game Experience, and Cybersickness to Traditional Gaming and Exercise in Youth Aged 8-12.

Objective: The purpose of this study was to (1) quantify the oxygen consumption (VO2) and heart rate (HR) of virtual reality (VR) exergaming in youth, (2) compare the physical activity intensity of VR gaming to moderate-intensity thresholds, and (3) quantify the game experience and cybersickness of VR gaming, compared with traditional gaming. Material and Methods: Youth (N = 28; age, 9.4 ± 1.2 years) completed 10-minute conditions: seated rest, seated videogame Katamari Forever (SVG-KF), treadmill walking (TW) (5.6 km/h, 0% grade), and VR exergames Beat Saber (BS) and Thrill of the Fight (TOF) while VO2 and HR were collected. Game experience and Child Simulator Sickness Questionnaires were collected after gameplay. Results: VO2 and HR for BS (9.1 ± 3.0 mL/kg/min and 119 ± 15 bpm), TW (17.1 ± 2.4 mL/kg/min and 135 ± 15 bpm), and TOF (16.9 ± 5.4 mL/kg/min and 145 ± 19 bpm) were significantly higher than that at rest (4.2 ± 1.5 mL/kg/min and 94 ± 12 bpm) and for SVG-KF (4.3 ± 1.3 mL/kg/min and 94 ± 12 bpm). BS was light-to-moderate, whereas TW and TOF were of moderate intensity based on HR and metabolic equivalents (METs). For game experience, SVG-KF (1.6 ± 1.6) was less challenging than BS (3.3 ± 1.0) and TOF (3.1 ± 1.1). BS was more visually satisfying (3.5 ± 0.7 vs 2.7 ± 0.9) and required more concentration than SVG-KF (3.6 ± 0.7 vs 3.1 ± 1.1). TOF (3.4 ± 0.8) was more fun than SVG-KF (2.8 ± 0.7). Two youths (7%) experienced cybersickness symptoms, but neither requested to stop play. Oculomotor symptoms (0.6 ± 0.9), although minimal, were significantly greater than nausea (0.2 ± 0.5) and disorientation (0.3 ± 0.6) in both games. Conclusions: VR exergames provided light- to moderate-intensity exercise, challenge, visual stimulation, attention, and fun with minimal cybersickness symptoms, compared with conventional gameplay in youth.

Exploring the physical, social and educational benefits of virtual reality exergame for people with dementia through co-designing to promote hand hygiene and influenza vaccine uptake

Exploring the physical, social and educational benefits of virtual reality exergame for people with dementia through co-designing to promote hand hygiene and influenza vaccine uptake

Acceptance of physical activity virtual reality games by residents of long-term care facilities: A qualitative study.

Little is known about the experience and the social and contextual factors influencing the acceptance of virtual reality (VR) physical activity games among long-term care (LTC) residents. Our study aims to address this research gap by investigating the unique experience of older adults with VR games. The findings will provide valuable insights into the factors influencing VR acceptance among LTC residents and help design inclusive VR technology that meets their needs and improves physical activity (PA) and well-being. We aimed to: (1) investigate how participants experience VR exergames and the meaning they associate with their participation; and (2) examine the factors that influence the participant's experience in VR exergames and explore how these factors affect the overall experience. We used a qualitative approach that follows the principles of the Interpretive Description methodology. Selective Optimization and Compensation (SOC) theory, Socioemotional Selectivity theory (SST) and technology acceptance models underpinned the theoretical foundations of this study. We conducted semi-structured interviews with participants. 19 Participants of a LTC were interviewed: five residents and ten tenants, aged 65 to 93 years (8 female and 7 male) and four staff members. Interviews ranged from 15 to 30 minutes and were transcribed verbatim and were analyzed using thematic analysis. We identified four themes based on older adults' responses that reflected their unique VR gaming experience, including (1) enjoyment, excitement, and the novel environment; (2) PA and motivation to exercise; (3) social connection and support; and (4) individual preferences and challenges. Three themes were developed based on the staff members' data to capture their perspective on the factors that influence the acceptance of VR among LTC resident including (1) relevance and personalization of the games; (2) training and guidance; and (3) organizational and individual barriers. VR gaming experiences are enjoyable exciting, and novel for LTC residents and tenants and can provide physical, cognitive, social, and motivational benefits for them. Proper guidance and personalized programs can increase understanding and familiarity with VR, leading to a higher level of acceptance and engagement. Our findings emphasize the significance of social connection and support in promoting acceptance and enjoyment of VR gaming among older adults. Incorporating social theories of aging helps to gain a better understanding of how aging-related changes influence technology acceptance among older adults. This approach can inform the development of technology that better meets their needs and preferences.

Exergames as an Effective Alternative to Real Environmental Tennis Training for Adolescents.

(1) Background: The popularity of motion-sensing computer-based games, like virtual reality (VR) exergames, is increasing among adolescents. However, their efficacy compared to conventional physical training methods remains unclear. This study investigated whether VR exergames produce effects on reaction time (RT) comparable to traditional tennis training in school-aged adolescents. (2) Methods: In total, 130 adolescents (mean age: 15.6 ± 2.0 years; 67 boys: 15.5 ± 2.2 years; 63 girls: 15.7 ± 1.8 years) were recruited in schools and assigned to one of three groups: VR exergame (G1, n = 39), tennis training (G2, n = 25), or control (G3, n = 66). Participants' RTs were evaluated before and after the interventions. G1 engaged in VR exergames for 8 min, G2 underwent traditional tennis training for 30 min, and G3 did not participate in any physical activity. (3) Results: Our results indicated that in G3, girls exhibited slower RTs compared to boys (p < 0.0). No differences were observed in RTs when comparing G1 and G2. (4) Conclusions: Sex appeared to influence RT, with girls showing slower RTs than boys in G3. The findings suggest that VR exergames and traditional tennis training have similar impacts on RT. This indicates the potential of VR exergames as an alternative to conventional physical training for improving RT in adolescents.

Product Design Interaction and Experience Based on Virtual Reality Technology

Artificial intelligence involves imitating human thought, consciousness, and other aspects. This is similar to having machine with human brain that can think, produce independently. However, unlike human brain, it has a speed, memory advantage. A virtual reality interactive glove is built using a nine-axis inertial sensor, an artificial intelligence deep learning algorithm. In this research work, Product Design Interaction and Experience Based on Virtual Reality Technology (PDIE-VRT-SCGAN) were proposed. Initially, input gestures data are gathered from the Virtual Reality Experiences (VRE) dataset. The input gestures data is then pre-processed using Multi-Window Savitzky-Golay Filter (MWSGF) to reduce noises, increase overall quality of the gestures data. In order to improving overall user engagement in product design interactions on virtual reality (VR) technology, the pre-processed gestures data are then fed into an adversarial network called a Semi-Cycled Generative Adversarial Network (SCGAN). In general, SCGAN does not express some adaption of optimization strategies for determining optimal parameters to promise exact to improving overall user engagement in product design interactions using VR technology. Therefore, FOX-inspired Optimization (FIO) is proposed to enhance weight parameter of SCGAN method, which precisely improving the user experience in product design interaction. The efficacy of PDIE-VRT-SCGAN method is assessed using a number of performance criteria, including tracking accuracy, frame rate, latency, rendering time, error rate, and user error. The proposed PDIE-VRT-SCGAN method attains 22.36%, 25.42% and 18.17% higher tracking accuracy, 21.26%, 15.42% and 19.27% higher latency, 28.36%, 25.32% and 28.27% higher frame rate compared with existing methods, such as design and implementation of virtual reality interactive product software depend on artificial intelligence deep learning algorithm(DVRI-PS-AI-DL), virtual evaluation system for product designing utilizing virtual reality (VES-PD-VR), and analysis of unsatisfying user experiences with unmet psychological needs for virtual reality exergames utilizing deep learning approach (AUUE-UP-VRE-DLA) respectively.

Design of Virtual Reality Exergames for Upper Limb Stroke Rehabilitation Following Iterative Design Methods: Usability Study.

Since the early 2000s, there has been a growing interest in using exercise video games (exergames) and virtual reality (VR)-based interventions as innovative methods to enhance physical rehabilitation for individuals with multiple disabilities. Over the past decade, researchers and exercise professionals have focused on developing specialized immersive exercise video games for various populations, including those who have experienced a stroke, revealing tangible benefits for upper limb rehabilitation. However, it is necessary to develop highly engaging, personalized games that can facilitate the creation of experiences aligned with the preferences, motivations, and challenges communicated by people who have had an episode of stroke. This study seeks to explore the customization potential of an exergame for individuals who have undergone a stroke, concurrently evaluating its usability as a technological tool in the realm of physical therapy and rehabilitation. We introduce a playtest methodology to enhance the design of a VR exergame developed using a user-centered approach for upper limb rehabilitation in stroke survivors. Over 4 playtesting sessions, stroke survivors interacted with initial game versions using VR headsets, providing essential feedback for refining game content and mechanics. Additionally, a pilot study involving 10 stroke survivors collected data through VR-related questionnaires to assess game design aspects such as mechanics, assistance, experience, motion sickness, and immersion. The playtest methodology was beneficial for improving the exergame to align with user needs, consistently incorporating their perspectives and achieving noteworthy results. The pilot study revealed that users had a positive response. In the first scenario, a carpenter presents a game based on the flexion-extension movement of the elbow; the second scenario includes a tejo game (a traditional Colombian throwing game) designed around game mechanics related to the flexion-extension movement of the shoulder; and in the third scenario, a farmer challenges the player to perform a movement combining elbow flexion and extension with internal and external rotation of the shoulder. These findings suggest the potential of the studied exergame as a tool for the upper limb rehabilitation of individuals who have experienced a stroke. The inclusion of exergames in rehabilitation for stroke-induced hemiparesis has significantly benefited the recovery process by focusing on essential shoulder and elbow movements. These interactive games play a crucial role in helping users regain mobility and restore practical use of affected limbs. They also serve as valuable data sources for researchers, improving the system's responsiveness. This iterative approach enhances game design and markedly boosts user satisfaction, suggesting exergames have promising potential as adjunctive elements in traditional therapeutic approaches.

Designing a Weight Management Virtual Reality Exergame for Obese and Overweight Healthy Adults

Designing a Weight Management Virtual Reality Exergame for Obese and Overweight Healthy Adults

Assessing virtual reality acceptance in long-term care facilities: a quantitative study with older adults

Purpose Our study aimed to investigate the factors associated with the acceptance of virtual reality (VR) games among older adults living in LTC, with a particular emphasis on identifying social and individual factors that have been overlooked in existing technology acceptance models. Materials and methods We conducted VR gaming sessions, followed by a composite questionnaire to explore the factors associated with the acceptance of VR games among residents of LTC with a focus on technology acceptance models (TAM) and social factors derived from Selective Optimization with Compensation (SOC) theory and Socioemotional Selectivity Theory (SST). Results We studied 20 older adults aged 65 and older. Participants were moderately sedentary, with the majority of them having prior gaming experience. Participants with prior gaming experience had higher mean scores in most SOC theory and SST subscales, except for elective selection. Participants perceived the technology as useful and easy to use, with no heightened gaming-related anxiety. Significant correlations were found between perceived ease of use and selection strategies, and between attitudes towards gaming and elective selection strategies. No significant score differences were observed between male and female participants. Conclusions The positive correlation between VR acceptance and using SOC strategies suggests a positive response to straightforward experiences. Our study highlights VR exergaming’s potential benefits for encouraging LTC residents’ engagement in valued activities and pursuing goals. Moreover, social theories of aging can inform technology acceptance and guide the design and marketing of VR exergames to better suit older adults’ needs and preferences in LTC. IMPLICATIONS FOR REHABILITATION The findings of this study have important implications for rehabilitation programs aimed at enhancing physical activity (PA) and engagement among older adults living in long-term care (LTC) facilities. The use of virtual reality (VR) games can be an important tool to promote PA and improve the overall well-being of LTC residents. Based on the results, the following implications can be drawn: Integrating VR exergaming in rehabilitation: The positive perception of VR technology’s usefulness and ease of use among older adults in LTC suggests that VR exergaming can be effectively integrated into rehabilitation programs. Healthcare professionals and rehabilitation specialists in LTC facilities can consider incorporating VR-based exercise routines and gaming sessions to motivate and engage residents in physical activities. By doing so, they can create enjoyable and interactive rehabilitation experiences that may lead to improved adherence to exercise regimens. Addressing social factors for VR acceptance: Our study highlights the significance of social factors derived from theories of aging, such as Selective Optimization with Compensation (SOC) and Socioemotional Selectivity Theory (SST), in influencing VR acceptance among LTC residents. Rehabilitation programs should take into account these social aspects and create a supportive and encouraging environment for older adults to engage with VR exergames. Encouraging social interactions and providing opportunities for residents to share their experiences with VR gaming may enhance acceptance and overall engagement. Tailoring VR exergames for older adults: The correlation between VR acceptance and the use of SOC strategies indicates that customized experiences may be well-received by LTC residents. Game developers and rehabilitation specialists should consider designing VR exergames that align with the specific preferences and needs of older adults. This could involve providing choices and options for users to optimize their gaming experiences based on their individual abilities and interests. Recognizing gaming experience: Our study highlights that prior gaming experience positively influenced participants’ attitudes towards VR gaming. Rehabilitation professionals should acknowledge and leverage this prior experience when introducing VR exergaming to older adults in LTC. By incorporating elements familiar to older adults or providing guidance for those new to gaming, rehabilitation programs can foster a more seamless and enjoyable transition to VR exergames. Promoting goal pursuit and valued activities: Our study suggests that VR exergaming has the potential to encourage LTC residents’ engagement in valued activities and goal pursuit. Rehabilitation programs can utilize VR exergaming as a means to help residents achieve specific rehabilitation goals and engage in activities that are meaningful to them. This approach can contribute to a sense of purpose and satisfaction in the rehabilitation process. Overall, the integration of VR exergaming in rehabilitation for older adults in LTC facilities has promising implications for improving physical activity levels, enhancing engagement, and addressing the holistic well-being of residents. By considering the social factors influencing VR acceptance and tailoring experiences to individual preferences, rehabilitation professionals can optimize the potential benefits of VR technology in LTC settings.

Age in Place, Move in VR: Investigating the Feasibility and Usability of a Custom‐made Virtual Reality Exergame to Promote the Well‐being of Community‐Dwelling Older Adults

AbstractBackgroundInteractive virtual reality (VR) games combined with exercise (exergames) are a plausible strategy to encourage physical activity (PA) among older adults. However, there is little systematic evaluation of the feasibility, usability, and potential benefits of deploying at‐home VR exergames among this population.MethodFifteen community‐dwelling older adults (M = 67.33 ± 5.3, age range 60‐77) (Table1) were recruited to play 18 sessions (each 15‐20 min) of a custom‐made VR exergame at home over six weeks. Recruitment, retention, and adherence rates were calculated to determine feasibility. The usability of the exergame was assessed through i) a game user experience questionnaire, ii) a self‐reported physical/emotional discomfort questionnaire, and iii) a perceived enjoyment scale. The exploratory outcome measures included changes in i) PA, ii) exercise self‐efficacy, iii) affect, iv) various cognitive and perceptual tasks and were assessed i) before and after acute data, and ii) before and after the intervention.ResultThirteen participants completed the study (13% attrition rate) without missing any exergaming session (100% adherence rate). The completion rate of cognitive assessments, perceptual tasks, and self‐reported questionnaires was = 97%. Low levels of cybersickness were reported (M = 0.9 ±1.0 out of 10). The average perceived enjoyment and perceived rate of exertion were 3.2. ±1.1 (out of 5) and 2.4±1.9 (out of 10), respectively. Most of the participants (92.3%) found the exergame’s instructions easy to follow and had an overall positive experience (84.6%). Whereas the exergame was perceived as useful for increasing PA levels (61.6%), mood enhancement was reported among less than half of participants (46.2%) and only 38% indicated that they would choose VR exergaming for at‐home PA. The likelihood of playing VR exergames in the future was also low (38.5%). The exploratory outcome measures are presented in Table 2.ConclusionOur study provides insights into the feasibility and usability of a custom‐made VR exergaming intervention to promote PA in community‐dwelling older adults which may potentially benefit their well‐being. Our findings inform the future adoption of VR at home. Our results can also be used to inform large‐scale trials and support the design and deployment of other remote exergames and assessments.

Home-Based Virtual Reality Exergame Program after Stroke Rehabilitation for Patients with Stroke: A Study Protocol for a Multicenter, Randomized Controlled Trial.

It is essential for stroke patients to maintain their therapy even after discharging inpatient rehabilitation. This is because recovery is an ongoing process that requires consistent effort. Virtual reality exergame training (VRET) is becoming widely used in stroke rehabilitation to improve physical, social, and psychological outcomes. Home-based VRET may be a more convenient and accessible option for stroke rehabilitation. This study will aim to determine the effectiveness of home-based VRET for patients with stroke who have been discharged from the hospital. This trial will randomly assign 120 participants to 8 weeks of either a VRET (intervention group) or daily life (control group). The study will measure cardiopulmonary endurance, muscular strength, functional capacity, gait, activities of daily living, and quality of life. Our main objective is to determine whether it is safe for patients to undergo VRET at home after they have been discharged from the hospital with a doctor's note. Additionally, we aim to examine whether stroke patients are capable of exercising at home after being discharged from the hospital. This study's outcome could pave the way for developing more comprehensive exercise protocols for stroke patients. Our findings will provide valuable insights into the efficacy of VRET as a therapeutic tool for stroke patients.

A computerized assessment tool for the upper extremities motor performance in individuals with Parkinson's disease

ObjectiveComputerized assessment of Parkinson's disease (PD) patients' motor performance can pave the way to subject-specific design of the rehabilitative interventions. The objective is to propose a computerized assessment tool for upper extremities motor performance in PD. It is based on kinematic indices and a virtual reality exergaming system. The reliability, construct and discriminative validity of the proposed tool were investigated. MethodsA set of virtual tasks was designed and integrated to the therapeutic programs of the participants including uni/bimanual, in-phase/anti-phase hand movements on the less/more affected sides. 33 persons with PD participated in a test re-test study to determine the reliability, discriminative validity on the medication states, and validity of the kinematic indices. Clinical assessments, including Box and Block Test, 9-Hole Peg Test, Movement Disorders Society motor section of the Unified PD Rating Scale (MDS-UPDRS III), were performed for validity assessment. ResultsTask type has a significant impact on the validity of the indices. Reaching tasks were shown to be superior. Besides, it was demonstrated that a minimum of 3 repeats is needed for reliable results in the proposed setting. Jerk indices, curvature, and spectral speed metrics lack either reliability or validity. Temporal speed metrics have superior reliability (Intraclass Correlation Coefficient ICC ≥ 0.9) and validity (Pearson ≥ 0.6) in reaching tasks. ConclusionTemporal speed metrics and point reaching virtual tasks were shown to have high potentials for objective assessment of upper extremity (UE) motor performance in PD in the context of a virtual reality exergaming rehab program.

“I Feel My Abs”: Exploring Non-standing VR Locomotion

Virtual Reality (VR) games and experiences predominantly have the users interact while standing or seated. However, this only represents a fraction of the full diversity of human movement. In this paper, we explore a novel non-standing approach to VR locomotion where the user performs locomotion movements in the air or only slightly touching the ground with their feet. For instance, the user may lie supine on the ground, reminiscent of the Bicycle Crunch, a core training movement common in Pilates and other forms of bodyweight exercise. Although this cannot generally replace traditional VR locomotion, it provides two benefits that we believe can be of use for specific application domains such as VR exergames: First, the user's lower body movement is not impeded by a small real-life space, allowing versatile navigation of large virtual worlds using walking, running, strafing, and jumping. Second, we allow new ways to activate parts of the body that remain passive in most existing VR interactions. We describe and discuss four different variants of the approach, and investigate two prototypes further in a qualitative user study, to better understand their strengths, weaknesses, and application potential.

Poster (Clinical/Best Practice Implementation) ID 1981325

Background Many barriers prevent those with spinal cord injury or disease (SCI/D) from adhering to recommended exercise guidelines, thus increasing risks of secondary health conditions. Mainstream technology options, such as virtual reality (VR), have the potential to facilitate needed exercise participation. However, further research on VR exercise modalities is needed to determine feasibility, effectiveness and to ultimately guide practice recommendations. Objectives The goal of this pilot feasibility study was to determine whether VR exergaming is non-inferior to the current standard of care (SoC) upper extremity aerobic exercise for individuals with SCI/D. Methods/Overview 25 participants with SCI/D completed 10-minute exercise sessions with either VR or the SoC, and after a rest break, then completed 10 minutes of exercise with the other modality. Primary outcomes of heart rate (HR) and rate of perceived exertion (RPE) were collected at baseline, 5 minutes into exercise, and at 10 min (end of the exercise session) for each modality. Secondary exploratory measures included a Numeric Pain Rating Scale measured pre- and post- each exercise session, and a post-study likeability survey. Results There were no significant differences in HR or RPE between virtual reality exergaming and the standard of care, and 100% of participants preferred the VR over SoC for the exercise. Conclusions VR exergaming was non-inferior to the SoC for short duration upper extremity exercise in those with SCI/D. Implementing VR for patients with SCI/D should be studied further to observe the longer term effect on cardiovascular health and to determine feasibility and compliance for home use.

Virtual reality exergame in older patients with hypertension: a preliminary study to determine load intensity and blood pressure

BackgroundLifestyle changes and physical activity can make an important contribution to reducing the risk factor for high blood pressure (BP). Whether virtual reality (VR) exergames are also appropriate and make a positive contribution to the reduction of BP has not yet been sufficiently investigated. Therefore, the aim of the study was to gain knowledge of the load intensities to be achieved during a VR exergame and to examine the short-term effects on BP.MethodsFor the preliminary study, 22 participants with hypertension over the age of 65 years were analyzed. The study took place in a mobile laboratory truck. All participants visited on two occasions. During visit 1, VR strength endurance training (VR-SET) and during visit 2, VR endurance training (VR-ET) was performed. Each VR session lasted approximately 25 min and was of a moderate intensity. Heart rate (HR) was measured across the entire session, as well as BP before and after the VR exergame. The Rating of Perceived Exertion (RPE) and task load using NASA Task Load Index were determined after each VR session. Included in the statistical analysis were the Shapiro–Wilk test, the paired t-test, the Wilcoxon test and ANOVA for repeated measures.ResultsDuring the “main part” (p < .001), at the “end” (p = .002) and for the “maximum HR” (p < .001), significant load differences between both VR sessions could be determined. In addition, significantly more participants in the VR-SET group achieved a moderate load intensity of at least 40% of heart rate reserve (p = .014). Regarding RPE, participants rated their subjectively perceived exertion significantly higher in the VR-SET than in the VR-ET (p = .028). Systolic BP decreased significantly in both VR sessions when compared before VR session and 5 min after VR session (p = .015; p = .003), as well as before VR session and 10 min after VR session (p = .018; p < .001).ConclusionsAn individual moderate load intensity of 40% can be reached during VR-SET. In addition, a positive short-term effect of the VR exergame on BP behavior (postexercise hypotension) was observed after both VR sessions. The preliminary results indicate that a VR exergaming could lead to blood pressure lowering effects for older people with hypertension.Trial registrationThe study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00022881, 07/09/2020, https://drks.de/search/de/trial/DRKS00022881).