Immersive Virtual Reality Influences Physiologic Responses to Submaximal Exercise: A Randomized, Crossover Trial

Sebastian Rutkowski; Patryk Szary; Jerzy Sacha; Richard Casaburi

doi:10.3389/fphys.2021.702266

Immersive Virtual Reality Influences Physiologic Responses to Submaximal Exercise: A Randomized, Crossover Trial

Front Physiol. 2021 Sep 30:12:702266. doi: 10.3389/fphys.2021.702266. eCollection 2021.

Authors

Sebastian Rutkowski¹, Patryk Szary², Jerzy Sacha¹, Richard Casaburi³

Affiliations

¹ Department of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland.
² Faculty of Physiotherapy, University School of Physical Education in Wroclaw, Wroclaw, Poland.
³ Rehabilitation Clinical Trials Center, Division of Respiratory and Critical Care Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, United States.

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.

Keywords: VR; exercise capacity; exercise testing; heart rate variability; immersion; virtual reality.

Associated data

ClinicalTrials.gov/NCT04197024