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Is your virtual self as sensational as your real? Virtual Reality: The effect of body consciousness on the experience of exercise sensations
Abstract and Figures
Objectives:
Past research has shown that Virtual Reality (VR) is an effective method for reducing the perception of pain and effort associated with exercise. As pain and effort are subjective feelings, they are influenced by a variety of psychological factors, including one's awareness of internal body sensations, known as Private Body Consciousness (PBC). The goal of the present study was to investigate whether the effectiveness of VR in reducing the feeling of exercise pain and effort is moderated by PBC.
Design and methods:
Eighty participants were recruited to this study and were randomly assigned to a VR or a non-VR control group. All participants were required to maintain a 20% 1RM isometric bicep curl, whilst reporting ratings of pain intensity and perception of effort. Participants in the VR group completed the isometric bicep curl task whilst wearing a VR device which simulated an exercising environment. Participants in the non-VR group completed a conventional isometric bicep curl exercise without VR. Participants' heart rate was continuously monitored along with time to exhaustion. A questionnaire was used to assess PBC.
Results:
Participants in the VR group reported significantly lower pain and effort and exhibited longer time to exhaustion compared to the non-VR group. Notably, PBC had no effect on these measures and did not interact with the VR manipulation.
Conclusions:
Results verified that VR during exercise could reduce negative sensations associated with exercise regardless of the levels of PBC.
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... This suggests that users are willing to physically exert themselves while being immersed in virtual worlds. Previous work showed that exercising in VR can increase physical activity, motivation, and exercise adherence [16,36,43]. Consequently, VR is a promising technology to promote physical activity and create effective exercise environments [9]. ...
... Results indicated that participants completed more repetitions in VR. These outcomes corroborate those of Matsangidou et al. [43], who documented lower perceived pain levels during biceps curls performed in VR compared to a real-world setting. As behavior and perception can consciously be influenced, previous work also studied physiological effects [18,25,27]. ...
Virtual reality enables embodying different avatars. Coined the Pro-teus effect, previous work found that the visual characteristics of an avatar can cause behavioral, attitudinal, and perceptual effects. Recent work suggests that avatars' muscularity can even have physiological effects while cycling in virtual reality. As the effects have not been replicated it is, however, unclear how robust they are and if effects are limited to specific activities, such as cycling. Therefore, we conducted a study to understand if avatars' muscularity also causes physiological and perceptual effects for other tasks and if the effects can be replicated. 16 participants embodied a muscular and a non-muscular avatar while rowing on an indoor rower. We found that over time participants' heart rates increased significantly slower when embodying a muscular avatar compared to a non-muscular avatar. While not significant, descriptive statistics suggest the same trend for perceived exertion. Overall, the results confirm previous findings and support the conclusion that avatars can cause physiological effects for a range of physical activities.
... This is in line with our previous research [15]. The immersive nature of VR therapy likely contributed to its effectiveness, providing an engaging and distracting environment that helped mitigate negative emotional states [25]. This observation aligns with previous research highlighting the potential of VR in treating psychiatric disorders [13]. ...
Background: While cardiac rehabilitation (CR) primarily focuses on restoring physical strength, preventing relapse, and reducing rehospitalization rates, psychological interventions play a complementary role by supporting mental health, which is crucial for patients’ long-term adherence and overall recovery. The effectiveness of psychological interventions in CR is debated, and while technologies like virtual reality (VR) therapy show promise, they have limitations for patients with coronary artery disease (CAD). Therefore, this study examines non-sleep deep rest (NSDR) relaxation, a novel and easily implementable technique, and compares its impact on depression, anxiety, and stress with VR therapy and standard care. Methods: Forty-five CAD patients undergoing CR in ambulatory conditions were divided into three groups: the NSDR group, which received eight sessions of NSDR relaxation as part of their rehabilitation; the VR group, which received eight sessions of VR therapy as part of their rehabilitation; and the control group, which received standard care including Schultz Autogenic Training (SAT). The outcomes were measured using the Hospital Anxiety and Depression Scale (HADS) and the Perception of Stress Questionnaire (PSQ). Results: Both NSDR relaxation and VR therapy were effective in reducing the HADS total score, anxiety levels, the PSQ general score, and emotional tension. No significant differences were observed between the two treatment approaches. However, SAT was found to be insufficient for effectively improving the mental state of cardiac patients. Conclusions: This study suggests that NSDR relaxation is an effective psychotherapeutic intervention in CR. NSDR and VR therapy showed similar benefits, offering promising alternatives to traditional methods. Integrating these techniques could enhance patient outcomes and adherence in CR. Further research is needed to refine these interventions and optimize their clinical application.
... During exercise in VR, this phenomenon, known as cognitive distraction, can alleviate the discomfort associated with hard training. The few studies on this topic published to date suggest that VR may be useful in distracting from unpleasant bodily sensations occurring during aerobic PA in children with overweight and obesity [9] and in reducing negative sensations associated with the performance of isometric exercises [29]. ...
Background:
One of the main contemporary forms of physical activity (PA) involves exercises and games in an immersive virtual reality (VR) environment, which allows the user to practice various forms of PA in a small space. Unfortunately, most of the currently available VR games and workout applications are mostly based on upper body movements, especially the arms, which do not guarantee sufficiently high exercise intensity and health benefits. Therefore, it is worth seeking solutions to help increase the exercise load during PA in VR.
Objective:
The main aim of this study was to evaluate the effect of elastic arm resistance in the form of latex resistance bands of different elasticity levels on the intensity of students' PA while playing the BoxVR game. We further assessed the satisfaction of this form of exercise and its associations with PA intensity.
Methods:
A total of 21 healthy and physically fit men (mean age 22.5, SD 2.0 years) were included in the study. The tests consisted of 3 10-minute games. One game was run with no load and the other two were run with 1.5-meter latex resistance bands (low and high resistance). The order of the tests was randomized and the participants rested for 20 minutes after each exercise. Exercise intensity was estimated using objective (heart rate monitoring) and subjective (Borg scale) methods. The Physical Activity Enjoyment Scale was used to assess satisfaction with the PA. The effect of elastic resistance on exercise intensity and user enjoyment was estimated using ANOVA for repeated measures.
Results:
The ANOVA results indicated that incorporation of elastic resistance caused a significant change (F2,40=20.235, P<.001; η²p=0.503) in the intensity of PA in VR, which was low while playing without resistance and then increased to a moderate level with additional resistance. The use of elastic bands also changed participants' perceptions of the enjoyment of exercise in VR (F2,40=9.259, P<.001; η²p=0.316). The students rated their satisfaction with PA in VR on a 7-point scale highly and similarly when exercising without an upper limb load (mean 6.19, SD 0.61) and with slight elastic resistance (mean 6.17, SD 0.66), whereas their satisfaction declined significantly (mean 5.66, SD 0.94) when incorporating a higher load.
Conclusions:
The intensity of PA among students playing the BoxVR game is at a relatively low level. With the added resistance of elastic bands attached to the upper limbs, the intensity of the exercise increased to a moderate level, as recommended for obtaining health benefits. Participants rated the enjoyment of PA in VR highly. The use of slight elastic resistance did not negatively affect satisfaction with the BoxVR game, although user satisfaction declined with a higher load. Further research should be undertaken to increase the effectiveness of exercise in VR so that regular users can enjoy the health benefits.
... Interactive technologies are progressively being implemented within exercise contexts and this represents a shift towards technologies that fall along the x-axis of the EPI Cube (Flavián et al., 2019). For example, researchers have used VR to accompany isometric strength tasks and reported lower pain ratings and longer times-to-exhaustion when compared to a control condition (Matsangidou et al., 2019). Likewise, Kocur et al. (2020) examined the effects of VR avatars and found that muscular avatars prompted lower ratings of perceived exertion (RPE) when compared to medium and non-muscular avatars. ...
... This would allow these people to perform more intense and longer exercises in a virtual environment. The few studies published to date suggest that VR may be useful in distracting from unpleasant bodily sensations occurring during aerobic PA in overweight and obese children [56] and in reducing negative sensations associated with the performance of isometric exercises [57]. ...
Background
Over the last few years, there has been a growing interest in workout apps and active virtual reality video games (AVRGs), which provide entertainment and enable users to undertake various forms of physical activity (PA) at home. Presumably, these types of exercises can be particularly useful for people with physical disabilities, who experience problems with access to sports and leisure facilities due to architectural and communication barriers. However, it is interesting whether the intensity of PA in VR is high enough to provide users with health benefits, as it is mainly based on arm movements.
Objective
The main aim of the study was to evaluate the intensity of physical exercise of wheelchair boxers during a boxing training session using the FitXR app in immersive VR in light of health-related PA recommendations. The effect of Velcro-fastened hand-held weights (HHWs) on the intensity of PA undertaken by people in VR was also examined, and the attractiveness of virtual exercise were assessed in the opinion of users.
Methods
PA intensity was evaluated using a heart rate monitor based on the percentage of maximal heart rate (% HRmax) and the Borg’s rating of perceived exertion (RPE 6–20). The attractiveness perceived during exercise by users were evaluated using the Physical Activity Enjoyment Scale (PACES 1–7 scale).
Results
The study shows that the exercise intensity of the athletes during wheelchair boxing training in VR is at a beneficial moderate level for health (HR ave =68.98% HR max ). The use of HHWs (0.5 kg) does not significantly increase the PA intensity of the individuals during virtual exercise. Users with disabilities highly rated the attractiveness (6.32 ± 0.79 points) of PA during virtual boxing training.
Conclusions
Boxing exercises in VR can be an attractive and health-related form of PA for wheelchair boxers and a supplement to their conventional training.
... In addition to this type of training, one emerging technology with the potential to infl uence chronic LBP that cannot be achieved by other means is Virtual Reality (VR) [20]. VR is a goal-based reality and simulation of computer games that allow changing people's experience of their perceived world [21,22]. Rapid advances in technologies such as VR have shown promise for the treatment of a variety of diseases and disorders such as chronic pain. ...
Background: Non-specifi c chronic low back pain is defi ned as a complex disorder involving structural, biomechanical, cognitive, psychological, social, and lifestyle
factors. This randomized clinical trial study compared the effects of 8-week Virtual Reality Training (VRT) and pain neuroscience plus motor control training (PNE/MCT)
on pain, disability, health, and quality of life of women with non-specifi c chronic back pain.
Methodology: This research is a single-center parallel RCT. Thirty-six participants participated in this study. They were divided into two groups: VRT (G1) and PNE/
MCT (G2), both with 18 women. The training was performed for eight weeks for 45 minutes – 60 minutes. The VRT was applied by Oculus Quest 2. Visual Analogue Scale
(VAS), disability (Oswestry Disability Index), general health (GHQ-28), and quality of life (QOL- WHO) were assessed before and after eight training weeks using a within�between group analysis (ANOVA 2×2).
Results: Before training, no difference was observed between the groups (p > 0.05). After the intervention, both groups improved VAS, disability, GHQ, and QOL (all
p < 0.001). In the comparison between the groups, the G1 had a better performance according to the p-value and effect size in anxiety (p = 0.001, ES= 0.71), depression
symptoms (p = 0.03, ES: 0.25), physical health (p = 0.03, ES: -0.24), mental health (p = 0.001, ES: 0.66), and total QOL (p = 0.048, ES: 0.21) than G2.
Conclusion: Despite the effectiveness of both interventions, VRT improved the general health and quality of life in women with NSCLBP more than PNE/MCT.
... In recent years, the popularity and interest of health-related applications and exercise systems has grown. Researchers and developers of exergames [69] or immersive fitness applications [1] leveraged computer-generated sports environments to promote physical activity [47]. In immersive VR applications, e.g., FitXR [19], users perceive the virtual environment from a first-person perspective while their motions are registered by controllers and transmitted as user input during workouts in VR. ...
Virtual reality therapy has been shown to be effective in coping with psychological disorders accompanied by cardiovascular disease. Age appears to be a factor that can affect the effectiveness of psychological therapy in a virtual environment. Therefore, the aim of the study was to explore whether there are age-related differences in the effectiveness of reducing levels of depression and anxiety during a virtual reality psychological intervention implemented for rehabilitation. The study included 25 younger (< 65 years) and 25 older (65 +) patients with cardiovascular disease who participated in virtual reality therapy to cope with anxiety and depression. The Hospital Anxiety and Depression Scale was used to assess anxiety and depressive disorders before and after intervention. Significant reductions in anxiety and depression scores after intervention were observed in both age-matched groups, and no significant differences were found between the younger and older participants. Further evaluation of patient age as a predictor of the effectiveness of psychological intervention in virtual reality did not show a significant effect of age on effectiveness in reducing anxiety and depressive disorders. The results obtained suggest that older patients benefit similarly to younger patients from psychological intervention in a virtual environment. Furthermore, age does not appear to be considered a predictor of effectiveness in reducing the level of anxiety and depression in patients with cardiovascular disease using virtual reality therapy.
Objetivo: Comparar os efeitos dos exercícios por realidade virtual (RV)com o exercício físico convencional para as capacidades cognitivas e psicológicas das pessoas idosas. Métodos: Incluídos artigos publicados entre 2012 e 2021, das bases de dados PubMed, Scielo, Cochrane Library e Web of Science. Critérios de inclusão: estratégia PICO (Participante, Intervenção, Comparação e Outcome/Desfecho; RoB 2- Cochrane para analisar o risco de viés para ensaios randomizados; GRADE Pro, avaliação da qualidade das evidências. Resultados e discussão: 403 artigos inicialmente identificados, 23 elegíveis para a revisão sistemática e 14 incluídos na metanálise. Instrumentos encontrados: Trail Making Test (TMT-B), Stroop Test, Montreal Cognitive Assessment (MoCA), Mini Exame do Estado Mental (MEEM) e Short Form Health Survey (SF-36). No TMT-B observamos heterogeneidade (Tau²=0,51, I²=82,97%, Q=17,51, p=0,001) e diferença estatisticamente significativa entre os grupos, favorecendo a intervenção por RV (p=0,028). No Stroop Test, não observamos heterogeneidade (Tau²=0, I²=0, Q=1,53, p=0,464) e não houve diferença entre os grupos (p=0,194). Nos testes MEEM e MoCA, tivemos heterogeneidade entre os grupos (Tau²=0,17, I²=63,47%, Q=18,055, p=0,012), favorecendo a RV de maneira estatisticamente significativa (p=0,008). O SF-36 não apresentou heterogeneidade entre os grupos (Tau²=0, I²=0, Q=1,53, p=0,464) e não houve diferença estatística significativa (0,657). Conclusão: Ainda não é possível afirmar que apenas a utilização da RV é eficiente, porém ressaltamos que as intervenções realizadas com as pessoas idosas, nas quais eles se sentem parte e são responsáveis pelo seu desempenho, mostram a interação e motivação para o exercício físico, ajudando a terem uma vida mais saudável e com mais qualidade.
Virtual reality is a technology that allows users to experience a computer-simulated reality with visual, auditory, tactile and olfactory aspects. In recent decades, there has been considerable interest in using virtual reality for clinical purposes, including pain management. This articles describes a systematic review of research on virtual reality and pain management, with the aim of examining the feasibility of using virtual reality technologies and content design approaches in real-world clinical situations. More specifically, this article focuses on consumer virtual reality technologies. An exhaustive search identified 29 relevant studies from 2009 to 2016. Overall, the studies indicate that virtual reality is an effective technology to ameliorate pain in clinical settings. However, their results are inconclusive. Further research is needed to discover under which circumstances virtual reality is an efficient tool and the attributes or characteristics of virtual reality that are crucial in pain management.
To compare the predictive capacity of experimental pain and exercised-induced pain (EIP) on exercise performance. Thirty-two recreationally active male (n = 23) and female (n = 9) participants were recruited. Participants completed measures of pain tolerance by cold pressor test (CPT), pain pressure threshold via algometry (PPT), and EIP tolerance using an RPE clamp trial. A VO2max test provided traditional predictors of performance [VO2max , gas-exchange threshold (GET), peak power output (PPO)]. Finally, participants completed a 16.1-km cycling time trial (TT). No correlation was found between experimental pain measures (CPT, PPT) and TT performance. However, there was a significant correlation between EIP tolerance and TT performance (R = -0.83, P < 0.01). Regression analysis for pain and physiological predictor variables (mean pain in CPT, PPT, EIP tolerance, VO2max , PPO, GET) revealed that a significant model (P < 0.01) emerged when only PPO (Adjusted R(2) = 0.739) and EIP tolerance (ΔR(2) = 0.075) were used to predict TT performance. These findings suggest that EIP tolerance is an important factor in endurance performance. However, PPT and CPT have limited ability to assess this relationship, and so their use in EIP research should be treated with caution.
When we look at our hands we are immediately aware that they belong to us and we rarely doubt about the integrity, continuity and sense of ownership of our bodies. Here we explored whether the mere manipulation of the visual appearance of a virtual limb could influence the subjective feeling of ownership and the physiological responses (Skin Conductance Responses, SCRs) associated to a threatening stimulus approaching the virtual hand. Participants observed in first person perspective a virtual body having the right hand-forearm (i) connected by a normal wrist (Full-Limb) or a thin rigid wire connection (Wire) or (ii) disconnected because of a missing wrist (m-Wrist) or a missing wrist plus a plexiglass panel positioned between the hand and the forearm (Plexiglass). While the analysis of subjective ratings revealed that only the observation of natural full connected virtual limb elicited high levels of ownership, high amplitudes of SCRs were found also during observation of the non-natural, rigid wire connection condition. This result suggests that the conscious embodiment of an artificial limb requires a natural looking visual body appearance while implicit reactivity to threat may require physical body continuity, even non-naturally looking, that allows the implementation of protective reactions to threat.
Objective: To systematically review the Current evidence for the effectiveness of Virtual Reality (VR), in conjunction with pharmacologic analgesia oil reducing pain and anxiety in burn injury patients undergoing wound dressing changes and physiotherapy management compared with pharmacologic analgesia alone or other forms of distraction. Methods: A comprehensive search was conducted between December 2007 and January 2008, and updated in January 2009, before publication. Computerized bibliographic databases were individually searched using specifically developed search strategies to identify eligible studies. Results: Nine studies were deemed eligible for inclusion ill this review, Wound dressing changes was the most common procedure during which VR was trialed. Pain was the primary outcome measure in all of the Studies included. Anxiety was a secondary outcome measure in 3 of the 9 included studies. VR, in conjunction with pharmacologic analgesics, significantly reduced pain experienced by burn injury patients during wound dressing changes and physiotherapy. There is equivocal evidence for the effect of VR in Conjunction with pharmacologic analgesics oil reducing anxiety in burn injury patients during Wound dressing changes and physiotherapy. Discussion: This is the first known systematic review to report oil the effectiveness of VR, in conjunction with pharmacologic analgesia oil reducing pain and anxiety in burn injury patients undergoing wound dressing changes and physiotherapy management compared with pharmacologic analgesia alone or other forms of distraction. Used as all adjunct to the Current burn pain management regimens, VR could possibly assist health professionals in making the rehabilitation process for burn patients less excruciating, thereby improving functional outcomes. Further research investigating the effect of VR oil anxiety in burn injury patients is warranted.
