The Immediate Impact of Virtual Reality Exergaming on Heart Rate, Rate of Perceived Exertion, and Technology Acceptance in Healthy Individuals: A Pre-Post Pilot Cohort Study

Physical rehabilitation traditionally relies on face-to-face clinical sessions and home-based exercise programmes, yet adherence rates remain suboptimal, ranging between 30% and 50%. Adherence is crucial for effective outcomes, but is often undermined by low motivation and engagement. Sedentary lifestyles, which account for 5.3 million global deaths annually, exacerbate these challenges. VR exergaming has emerged as an innovative intervention, offering immersive environments that engage participants in physical movements, potentially enhancing adherence. Despite its growing popularity, there is limited empirical evidence evaluating the immediate physiological and psychological impacts of VR exergaming. This pilot cohort study aims to investigate its immediate effects on heart rate, perceived exertion, and technology acceptance, providing data that could inform future rehabilitation approaches, through a prospective pilot pre- and post-cohort design within a university research laboratory setting.

Participants engaged in a 20-minute session of the VR game Beat Saber, played on the Meta Oculus Quest 2™ headset. Gameplay required dynamic movements, including lateral side steps and squats, designed to elicit moderate-intensity exercise while maximising engagement. This immersive environment aimed to enhance adherence by making the exercise experience enjoyable while reducing perceived fatigue.

Outcome Measures and Data Collection:

Primary outcomes included HR, RPE, and technology acceptance, assessed using the UTAUT questionnaire administered before and after the VR session. HR was continuously recorded with a Polar monitor, and RPE was reported using the CR-10 Borg scale. The UTAUT questionnaire, adapted for VR specificity, evaluated key aspects of technology acceptance such as performance expectancy and effort expectancy, offering insight into the psychological effects of VR exergaming.

Statistical analyses were conducted using both frequentist and Bayesian approaches. This dual analysis provided comprehensive insights into the intervention's impact, yielding p-values and Bayes factors that contextualised statistical and practical significance. Bayesian analysis was particularly valuable in quantifying the intervention's efficacy relative to baseline measures, offering nuanced conclusions about the likelihood of its impact.