Project Abstract

<p> </p><p>Abstract
</p><p>Physical inactivity represents a major public health concern, increasing risks for chronic diseases like obesity, diabetes, cardiovascular disease, and certain cancers. Despite widespread knowledge of exercise benefits, adherence to physical activity recommendations remains alarmingly low, particularly among sedentary adults. Novel behavioral interventions leveraging emerging technologies show promise for enhancing exercise motivation and engagement. Virtual reality (VR) exercise has garnered attention due to its ability to provide immersive, enriching experiences that distract from physical exertion while allowing explorations of vivid virtual worlds. However, empirical evidence evaluating VR's potential to boost long-term exercise adherence is limited. This study aims to conduct a randomized controlled trial examining the effects of a 12-week VR-based exercise program compared to traditional fitness facility and control conditions on physical activity levels among insufficiently active adults aged 25-55. Participants will be randomly assigned to a VR exercise intervention using consumer-grade headsets and accessories, a facility-based exercise program, or a no-treatment control group. Physiological measures including weight, body composition, cardiorespiratory fitness, and biomarkers will be assessed at baseline, 12 weeks, and 6-month follow-up. Self-reported physical activity, sedentary behavior, exercise motivation, self-efficacy, enjoyment, and user experience will also be evaluated at multiple timepoints. Primary outcomes are minutes of moderate-to-vigorous physical activity and metabolic equivalent expenditure. It is hypothesized that the VR condition will produce superior exercise adherence and physiological outcomes compared to traditional exercise due to increased motivation, enjoyment, and immersive distraction. Ultimately, this study can provide important insights into VR's potential as an adherence-enhancing tool to increase physical activity and facilitate public health efforts targeting sedentary lifestyles.</p> <br><p></p>

Project Overview

<p> </p><p>Chapter 1: Introduction</p><p>1.1 Background The profound impacts of physical inactivity on individual and public health represent a critical societal issue. Sedentary lifestyles and insufficient physical activity have been identified as leading risk factors for numerous chronic conditions including cardiovascular disease, type 2 diabetes, certain cancers, osteoporosis, depression, and premature mortality (Lee et al., 2012; Ding et al., 2016). Despite extensive knowledge of the wide-ranging benefits of regular exercise, global estimates suggest over 25% of adults fail to meet recommended activity levels, with even higher rates among adults in high-income Western nations (Guthold et al., 2018). Enhancing physical activity adherence, especially among insufficiently active populations, has emerged as a key public health priority.</p><p>While conventional exercise interventions can produce meaningful behavioral changes, suboptimal longer-term adherence remains a persistent challenge. High proportions of individuals struggle to maintain physical activity habits due to factors like lack of motivation, enjoyment, social support, environmental access barriers, and competing lifestyle demands (Falck et al., 2017). Novel intervention approaches that mitigate these pervasive barriers by enhancing intrinsic motivation, self-efficacy beliefs, and the overall enrichment of the exercise experience may hold potential to promote better long-term adherence.</p><p>1.2 Problem Statement The potential of virtual reality (VR) technology to serve as an adherence-enhancing tool for increasing physical activity has received growing attention but lacks robust empirical evaluation. VR exercise systems enable users to engage in a variety of physical activities like walking, running, cycling, or game interactions while immersed in digitally rendered virtual environments. These simulated environments can range from naturalistic scenery to imaginative game worlds with interactive elements and storylines. The innate attributes of VR including immersion, presence, embodied engagement, gamified experiences, and perceived novelty might beneficially influence key predictors of exercise adherence like intrinsic motivation, enjoyment, perceived exertion, and self-efficacy (Jones &amp; Griffiths, 2021). However, the vast majority of studies examining VR for fitness have been limited by short durations, lack of controlled comparisons, and failing to quantify real-world physical activity outcomes.</p><p>1.3 Significance of the Study As the availability and affordability of consumer-grade VR hardware rapidly increases, a rigorous investigation into VR's capacity to promote physical activity adherence among insufficiently active populations is urgently needed. This randomized controlled trial represents one of the first long-duration studies quantitatively evaluating the effects of a VR exercise program on objective physical activity levels, physiological outcomes, and psychological determinants of adherence compared to both a traditional facility-based exercise condition and a no-treatment control group. By examining key behavioral, physiological, and experiential measures over a 6-month period, valuable insights will emerge regarding:</p><ul><li>The overall efficacy of VR exercise programming for increasing physical activity levels and associated health outcomes</li><li>Notable advantages or disadvantages of VR compared to conventional exercise regarding motivation, adherence, and user experiences</li><li>Specific intervention design factors (environments, games, narratives, accessories) that enhance VR's potential as an adherence tool</li><li>Population segments that may be particularly receptive or resistant to VR-based exercise promotion</li></ul><p>These findings can help clarify the value proposition of integrating VR technology into broader public health initiatives targeting sedentary lifestyles and preventable lifestyle diseases. On an individual level, demonstrating specific adherence-enhancing effects of VR exercise could support the use of such programs to foster lasting physical activity habits and healthy active living.</p><p>1.4 Research Aims &amp; Hypotheses The primary aims and hypotheses of this study are:</p><p>Aim 1: Examine the effects of a 12-week VR exercise intervention versus facility-based exercise programming and no-treatment control on physical activity levels in sedentary adults. H1: Participants in the VR condition will demonstrate greater overall increases in moderate-to-vigorous physical activity compared to both control conditions.</p><p>Aim 2: Investigate differential impacts of the VR and facility-based exercise conditions on physiological and psychological outcomes over the 12-week program and 6-month follow-up: H2a: The VR condition will produce superior improvements in physiological outcomes (weight, body composition, cardiorespiratory fitness, biomarkers). H2b: The VR condition will lead to higher ratings of intrinsic motivation, exercise self-efficacy, enjoyment, and positive user experience compared to facility-based exercise.</p><p>Aim 3: Determine dose-response relationships between VR platform usage metrics (time spent immersed, interactions, environments explored) and physical activity/exercise outcomes. H3: Greater immersion and engagement with the VR exercise platform will correspond to larger increases in physical activity across the intervention.</p><p>1.5 Definition of Key Terms Virtual Reality (VR) Exercise: Physical activities like walking, running, cycling, gameplay, etc. performed while immersed in a simulated digital environment via a head-mounted display and interactive hardware.</p><p>Physical Activity Adherence: Sustaining participation in exercise/physical activity behaviors over an extended period in alignment with public health recommendations.</p><p>Intrinsic Motivation: Internal drivers like interest, enjoyment, and inherent satisfaction that energize participation in an activity like exercise.</p><p>Self-Efficacy: Confidence in one's abilities to execute the actions required to achieve desired outcomes like an exercise/fitness goal.</p><p>Immersion: The subjective sense of cognitive and sensory immersion/presence experienced within a virtual environment facilitated by technical immersion.</p><p>Exergaming: Video games and gamified experiences that require aerobic physical effort or movement serving as exercise.</p> <br><p></p>