Virtual Reality Exercise for Mental Health

(UVIC VR Fit Trial)

Overseen By Ryan Rhodes, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Victoria

Disqualifiers: Physical limitations, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 1

Duration: 10 weeks

150 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Supernatural VR Fitness App for mental health?

Research shows that virtual reality (VR) can be effective for mental health by reducing stress and improving engagement through immersive experiences. Serious games, which include VR, have shown promise in treating depression and other mental health conditions by making therapy more engaging and accessible. ^{1 2 3 4 5}

Is virtual reality exercise generally safe for humans?

Research on virtual reality exercise, including various VR games and systems, suggests it is generally safe for humans. Participants in studies have shown positive responses, such as increased physical activity and enjoyment, without significant safety concerns reported. ^{3 6 7 8 9}

How is the Supernatural VR Fitness App treatment different from other mental health treatments?

The Supernatural VR Fitness App is unique because it uses virtual reality (VR) to create an immersive exercise experience, which can increase enjoyment and motivation compared to traditional exercise. This VR approach can also enhance cognitive performance and provide a novel way to engage in moderate-to-vigorous physical activity, potentially offering mental health benefits through embodied simulations that mimic real-world experiences. ^{6 8 10 11 12}

What is the purpose of this trial?

The primary purpose of this investigation is to examine the effectiveness of virtual reality (VR) exercise (Supernatural exergaming via Meta Platforms Technologies, LLC) for improving mental health as indicated by (1) both short-term mood (one exercise bout) and long-term (10-weeks) mood (depression and anxiety symptoms), (2) well-being (i.e., vitality) over a 10-week period, and (3) perceived cognitive function over a 10-week period. The secondary purpose of this study is to examine the effectiveness of VR exercise for improving both physical activity behaviour and physical activity motivation (attitudes, capability, opportunity, behavioural regulation, habit, identity) over a 10-week period. The tertiary purpose is to examine whether key motivational variables (e.g., attitudes, capability, opportunity, behavioural regulation, habit, identity) regarding Supernatural use explain variability in Supernatural use over time.

Research Team

Ryan Rhodes, PhD

Principal Investigator

Lab Director and Professor

Eligibility Criteria

This trial is for individuals experiencing mental health issues like depression and anxiety. Participants should be interested in using virtual reality (VR) exercise as a potential treatment. The study will track mood, well-being, cognitive function, physical activity behavior, and motivation over 10 weeks.

Inclusion Criteria

Experience no health constraints that limit moderate-to-vigorous physical activity participation as identified by the Physical Activity Readiness Questionnaire (PARQ+)

Living in the Greater Victoria area

I am between 19 and 64 years old.

Exclusion Criteria

If participant is flagged by the PARQ+ and is not cleared to participate in physical activity by their physician they are ineligible to participate

Does not meet any of the above inclusion criteria

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Orientation and Initial Exercise

Participants complete a VR exercise tutorial and initial treadmill or VR exercise session

1 week

1 visit (in-person)

Treatment

Participants engage in VR exercise using the Meta Quest 3 headset for 10 weeks

10 weeks

Weekly self-reported logs

Follow-up

Participants are monitored for mental health outcomes and physical activity behavior

4 weeks

Treatment Details

Interventions

• Supernatural

Trial Overview The effectiveness of a VR exercise program called Supernatural is being tested to see if it can improve mental health outcomes such as mood, vitality, and cognitive function. It also looks at whether the program boosts physical activity levels and motivation over a period of 10 weeks.

Participant Groups

Group I: Virtual Reality Exercise Condition Experimental Treatment 1 Intervention

Participants will complete a virtual reality (VR) exercise tutorial (Supernatural gameplay) and a Supernatural affect measurement workout (Flow or Boxing) in the Behavioural Medicine Lab (UVic). The tutorial will include watching Supernatural YouTube instructional videos, then completing a Supernatural training (\~5-6 min), a 'getting started' low intensity Supernatural workout (\~3 min), a low intensity Supernatural workout (\~3 min), and a medium intensity Supernatural workout (\~3 min). Participants will then complete the affect measurement medium intensity Supernatural workout (18-20 min). Participants will be provided a Virtual Reality headset (i.e., Meta Quest 3 headset) equipped with a Supernatural account for 10 weeks and will be instructed to participate in 75 minutes of medium intensity Supernatural physical activity per week which is equivalent to 75 minutes of vigorous physical activity (in line with the Canadian physical activity guidelines).

Group II: Waitlist Control Condition Active Control 1 Intervention

Participants will complete a control treadmill walk/run exercise session in the Behavioural Medicine Lab (30 min) that emulates the lab-based Supernatural exercise session (intervention condition). The treadmill run/walk will be the comparison condition for examining the effects of Supernatural exercise on mood and affect. First, participants will complete a 10 min treadmill orientation where they will walk for 3 min at 3 mph, walk for 3 min at 3.5 mph, walk/jog for 3 min at 4 mph, and walk for 1 min at 3 mph. Participants will then complete a 19.5-20 min treadmill walk/jog where they will complete a 1 min warmup at 3 mph, walk/jog for 17.5 min at 4 mph. Participants will then be asked to continue as they are for 10 weeks and will have the opportunity to bring home the Meta Quest 3 headset equipped with Supernatural for 10 weeks post-study.

Who Is Running the Clinical Trial?

University of Victoria

Lead Sponsor

Trials

59

Recruited

12,000+

Meta Platforms, Inc.

Collaborator

Trials

3

Recruited

3,700+

Findings from Research

Applied games, including serious games and gamification, can enhance mental health internet interventions by reaching more users, increasing engagement, and utilizing various therapeutic mechanisms.

There is promising evidence supporting the effectiveness of serious games for depression, but more independent trials and comparisons with traditional interventions are needed to fully understand their impact.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Serious Games and Gamification for Mental Health: Current Status and Promising Directions. Fleming, TM., Bavin, L., Stasiak, K., et al.[2022]

Virtual reality (VR) has been effectively used over the past 20 years to enhance mental health across various clinical conditions, including chronic pain, neurological disorders, and psychological issues.

Recent studies indicate that VR can help correct perceptual distortions of self and environment, which are crucial for mental well-being, by creating virtual body ownership illusions, suggesting a promising avenue for future clinical applications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual Body Ownership Illusions for Mental Health: A Narrative Review. Matamala-Gomez, M., Maselli, A., Malighetti, C., et al.[2021]

A study involving 42 overweight women found that a brief online intervention effectively increased physical activity levels and self-efficacy expectations, regardless of avatar type used.

While using avatars did not enhance the overall effectiveness of the intervention, participants represented by 'ideal avatars' experienced reduced anxiety during physical activity, suggesting a potential psychological benefit.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Manipulating Self-Avatar Body Dimensions in Virtual Worlds to Complement an Internet-Delivered Intervention to Increase Physical Activity in Overweight Women. Navarro, J., Cebolla, A., Llorens, R., et al.[2020]

Virtual Reality (VR) is being explored in mental health treatment, with ongoing development of applications specifically for patients with claustrophobia and acrophobia, indicating its potential therapeutic use.

Current VR technology has limitations, such as inadequate resolution and restricted movement, which need to be addressed before it can fully realize its potential in mental health applications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

From toy to tool: the development of immersive virtual reality environments for psychotherapy of specific phobias. Bullinger, AH., Roessler, A., Mueller-Spahn, F.[2005]

A study involving 50 psychiatric patients showed that the VR relaxation tool (VRelax) significantly reduced negative affective states, such as anxiety and sadness, more effectively than standard relaxation exercises.

Both VRelax and standard relaxation improved overall mood, but VRelax provided a greater immediate benefit in specific emotional states, suggesting it could be a valuable self-management tool for enhancing psychiatric treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual Reality Relaxation for Patients With a Psychiatric Disorder: Crossover Randomized Controlled Trial. Veling, W., Lestestuiver, B., Jongma, M., et al.[2021]

The study found that the active VR game 'Hot Squat' (HS) achieved moderate physical activity intensity, significantly higher than other games like 'Beat Saber' (BS) and 'Holopoint' (HP), indicating its potential for effective exercise in young adults.

While 'Hot Squat' elicited the highest physical activity levels, 'Beat Saber' and 'Holopoint' were rated as more enjoyable, suggesting that games requiring less exertion may be more appealing for sustained engagement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical Activity Intensity, Perceived Exertion, and Enjoyment During Head-Mounted Display Virtual Reality Games. Evans, E., Naugle, KE., Kaleth, AS., et al.[2021]

Using a VirZoom VR exercise bike (vBike) led to significantly higher physical activity levels, measured by pedal revolution counts, compared to both an exergaming bike (eBike) and a traditional stationary bike (tBike) in a study with 48 college students.

Participants reported lower perceived exertion while using the vBike compared to the tBike, suggesting that VR exercise may provide a more enjoyable and less intense workout experience, which could encourage more people to engage in physical activity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acute Effects of Virtual Reality Exercise Biking on College Students' Physical Responses. Zeng, N., Liu, W., Pope, ZC., et al.[2023]

Virtual reality (VR) technologies are evolving in clinical settings, showing promise in creating engaging environments for various health conditions, particularly through interactive digital games and exergaming.

Current exergames can increase energy expenditure significantly compared to sedentary activities, but they do not yet provide the intensity needed to match actual sports or meet recommended exercise levels for children, suggesting they should complement rather than replace traditional exercise.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality and interactive digital game technology: new tools to address obesity and diabetes. Skip Rizzo, A., Lange, B., Suma, EA., et al.[2021]

A study involving 40 female office workers found that exercising in an immersive virtual reality environment was significantly preferred over traditional cycling, indicating high acceptance and enjoyment of the VR exercise system.

Participants expressed a strong intention to continue using the VR system for exercise, suggesting it could be a beneficial tool for promoting physical activity during work breaks, although further research is needed to assess its long-term effects on health and adherence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Applicability of an Immersive Virtual Reality Exercise Training System for Office Workers during Working Hours. Touloudi, E., Hassandra, M., Galanis, E., et al.[2022]

Active video games in fully immersive virtual reality (AVR) significantly increased moderate-to-vigorous physical activity (MVPA) compared to sedentary virtual reality (SVR) and control sessions, as measured by heart rate and accelerometers in a study of 29 college students.

Participants reported a more engaging and enjoyable experience during AVR sessions, which also led to marginally better cognitive performance on a memory test, indicating that AVR can enhance both physical activity and cognitive function without increasing motion sickness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Active video games in fully immersive virtual reality elicit moderate-to-vigorous physical activity and improve cognitive performance in sedentary college students. Sousa, CV., Hwang, J., Cabrera-Perez, R., et al.[2022]

In a pilot study with 12 healthy college students, using a VR-based exercise bike (VirZoom) resulted in significantly higher self-efficacy and enjoyment compared to traditional stationary biking, suggesting it may be a more motivating exercise option.

Despite no significant differences in blood pressure changes between the two exercise methods, participants reported lower perceived exertion during VR biking, indicating that VR may make exercise feel easier and more enjoyable.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acute Effect of Virtual Reality Exercise Bike Games on College Students' Physiological and Psychological Outcomes. Zeng, N., Pope, Z., Gao, Z.[2018]

A meta-review of 25 articles over the past 22 months shows that virtual reality (VR) is effective in diagnosing and treating mental health disorders, particularly in anxiety, eating disorders, and pain management, with benefits that extend into real-world situations.

The effectiveness of VR is attributed to its ability to create 'embodied simulations' that mirror how the brain processes and predicts sensory experiences, suggesting that tailored virtual environments could enhance cognitive and emotional regulation in therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neuroscience of Virtual Reality: From Virtual Exposure to Embodied Medicine. Riva, G., Wiederhold, BK., Mantovani, F.[2020]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

Serious Games and Gamification for Mental Health: Current Status and Promising Directions. [2022]

2. Switzerland pubmed.ncbi.nlm.nih.gov

Virtual Body Ownership Illusions for Mental Health: A Narrative Review. [2021]

3. Switzerland pubmed.ncbi.nlm.nih.gov

Manipulating Self-Avatar Body Dimensions in Virtual Worlds to Complement an Internet-Delivered Intervention to Increase Physical Activity in Overweight Women. [2020]

4. Netherlands pubmed.ncbi.nlm.nih.gov

From toy to tool: the development of immersive virtual reality environments for psychotherapy of specific phobias. [2005]

5. Canada pubmed.ncbi.nlm.nih.gov

Virtual Reality Relaxation for Patients With a Psychiatric Disorder: Crossover Randomized Controlled Trial. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Physical Activity Intensity, Perceived Exertion, and Enjoyment During Head-Mounted Display Virtual Reality Games. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Acute Effects of Virtual Reality Exercise Biking on College Students' Physical Responses. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Virtual reality and interactive digital game technology: new tools to address obesity and diabetes. [2021]

9. Switzerland pubmed.ncbi.nlm.nih.gov

Applicability of an Immersive Virtual Reality Exercise Training System for Office Workers during Working Hours. [2022]

10. China pubmed.ncbi.nlm.nih.gov

Active video games in fully immersive virtual reality elicit moderate-to-vigorous physical activity and improve cognitive performance in sedentary college students. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

Acute Effect of Virtual Reality Exercise Bike Games on College Students' Physiological and Psychological Outcomes. [2018]

12. United States pubmed.ncbi.nlm.nih.gov

Neuroscience of Virtual Reality: From Virtual Exposure to Embodied Medicine. [2020]