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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to test whether virtual reality (VR) exercise can boost mental well-being, focusing on vitality, depression, anxiety, and cognitive function over 10 weeks. Participants will use a VR platform called Supernatural, a VR fitness app, for guided workouts, while others will perform treadmill exercises in a control group. The trial also examines how VR might motivate increased physical activity. Ideal participants live in the Greater Victoria area, currently engage in less than 75 minutes of vigorous exercise weekly, and have no health constraints limiting exercise. As an unphased trial, this study offers a unique opportunity to explore innovative ways to enhance mental and physical health through VR.

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 prior data suggests that this virtual reality exercise is safe for mental health?

Research shows that virtual reality (VR) exercise programs, such as the Supernatural app, are generally easy to use. Many individuals have used the Supernatural VR Fitness App for workouts on Meta Quest headsets and reported positive experiences. Users, including those with specific needs like wheelchair users and veterans with PTSD (post-traumatic stress disorder), have successfully used the app without issues.

This suggests that the app is user-friendly and adaptable for different users, with no widespread reports of negative effects. Although specific clinical trial data on its safety is lacking, the app's popularity in various communities suggests it is safe for most people. However, as with any new exercise routine, consulting a healthcare provider before starting is advisable, especially if there are any health concerns. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using Supernatural, a virtual reality exercise program, for mental health because it offers a unique and engaging way to incorporate physical activity into mental health treatment. Unlike traditional exercise routines, Supernatural uses immersive VR technology to create a more enjoyable and interactive fitness experience, which could improve adherence and motivation. Moreover, the use of VR allows for a personalized and varied workout environment, potentially enhancing mood and affect more effectively than conventional methods. This innovative approach aligns with physical activity guidelines, aiming to deliver mental health benefits through a medium that feels less like a chore and more like a game.

What evidence suggests that virtual reality exercise is effective for improving mental health?

This trial will compare the effects of virtual reality (VR) workouts using Supernatural with traditional treadmill exercises. Research has shown that VR workouts like Supernatural are as effective as traditional cardio exercises such as running and swimming. One study found that these VR workouts use as much energy as common vigorous activities. Participants in the VR exercise condition will experience the Flow and Boxing modes in Supernatural, which are considered vigorous exercises. These modes may also improve mental health by boosting mood and reducing symptoms of anxiety and depression. Additionally, VR exercises can enhance overall well-being and energy levels. ^{6 7 8 9}

Who Is on the Research Team?

Ryan Rhodes, PhD

Principal Investigator

Lab Director and Professor

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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 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]

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]

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]

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]

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]

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]

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]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT06367439

NCT06367439 | Examining the Effects of Virtual Reality ... The primary purpose of this investigation is to examine the efficacy of virtual reality (VR) exercise (Supernatural exergaming via Meta Platforms ...

2. about.fb.com about.fb.com/news/2024/06/new-study-proves-effectiveness-of-vr-workouts/

New Study Proves Effectiveness of VR Workouts - About Meta A new research study showed that a Supernatural VR workout is equivalent to common cardio and fitness activities such as running, ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11185914/

Examining and Comparing the Energy Expenditure of Two ... Both Flow and Boxing gameplay modes of Supernatural classify as vigorous physical activity and demonstrate the potential to promote mental and ...

4. fortune.com fortune.com/well/article/meta-virtual-reality-workouts-just-as-good-as-real-life-fitness/

Here's how Meta's virtual-reality workout compares to real- ... A new study finds the workouts just as effective as real-life “high-quality cardiovascular activity” like running, boxing, and swimming.

5. getsupernatural.com getsupernatural.com/faq

FAQ - Supernatural VR Fitness App on Meta Quest Supernatural is a high-energy full body workout that targets every major muscle group and gets your heart pumping. Each workout consists of a series of songs ...

6. meta.com meta.com/quest/supernatural/?srsltid=AfmBOoqB5ExSANYcmrh5w3JCMn_-BAvIZ6Zj6xdpj8cyL3PvZWz2Vc-E

Supernatural VR Fitness App on Meta Quest Workout like never before in virtual reality with the Supernatural VR Fitness App – only available on Meta Quest headsets. Start your personalized VR workout

7. play.google.com play.google.com/store/apps/details?id=within.flow.android.flowapp&hl=en_US

Supernatural - Companion App Supernatural is an immersive, virtual reality fitness service for the Meta Quest. New workouts daily that transport you to the most stunning destinations in ...

8. wired.com wired.com/story/supernatural-virtual-reality-exercise-gyms/

Supernatural VR Makes Working Out More Accessible ... There are people who use the app in wheelchairs and military veterans with PTSD who like that the app lets them block out the rest of the world.

9. reddit.com reddit.com/r/OculusQuest/comments/1ily4te/supernatural_fitness_is_a_game_changer_for_me/

Supernatural Fitness is a game changer for me Today I found Supernatural Fitness and it's going to be a game changer for me. I have Thrill of the Fight which I get quite a bit of exercise ...