Recovering from COVID-19 is a challenge, especially for those experiencing persistent symptoms like fatigue, cognitive impairment, and poor sleep quality. Fortunately, exercise has been shown to improve these conditions. A recent study compared two types of treadmill exercise programs for post-COVID-19 subjects: traditional treadmill exercise and a virtual reality (VR)-simulated treadmill exercise. Let’s dive into the findings and explore how these methods could help enhance recovery for COVID-19 survivors.
The Study: Traditional vs. Virtual Reality-Simulated Treadmill Exercise
The study, published in the Journal of Exercise Science & Fitness, aimed to determine whether adding VR to treadmill exercise could yield better outcomes in terms of fatigue, cognitive function, sleep quality, and participant satisfaction among post-COVID-19 patients.
Methodology
The study was conducted as a randomized, parallel-group intervention trial. Sixteen post-COVID-19 participants, aged 30-60, were recruited based on specific criteria, including persistent symptoms of dyspnea (shortness of breath), fatigue, and mild cognitive impairment. They were randomly assigned to one of two groups:
- Non-VR Group: Participants received a traditional treadmill aerobic exercise program.
- VR Group: Participants performed the same treadmill exercise, but with the addition of non-immersive VR.
Both groups exercised three times a week for four weeks at moderate intensity, defined as 50-60% of their heart rate reserve. The VR group exercised in a simulated environment (e.g., jogging on a virtual track with scenery) displayed on a screen in front of the treadmill, allowing interaction through a game console.
Outcome Measures
The researchers measured four key outcomes:
- Fatigue: Assessed using the Chalder Fatigue Scale.
- Cognitive Function: Evaluated with the Montreal Cognitive Assessment (MoCA).
- Sleep Quality: Measured with the Pittsburgh Sleep Quality Index (PSQI).
- Participant Satisfaction: Rated on a 5-point Likert scale.
Key Findings
1. Improvement in Fatigue, Cognitive Function, and Sleep Quality
Both groups demonstrated significant improvements in fatigue, cognitive function, and sleep quality after the four-week exercise program. However, there were no significant differences between the VR and non-VR groups regarding these three outcomes.
This finding suggests that while adding VR to treadmill exercise did not result in superior physical or cognitive benefits compared to traditional exercise, both exercise programs effectively alleviated post-COVID-19 symptoms:
- Fatigue: Participants in both groups reported a significant reduction in fatigue, as measured by the Chalder Fatigue Scale.
- Cognitive Function: Both groups showed substantial improvement in cognitive function, assessed using the MoCA questionnaire.
- Sleep Quality: Sleep quality improved significantly in both groups, as indicated by the PSQI scores.
2. Higher Participant Satisfaction with VR-Simulated Exercise
While the physical and cognitive outcomes were similar between the two groups, the VR group reported significantly higher satisfaction with the exercise program. This was evident from the 5-point Likert scale, where more participants in the VR group expressed being “very satisfied” or “extremely satisfied” compared to the non-VR group.
This increased satisfaction could be attributed to the enhanced engagement and enjoyment provided by the VR environment, which made the exercise experience more interactive and enjoyable. This result aligns with previous studies that show VR-enhanced exercise can be more motivating and enjoyable, potentially leading to better adherence to exercise programs.
Why Virtual Reality? The Science Behind the Benefits
Enhanced Enjoyment and Motivation
VR technology adds an element of fun and distraction, which can make exercise feel less like a chore. This enhanced enjoyment may help increase long-term adherence to exercise routines, a crucial factor for sustained health benefits. VR environments can simulate outdoor settings, games, or scenarios that engage users more effectively than traditional treadmill workouts.
Reducing Perceived Exertion
Virtual reality has been shown to reduce the perception of fatigue during exercise by diverting the user’s attention away from discomfort or exertion. This distraction can make moderate to high-intensity workouts feel easier, encouraging participants to push themselves further and achieve better fitness outcomes.
Potential Cognitive Benefits
Exercise is known to enhance cognitive function by increasing blood flow to the brain and promoting neurogenesis (the growth of new brain cells). The interactive nature of VR could amplify these benefits by engaging multiple senses and cognitive processes, potentially improving memory, attention, and overall mental acuity.
Practical Implications for Rehabilitation
Greater Satisfaction Can Improve Adherence
The increased satisfaction reported by participants in the VR group is a key finding, particularly for designing rehabilitation programs for post-COVID-19 patients. Making exercise a more enjoyable experience can improve adherence, which is critical for long-term health outcomes. This approach may be especially valuable for individuals who find traditional exercise monotonous or challenging due to lingering symptoms.
Designing VR-Enhanced Exercise Programs
To maximize benefits, VR-enhanced exercise programs should be designed with the following considerations:
- Intensity and Duration: Follow established exercise guidelines for moderate-intensity aerobic workouts, typically lasting 30-45 minutes.
- Engagement: Use interactive VR environments that match the user’s preferences, such as nature trails, urban settings, or gamified challenges.
- Supervision: Ensure that exercises are conducted under the supervision of a qualified professional, especially for individuals with health conditions.
Future Research Directions
While this study provides promising insights, more research is needed to explore the long-term benefits of VR-simulated exercise in larger populations and across different settings. Future studies could examine the effects of various types of VR environments (e.g., immersive vs. non-immersive), different exercise modalities (e.g., cycling, rowing), and combinations with other rehabilitation techniques.
Conclusion
In conclusion, adding non-immersive VR to a treadmill exercise program may not necessarily improve physical or cognitive outcomes more than traditional exercise for post-COVID-19 patients. However, it does significantly enhance participant satisfaction, which could lead to better adherence and long-term health benefits. For those recovering from COVID-19, incorporating VR into rehabilitation could provide a more engaging and enjoyable exercise experience. By making exercise fun and accessible, VR technology offers a valuable tool in the ongoing effort to help COVID-19 survivors regain their health and vitality.
References
Ahmad, A.M., Awad Allah, S.A.M., Abd Elhaseeb, G.A., et al. (2024). Effects of conventional versus virtual reality-simulated treadmill exercise on fatigue, cognitive function, and participant satisfaction in post-COVID-19 subjects: A randomized trial. Journal of Exercise Science & Fitness, 22, 316-321. Available at: https://doi.org/10.1016/j.jesf.2024.04.003