Aerobic Stimulus Induced by Virtual Reality Games in Stroke Survivors

Arch Phys Med Rehabil. 2018 May;99(5):927-933. doi: 10.1016/j.apmr.2018.01.014. Epub 2018 Feb 8.


Objective: To evaluate whether virtual reality games (VRGs) in stroke survivors produce significant and reproducible heart rate and oxygen consumption (V˙o2) responses during their execution, corresponding to an intensity between the anaerobic threshold (AT) and the respiratory compensation point (RCP).

Design: Single-subject, repeated-measure design.

Setting: Stroke survivors registered from a rehabilitation program.

Participants: Chronic hemiparetic stroke survivors (N=12; 10 men; mean age ± SD, 58±12y) rated at 3 or 4 in the Functional Ambulation Categories.

Interventions: Participants underwent, in a random order, 2 identical sessions of VRGs (console Xbox 360 + Kinect) and 1 control session (38min watching a movie). The VRG sessions were composed of 4 sets of VRGs (3min of tennis, 1min for changing the game, and 4min of boxing) interspaced with 2 minutes of rest.

Main outcome measures: Heart rate and V˙o2 were measured during the experimental sessions and compared with heart rate and V˙o2 obtained at AT and RCP assessed during a maximal cardiopulmonary exercise test.

Results: Heart rate and V˙o2 during VRGs had good reproducibility (intraclass correlation coefficients, ≥.91 and ≥.85, respectively; coefficients of variation, ≤6.7% and ≤13.7%, respectively). Heart rate during VRGs was similar to AT and significantly lower than RCP (P≤.05), while V˙o2 was significantly lower than AT and RCP (P<.05).

Conclusions: An acute session of VRGs composed of tennis and boxing games using the console XBox 360 + Kinect promotes reproducible responses of heart rate and V˙o2 that corresponded, respectively, to AT and below AT, characterizing a low-intensity aerobic stimulus.

Keywords: Anaerobic threshold; Heart rate; Oxygen consumption; Rehabilitation; Stroke; Virtual reality exposure therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anaerobic Threshold
  • Boxing / physiology
  • Exercise Test
  • Exercise*
  • Female
  • Heart Rate
  • Humans
  • Male
  • Middle Aged
  • Oxygen Consumption
  • Paresis / etiology
  • Paresis / rehabilitation*
  • Stroke / complications
  • Stroke / physiopathology*
  • Stroke Rehabilitation / methods*
  • Tennis / physiology
  • Video Games*
  • Virtual Reality