Virtual Reality Exercise as a Coping Strategy for Health and Wellness Promotion in Older Adults during the COVID-19 Pandemic

Zan Gao, Jung Eun Lee, Daniel J McDonough, Callie Albers, Zan Gao, Jung Eun Lee, Daniel J McDonough, Callie Albers

Abstract

The December 2019 COVID-19 outbreak in China has led to worldwide quarantine, as recommended by local governments and the World Health Organization. Particularly affected are older adults (i.e., those aged ≥ 65 years) who are at elevated risk for various adverse health outcomes, including declines in motor ability and physical activity (PA) participation, increased obesity, impaired cognition, and various psychological disorders. Thus, given the secular increases in the older adult population, novel and effective intervention strategies are necessary to improve physical activity behaviors and health in this population. Virtual reality (VR)-integrated exercise is a promising intervention strategy, which has been utilized in healthcare fields like stroke rehabilitation and psychotherapy. Therefore, the purpose of this editorial is to synthesize recent research examining the efficacy and effectiveness of VR exercise in the promotion of favorable health outcomes among the older adults. Results indicate the application of VR exercise to facilitate improved physical outcomes (e.g., enhanced motor ability, reduced obesity), cognition and psychological outcomes. VR exercise has also been observed to be an effective intervention strategy for fall prevention in this population. Future research should employ more rigorous research designs to allow for a more robust quantitative synthesis of the effect of VR exercise on the preceding outcomes to elucidate which type(s) of VR-based PA interventions are most effective in promoting improved health outcomes among older adults. Findings from this study will better inform the development of technology-savvy PA programs for wellness promotion in older adults who practice social distancing and exercise from home under the unprecedented global health crisis.

Keywords: cognition; fall prevention; motor ability; obesity; psychological outcomes.

Conflict of interest statement

The authors declare no conflict of interest.

References

    1. John Hopkins University Coronavirus COVID-19 Global Cases by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. [(accessed on 10 May 2020)]; Available online: .
    1. Centers for Disease Control and Prevention Mental health and coping during COVID-19. CDC. [(accessed on 12 April 2020)];2019 Available online: .
    1. Qiu J., Shen B., Zhao M., Wang Z., Xie B., Xu Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations. Gen. Psychiatry. 2020;33:e100213. doi: 10.1136/gpsych-2020-100213.
    1. Centers for Disease Control and Prevention Coronavirus Disease 2019 (COVID-19). CDC. [(accessed on 3 June 2020)];2019 Available online: .
    1. Zhu W. If you are physically fit, you will live a longer and healthier life: An interview with Dr. Steven N. Blair. J. Sport Health Sci. 2019;8:524. doi: 10.1016/j.jshs.2019.09.006.
    1. Chen L.J., Fox K.R., Sun W.J., Tsai P.S., Ku P.W., Chu D. Associations between walking parameters and subsequent sleep difficulty in older adults: A 2-year follow-up study. J. Sport Health Sci. 2018;7:95–101. doi: 10.1016/j.jshs.2017.01.007.
    1. Colby S.L., Ortman J.M. Projections of the size and composition of the US population: 2014 to 2060. Population estimates and projections. Curr. Popul. Rep. 2015:25–1143.
    1. Lagerros Y.T., Hantikainen E., Michaelsson K., Ye W., Adami H.O., Bellocco R. Physical activity and the risk of hip fracture in the elderly: A prospective cohort study. Eur. J. Epidemiol. 2017;32:983–991. doi: 10.1007/s10654-017-0312-5.
    1. Park J., Yim J. A new approach to improve cognition, muscle strength, and postural balance in community-dwelling elderly with a 3-D virtual reality kayak program. Tohoku J. Exp. Med. 2016;238:1–8. doi: 10.1620/tjem.238.1.
    1. Preschl B., Wagner B., Forstmeier S., Maercker A. E-health interventions for depression, anxiety disorder, dementia, and other disorders in old age: A review. J. CyberTherapy Rehabil. 2011;4:371–386.
    1. Grenier S., Forget H., Bouchard S., Isere S., Belleville S., Potvin O., Rious M., Talbot M. Using virtual reality to improve the efficacy of cognitive-behavioral therapy (CBT) in the treatment of late-life anxiety: Preliminary recommendations for future research. Int. Psychogeriatr. 2015;27:1217–1225. doi: 10.1017/S1041610214002300.
    1. Pedersen M.T., Vorup J., Bangsbo J. Effect of a 26-month floorball training on male elderly’s cardiovascular fitness, glucose control, body composition, and functional capacity. J. Sport Health Sci. 2018;7:149–158. doi: 10.1016/j.jshs.2017.12.002.
    1. Kang H.W., Park M., Wallace J.P. The impact of perceived social support, loneliness, and physical activity on quality of life in South Korean older adults. J. Sport Health Sci. 2018;7:237–244. doi: 10.1016/j.jshs.2016.05.003.
    1. Cho G.H., Hwangbo G., Shin H.S. The effects of virtual reality-based balance training on balance of the elderly. J. Phys. Ther. Sci. 2014;26:615–617. doi: 10.1589/jpts.26.615.
    1. Gao Z., Lee J. Emerging technology in promoting physical activity and health: Challenges and opportunities. J. Clin. Med. 2019;8:1830. doi: 10.3390/jcm8111830.
    1. Crespo A.B., Idrovo G.G., Rodrigues N., Pereira A.A. Virtual reality UAV simulation with body area networks to promote the elders life quality; Proceedings of the International Conference on Technology and Innovation in Sports, Health and Wellbeing (TISHW); Vila Real, Portugal. 1–3 December 2016; pp. 1–7.
    1. Tsatsis C.G., Rice K.E., Protopopova V., Ramos D., Jadav J., Coppola J.F., Broderick M., Putrino D. Lateropulsion rehabilitation using virtual reality for stroke patients; Proceedings of the Long Island Systems, Applications and Technology Conference (LISAT); Farmingdale, NY, USA. 5 May 2017; pp. 1–6.
    1. Rosa P.J., Morais D., Gamito P., Oliveira J., Saraiva T. The immersive virtual reality experience: A typology of users revealed through multiple correspondence analysis combined with cluster analysis technique. Cyberpsychol. Behav. Soc. Netw. 2016;19:209–216. doi: 10.1089/cyber.2015.0130.
    1. Liu W., Zeng N., Pope Z.C., McDonough D.J., Gao Z. Acute effects of immersive virtual reality exercise on young adults’ situational motivation. J. Clin. Med. 2019;8:1947. doi: 10.3390/jcm8111947.
    1. Qian J., McDonough D.J., Gao Z. The Effectiveness of virtual reality exercise on individual’s physiological, psychological and rehabilitative outcomes: A systematic review. Int. J. Environ. Res. Public Health. 2020;17:4133. doi: 10.3390/ijerph17114133.
    1. Kim A., Darakjian N., Finley J.M. Walking in fully immersive virtual environments: An evaluation of potential adverse effects in older adults and individuals with Parkinson’s disease. J. Neuroeng. Rehabil. 2017;14:16. doi: 10.1186/s12984-017-0225-2.
    1. Kim J., Son J., Ko N., Yoon B. Unsupervised virtual reality-based exercise program improves hip muscle strength and balance control in older adults: A pilot study. Arch. Phys. Med. Rehabil. 2013;94:937–943. doi: 10.1016/j.apmr.2012.12.010.
    1. Gao Z., Zeng N., Pope Z.C., Wang R., Yu F. Effects of exergaming on motor skill competence, perceived competence, and physical activity in preschool children. J. Sport Health Sci. 2019;8:106–113. doi: 10.1016/j.jshs.2018.12.001.
    1. Gao Z., Lee J.E., Zeng N., Pope Z.C., Zhang Y., Li X. Home-based exergaming on preschoolers’ energy expenditure, cardiovascular fitness, body mass index and cognitive flexibility: A randomized controlled trial. J. Clin. Med. 2019;8:1745. doi: 10.3390/jcm8101745.
    1. Gao Z., Pope Z.C., Lee J.E., Quan M. Effects of active video games on children’s psychosocial beliefs and school day energy expenditure. J. Clin. Med. 2019;8:1268. doi: 10.3390/jcm8091268.
    1. Xiong S., Zhang P., Gao Z. effects of exergaming on preschoolers’ executive functions and perceived competence: A pilot randomized trial. J. Clin. Med. 2019;8:469. doi: 10.3390/jcm8040469.
    1. Ye S., Pope Z.C., Lee J., Gao Z. Effects of school-based exergaming on urban children’s physical activity and cardiorespiratory fitness: A quasi-experimental study. Int. J. Environ. Res. Public Health. 2019;16:4080. doi: 10.3390/ijerph16214080.
    1. McDonough D.J., Pope Z.C., Zeng N., Lee J.E., Gao Z. Retired elite athletes’ physical activity, physiological, and psychosocial outcomes during single-and double-player exergaming. J. Strength Cond. Res. 2019;33:3220–3225. doi: 10.1519/JSC.0000000000003386.
    1. Zeng N., Pope Z.C., Lee J., Gao Z. Virtual reality exercise for anxiety and depression: A preliminary review of current research in an emerging field. J. Clin. Med. 2018;7:42. doi: 10.3390/jcm7030042.
    1. North M.M., North S.M., Coble J.R. Virtual reality therapy: An effective treatment for the fear of public speaking. Int. J. Virtual Real. 2015;3:1–6. doi: 10.20870/IJVR.1998.3.3.2625.
    1. Hong Y.J., Kim H.E., Jung Y.H., Kyeong S., Kim J.J. Usefulness of the mobile virtual reality self-training for overcoming a fear of heights. Cyberpsychol. Behav. Soc. Netw. 2017;20:753–761. doi: 10.1089/cyber.2017.0085.
    1. Standen P.J., Threapleton K., Richardson A., Connell L., Brown D.J., Battersby S., Platts F., Burton A. A low cost virtual reality system for home based rehabilitation of the arm following stroke: A randomized controlled feasibility trial. Clin. Rehabil. 2017;31:340–350. doi: 10.1177/0269215516640320.
    1. Manzoni G.M., Cesa G.L., Bacchetta M., Castelnuovo G., Conti S., Gaggioli A., Mantovani F., Molinari E., Cardenas-Lopez G., Riva G. Virtual reality-enhanced cognitive-behavioral therapy for morbid obesity: A randomized controlled study with 1 year follow-up. Cyberpsychol. Behav. Soc. Netw. 2016;19:134–140. doi: 10.1089/cyber.2015.0208.
    1. Bruun-Pedersen J.R., Serafin S., Kofoed L.B. Simulating nature for elderly users—A design approach for recreational virtual environments; Proceedings of the IEEE International Conference on Computer and Information Technology; Ubiquitous Computing and Communications; Dependable, Autonomic and Secure Computing; Pervasive Intelligence and Computing; Liverpool, UK. 26–28 October 2015; pp. 1566–1571.
    1. Bourrelier J., Ryard J., Dion M., Merienne F., Manckoundia P., Mourey F. Use of a virtual environment to engage motor and postural abilities in elderly subjects with and without mild cognitive impairment (MAAMI Project) IRBM. 2016;37:75–80. doi: 10.1016/j.irbm.2016.02.007.
    1. Volpe S.L., Sukumar D., Milliron B.J. Obesity prevention in older adults. Curr. Obes. Rep. 2016;5:166–175. doi: 10.1007/s13679-016-0213-z.
    1. Thomas J.G., Bond D.S. Review of innovations in digital health technology to promote weight control. Curr. Diabetes Rep. 2014;14:485. doi: 10.1007/s11892-014-0485-1.
    1. Bacon N., Farnworth L., Boyd R. The use of the Wii Fit in forensic mental health: Exercise for people at risk of obesity. Br. J. Occup. Ther. 2012;75:61–68. doi: 10.4276/030802212X13286281650992.
    1. Optale G., Urgesi C., Busato V., Marin S., Piron L., Priftis K., Gamberini L., Capodieci S., Bordin A. Controlling memory impairment in elderly adults using virtual reality memory training: A randomized controlled pilot study. Neurorehabilit. Neural Repair. 2010;24:348–357. doi: 10.1177/1545968309353328.
    1. Rendon A., Lohman E.B., Thorpe D., Johnson E.G., Medina E., Bradley B. The effect of virtual reality gaming on dynamic balance in older adults. Age Ageing. 2012;41:549–552. doi: 10.1093/ageing/afs053.
    1. Milat A.J., Watson W.L., Monger C., Barr M., Giffin M., Reid M. Prevalence, circumstances and consequences of falls among community-dwelling older people: Results of the 2009 NSW falls prevention baseline survey. NSW Public Health Bull. 2011;22:43–48. doi: 10.1071/NB10065.
    1. Tajima T., Saito Y., Kato R., Kibayashi Y., Miyachi M., Lee I.M., Oguma Y. Awareness of physical activity promotion, physical activity, and sedentary behavior in elderly Japanese. J. Phys. Fit. Sports Med. 2018;7:113–119. doi: 10.7600/jpfsm.7.113.
    1. Mirelman A., Rochester L., Maidan I., Del Din S., Alcock L., Nieuwhof F., Abbruzzese G. Addition of a non-immersive virtual reality component to treadmill training to reduce fall risk in older adults (V-TIME): A randomised controlled trial. Lancet. 2016;388:1170–1182. doi: 10.1016/S0140-6736(16)31325-3.
    1. Parijat P., Lockhart T.E., Liu J. Effects of perturbation-based slip training using a virtual reality environment on slip-induced falls. Ann. Biomed. Eng. 2015;43:958–967. doi: 10.1007/s10439-014-1128-z.
    1. Chiarovano E., de Waele C., MacDougall H.G., Rogers S.J., Burgess A.M., Curthoys I.S. Maintaining balance when looking at a virtual reality three-dimensional display of a field of moving dots or at a virtual reality scene. Front. Neurol. 2015;6:164. doi: 10.3389/fneur.2015.00164.
    1. Levy F., Leboucher P., Rautureau G., Komano O., Millet B., Jouvent R. Fear of falling: Efficacy of virtual reality associated with serious games in elderly people. Neuropsychiatr. Dis. Treat. 2016;12:877. doi: 10.2147/NDT.S97809.
    1. McDonough D.J., Pope Z.C., Zeng N., Liu W., Gao Z. Comparison of college students’ blood pressure, perceived exertion, and psychosocial outcomes during virtual reality, exergaming, and traditional exercise: An exploratory study. Games for Health. 2020;9:1–7. doi: 10.1089/g4h.2019.0196.
    1. Ryu J.-H., Park J.-W., Nahm F.S., Jeon Y.-T., Oh A.-Y., Lee H.J., Kim J.-H., Han S.-H. The effect of gamification through a Virtual Reality on preoperative anxiety in pediatric patients undergoing general anesthesia: A prospective, randomized, and controlled trial. J. Clin. Med. 2018;7:284. doi: 10.3390/jcm7090284.
    1. Samendinger S., Hill C.R., Kerr N.L., Winn B., Ede A., Pivarnik J.M., Ploutz-Snyder L., Feltz D.L. Group dynamics motivation to increase exercise intensity with a virtual partner. J. Sport Health Sci. 2019;8:289–297. doi: 10.1016/j.jshs.2018.08.003.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren