Virtual Reality-Based High-Intensity Interval Training For Pulmonary Rehabilitation: A Feasibility and Acceptability Study

Chronic obstructive pulmonary disease (COPD) is an irreversible lung disease affecting over 174 million worldwide. Pulmonary rehabilitation (PR), including cardiovascular exercise such as highintensity interval training (HIIT), can reduce frequency and severity of symptoms. However, oftentimes exercise regimens suffer from low motivation and poor adherence. This has previously been addressed by augmenting exercises with digital gaming experiences. However, to our knowledge no studies have yet investigated the feasibility of using immersive virtual reality (IVR) equipment on COPD-patients in HIIT. Through a longitudinal observational study, we investigated the feasibility and acceptability of using VR-headsets in a HIIT-based exercise program. Three older adults (age between 68-86) consented to participate. Heart rate, cadence, perceived exertion, nausea and motivation was measured both during VR-usage and standard training. Though the sample size implies low statistical power, which constitutes a serious limitation to external validity, motivation was retained during the study, and the use of VR did not lead to higher dyspnea, cardiovascular demands, nor serious adverse effects such as provoking exacerbation or instilling cybersickness. The results are encouraging and calls for further studies on how VR can be applied to HIIT exercise programs seeking to increase adherence. Future studies should investigate new ways of retaining motivation through higher interactivity or social collaborative experiences.