She’s pedaling fast along the streets of Paris. Perhaps it’s her view of the mighty Eiffel Tower. Perhaps it’s the cacophony of nearby concert attendees cheering her on. But she is keeping a better pace than ever before. If she can pass the cyclist just ahead, she knows she will get first place. She changes her gear, grips the handles, and prepares for this final push. Suddenly, she hears a nearby voice, “Nice job! It’s time to remove your virtual reality headset now.” She removes her headset and looks for where she placed her walker.

At the University of Maryland School of Nursing, Dr. Brittany Drazich and colleagues recently piloted an intervention titled Motivating Older Adults Through Immersive Virtual Exercise (MOTIVE), which brought virtual reality biking to older adults in Baltimore, Maryland. The MOTIVE intervention is specifically intended for older adults who experience financial strain and live in urban environments that might not be as conducive for exercise.

Dr. Drazich shared: “Older adults who are on fixed incomes and live in urban environments can experience compounding barriers to physical activity. There are environmental barriers like uneven sidewalks and higher crime rates. There are financial barriers for transportation to areas to exercise. Virtual reality physical activity allows older adults to visit exciting naturalistic environments in the comfort of their own senior living community.”

For the MOTIVE intervention, older adult residents participated in virtual reality biking sessions twice a week for eight weeks using the app HOLOFIT by Holodia. Through HOLOFIT, the participants explored 16 naturalistic virtual environments while they pedaled on a recumbent sedentary bicycle. While exploring these virtual environments such as Antarctica or Saturn, HOLOFIT provided options for racing (e.g., competing against other AI avatars), gamification (e.g., collecting virtual trophies), and training (e.g., a meter that guides participants through varying intensity levels). The research team selected the HOLOFIT fitness app because it provides motivation for physical activity through immersion and fun.

Left: View of Saturn through virtual reality headset and HOLOFIT app. Right: Equipment used by participants.

Left: View of Saturn through virtual reality headset and HOLOFIT app. Right: Equipment used by participants.

From the study results, it is clear that the participants did find the virtual reality exercise motivating. The participants attended an average of 15 out of 16 exercise sessions. According to Dr. Drazich: “You don’t typically see that level of dedication in research studies.” One MOTIVE participant, 76 years old, described: “Virtual reality was amazing. It gives you more incentive to keep going. Without the virtual reality, it would be monotonous and boring, which is why a lot of people give up exercise.”

Left: View of Tropical through virtual reality headset and HOLOFIT app. Right: Equipment used by participants.

Dr. Drazich and her colleagues also found that the MOTIVE participants significantly increased their overall levels of physical activity throughout the course of the study. The full results of the MOTIVE study were recently published in the peer-reviewed journal Geriatric Nursing.

Dr. Drazich stated: “We know that physical activity can prevent or treat at least 35 major chronic conditions. We know that physical activity can extend life expectancy. Through the MOTIVE study, we found that virtual reality physical activity apps such as HOLOFIT can motivate older adults to increase their physical activity. This could be a really powerful tool for improving health in this population.”

In terms of the next steps, Dr. Drazich plans to bring the MOTIVE intervention to more senior living facilities throughout Baltimore. She stated: “If we can demonstrate that virtual reality fitness directly decreases health disparities, perhaps we could influence policy such as subsidies for virtual reality equipment in low resource senior living communities.”

Dr. Brittany Drazich is an assistant professor at the University of Maryland School of Nursing where she researches innovative approaches to increasing physical activity among older adults.

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