Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 1, 2025
Open Peer Review Period: Feb 1, 2025 - Mar 29, 2025
Date Accepted: May 13, 2025
(closed for review but you can still tweet)
Stationary Cycling Exercise with Virtual Reality to Reduce Depressive Symptoms Among People with Mild to Moderate Depression: A Randomized Controlled Trial
ABSTRACT
Background:
Virtual reality (VR) stationary cycling provides a potential solution to enhance adherence and reduce depressive symptoms, particularly for people with depression. However, high-quality evidence is needed to support its implementation in clinical practice.
Objective:
This study evaluated the clinical effects of a 12-week VR-based stationary cycling program on depressive symptoms in sedentary adults with mild to moderate depression.
Methods:
This study is a 12-week, three-arm randomized controlled trial (RCT). Participants (aged 18-60 years) with depression were recruited and randomly assigned (1:1:1) to the VR high-intensity stationary cycling, VR moderate-intensity stationary cycling, or non-VR moderate-intensity stationary cycling group. The primary outcome was the change in depressive symptoms measured by the Hamilton Depression Rating Scale (HAMD-17) between baseline and 12 weeks. Effectiveness rate, satisfaction, compliance, and adverse events were assessed post-intervention. Outcomes were analyzed using an intention-to-treat approach.
Results:
Between January 2023 and June 2024, 114 participants were enrolled and randomly assigned to three groups (38 participants per group). 101 participants completed the trials (33 in non-VR moderate-intensity stationary cycling, 35 in VR moderate-intensity cycling, and 33 in VR high-intensity cycling). All 114 randomly assigned participants were included in the intention-to-treat analysis. At 12 weeks, a significant reduction in HAMD-17 scores was observed in all groups (10.87 [95% CI: 9.28, 12.46] for non-VR moderate-intensity, 14.22 [95% CI: 12.65, 15.79] for VR moderate-intensity, and 14.43 [95% CI: 13.01, 15.84] for VR high-intensity, respectively). Greater reductions were observed in the VR moderate-intensity and VR high-intensity groups compared to the non-VR group (mean differences: 3.35 [95% CI: 1.15, 5.54] and 3.55 [95% CI: 1.46, 5.64], respectively). No significant differences in symptom improvement were found between VR-based moderate- and high-intensity groups, but participants in the moderate-intensity group reported higher satisfaction.
Conclusions:
The VR stationary cycling program is an efficacious health intervention for alleviating depressive symptoms in participants with mild to moderate depression. These findings could facilitate incorporating VR health intervention into clinical practice, enhance the effectiveness of cycling-based interventions, and improve patient adherence, supporting its use as a complementary treatment for depression. Clinical Trial: Chinese Clinical Trial Registry Identifier: ChiCTR2500095241
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