This pilot cohort study aimed to investigate the immediate impact of Virtual Reality (VR) exergaming on heart rate (HR), rate of perceived exertion (RPE), and technology acceptance using the Unified Theory of Acceptance and Use of Technology (UTAUT) in healthy adults. Participants engaged in a 20-minute session of VR exergaming using the Meta Oculus Quest 2™ headset. HR and RPE were measured at baseline, during, and after the intervention, while technology acceptance was assessed pre- and post-intervention using the UTAUT questionnaire.

The results showed that VR exergaming increased HR while maintaining perceived exertion at low to moderate levels. Technology acceptance also improved significantly across all domains measured by UTAUT, with particularly notable increases in Performance Expectancy and Effort Expectancy. The findings suggest that VR exergaming is an effective method to enhance physical activity, motivation, and engagement, providing promising support for its use as a rehabilitation tool for individuals struggling with adherence and motivation.

Physical rehabilitation traditionally relies on face-to-face clinical sessions and home-based exercise programmes, yet adherence rates remain suboptimal, ranging between 30% and 50%. Adherence is crucial for effective outcomes, but is often undermined by low motivation and engagement. Sedentary lifestyles, which account for 5.3 million global deaths annually, exacerbate these challenges. VR exergaming has emerged as an innovative intervention, offering immersive environments that engage participants in physical movements, potentially enhancing adherence. Despite its growing popularity, there is limited empirical evidence evaluating the immediate physiological and psychological impacts of VR exergaming. This pilot cohort study aims to investigate its immediate effects on heart rate, perceived exertion, and technology acceptance, providing data that could inform future rehabilitation approaches, through a prospective pilot pre- and post-cohort design within a university research laboratory setting.

Participants engaged in a 20-minute session of the VR game Beat Saber, played on the Meta Oculus Quest 2™ headset. Gameplay required dynamic movements, including lateral side steps and squats, designed to elicit moderate-intensity exercise while maximising engagement. This immersive environment aimed to enhance adherence by making the exercise experience enjoyable while reducing perceived fatigue.

Outcome Measures and Data Collection:

Primary outcomes included HR, RPE, and technology acceptance, assessed using the UTAUT questionnaire administered before and after the VR session. HR was continuously recorded with a Polar monitor, and RPE was reported using the CR-10 Borg scale. The UTAUT questionnaire, adapted for VR specificity, evaluated key aspects of technology acceptance such as performance expectancy and effort expectancy, offering insight into the psychological effects of VR exergaming.

Statistical analyses were conducted using both frequentist and Bayesian approaches. This dual analysis provided comprehensive insights into the intervention's impact, yielding p-values and Bayes factors that contextualised statistical and practical significance. Bayesian analysis was particularly valuable in quantifying the intervention's efficacy relative to baseline measures, offering nuanced conclusions about the likelihood of its impact.

Inclusion Criteria:

• male or female participants
• University student or staff
• age 18-65
• able to read and comprehend written and spoken English

Exclusion Criteria:

• any musculoskeletal injury within the last six months
• recent operation,
• long term health conditions that affect ability to engage in exercise
• claustrophobia
• vertigo and motion sickness
• experiencing covid-19 symptoms

The researcher who completed the data analysis (JR) was blinded to the participants and specifics of the intervention.