Measuring Changes in Cortical Processes during VR-aided Physical Exercise - an EEG-based Approach

The application of virtual reality (VR) technologies during physical therapy is gaining popularity due to enhanced outcomes and increased patient engagement. However, the neurological mechanisms responsible for the observed advantages of VR devices in clinical rehabilitation are poorly understood. In this study, we attempted to quantify the changes in cortical biometrics associated with immersion in VR during a physical task. Five healthy young adults performed boxing exercises with guidance from either a VR-based game (with VR) or an instructional video (without VR). The exercises were performed either at moderate or advanced intensity levels while 64-channel electroencephalography (EEG) was recorded. The EEG power spectral density (PSD) quantified the level of cortical activation. The cortical activation was higher with VR versus without VR at the advanced intensity level (p < 0.001). Additionally, the cortical activation increased in proportion to the task intensity, with both VR and video guidance (p < 0.001). The demonstrated trends in cortical activation show potential for such EEG biomarkers in clinical settings, for example, tracking patient engagement during VR-based physical therapy or rehabilitation. The study also suggested more cortical activity through the use of VR at higher intensities.