Effects of smart walker-assisted gait in real-world vs. virtual reality on heart rate variability and blood pressure...

Integrating smart walkers and virtual reality (VR) holds promise for gait rehabilitation, emphasizing the importance of understanding their physiological effects to optimize treatment protocols.

Compare Heart Rate Variability (HRV) and Blood Pressure (BP) in a smart walker-assisted gait session: in real-world (SWS) and in an immersive VR scenario (VRS) in elderly.

Thirteen physically active elderly (66.00 ± 3.96 years) performed SWS and VRS (4 × 90s; 90s passive rest). HRV (baseline, recovery) and Maximum Heart Rate Percentage (%HRmax) were established (Polar®H10). BP (baseline, rest, recovery) was assessed with an aneroid sphygmomanometer. Rating of Perceived Exertion (RPE) and Cognitive Load (CL) were recorded (rest, recovery).

HRV significantly decreased HF (High-Frequency) and significantly increased LF/HF after VRS (p ≤ 0.05). Compared to baseline, systolic BP (bouts 2, 3: Δ% = 6.27, 7.94), and Double Product (bouts 1-4: Δ% = 34.70-42.43) significantly increased during SWS (p ≤ 0.05). Additionally, systolic BP (bout 4: Δ% = 6.71) and Double Product (bouts 1-4: Δ% = 34.87-43.18) significantly increased during VRS (p ≤ 0.05). No significant differences in HRV, BP, and %HRmax were observed between SWS and VRS (p > 0.05). The intensity of the sessions was "very light" (%HRmax = SWS: 52.3-55.7%; VRS: 53.9-56.0%), RPE = SWS: "Very, Very Easy"; VRS: "Easy" and CL = "Very Low Mental Effort".

Integrating a smart walker and an immersive VR scenario does not appear to substantially elevate the physiological demand on HRV and BP in elderly, suggesting a safe strategy for gait rehabilitation.