Exergaming With Beat Saber: An Investigation of Virtual Reality Aftereffects (Preprint)

<sec> <title>BACKGROUND</title> Virtual reality (VR) exergaming has the potential to target sedentary behavior. Immersive environments can distract users from the physical exertion of exercise and can motivate them to continue exergaming. Despite the recent surge in VR popularity, numerous users still experience VR sickness from using head-mounted displays (HMDs). Apart from the commonly assessed self-reported symptoms, depth perception and cognition may also be affected. Considering the potential benefits of VR exergaming, it is crucial to identify the adverse effects limiting its potential and continued uptake. </sec> <sec> <title>OBJECTIVE</title> This study aims to investigate the consequences of playing one of the most popular VR exergames for 10 and 50 min on aspects of vision, cognition, and self-reported VR sickness. </sec> <sec> <title>METHODS</title> A total of 36 participants played an exergame, called Beat Saber, using an HMD. A repeated measures within-subject design was conducted to assess changes in vision, cognition, and well-being after short (10 min) and long (50 min) durations of VR exposure. We measured accommodation, convergence, decision speed, movement speed, and self-reported sickness at 3 test periods—before VR, immediately after VR, and 40 min after VR (late). </sec> <sec> <title>RESULTS</title> Beat Saber was well tolerated, as there were no dropouts due to sickness. For most participants, any immediate aftereffects were short-lived and returned to baseline levels after 40 min of exiting VR. For both short and long exposures, there were changes in accommodation (&lt;i&gt;F&lt;/i&gt;&lt;sub&gt;1,35&lt;/sub&gt;=8.424; &lt;i&gt;P&lt;/i&gt;=.006) and convergence (&lt;i&gt;F&lt;/i&gt;&lt;sub&gt;1,35&lt;/sub&gt;=7.826; &lt;i&gt;P&lt;/i&gt;=.008); however, in the late test period, participants returned to baseline levels. Measures on cognition revealed no concern. The total simulator sickness questionnaire (SSQ) scores increased immediately after VR (&lt;i&gt;F&lt;/i&gt;&lt;sub&gt;1,35&lt;/sub&gt;=26.515; &lt;i&gt;P&lt;/i&gt;&amp;lt;.001) and were significantly higher for long compared with short exposures (&lt;i&gt;t&lt;/i&gt;&lt;sub&gt;35&lt;/sub&gt;=2.807; &lt;i&gt;P&lt;/i&gt;=.03), but there were no differences in exposure duration in the late test period, with scores returning to baseline levels. Although at a group level, participants’ sickness levels returned to baseline 40 min after VR exposure, approximately 14% of the participants still reported high levels of sickness in the late test period after playing 50 min of Beat Saber. We also showed that the participants who experienced a high level of sickness after a short exposure were almost certain to experience a high level of symptoms after a longer exposure. </sec> <sec> <title>CONCLUSIONS</title> Irrespective of the duration of exposure, this study found no strong evidence for adverse symptoms 40 min after exiting VR; however, some individuals still reported high levels of VR sickness at this stage. We recommend that users commit to a waiting period after exiting VR to ensure that any aftereffects have deteriorated. Exergames in HMDs have the potential to encourage people to exercise but are understudied, and the aftereffects of exergaming need to be closely monitored to ensure that VR exergames can reach their full potential. </sec> <sec> <title>CLINICALTRIAL</title> <p /> </sec>