# Augmented Reality and Virtual Reality in Exergaming
## 4 Discussion
### Related Studies Analysis  
Furthermore, to obtain a better understanding of the impact of AR and VR in exergaming, the studies, which received the most citations and are showcased in Table 6, are further examined. [PERSON] et al. (2019) investigated whether aerobic exercise could be safely and effectively performed at home by people with mild Parkinson's disease through the use of a VR exergame intervention. Participants in the intervention group used a stationary bike equipped with virtual environments and real-life video simulations to create an exergaming experience. Based on their results, the participants who exercised within the immersive environment showed a greater improvement in motor symptoms compared to those who performed traditional stretching exercises. While some participants experienced mild or unrelated side effects, the intervention was generally safe. The study suggested that home-based exercise through the use of VR exergames can constitute a feasible and promising option. [PERSON] et al. (2018) examined the use of VR exergames to enhance older adults' cognition. The study revealed that older adults who used VR exergaming showed better brain function and mental flexibility compared to those doing regular exercise. The improvement in cognitive performance seemed linked to changes in brain chemistry that support brain health. These users were also less likely to show early signs of memory decline. The outcomes of the study suggest that combining physical and mental activity through VR exergames may be more effective than traditional exercise alone for supporting brain health in older adults. Focusing on VR, [PERSON] et al. (2017) examined how VR exergames can influence older adults' rehabilitation and exercise by analyzing 60 related studies. The study revealed that mostly commercially available solutions are adopted and that safety measures are used during interventions. Based on their outcomes, no serious adverse events were observed; however, few studies commented upon the existence of adverse events. Based on their outcomes, the use of VR exergames resulted in positive outcomes in terms of the participants' gait and balance while, simultaneously, no negative effects were reported. Nonetheless, the PEDro classification revealed that the examined studies had several methodological limitations. Hence, the study pointed out the need for more experimental studies to occur that use robust and well-defined guidelines to successfully establish the use of VR exergames as part of older adults' rehabilitation and exercise. [PERSON] et al. (2018) explored how gameful approaches, including VR and exergames, are being used to support mental health. They highlighted that these formats are among the key categories of applied games with promising potential for therapeutic benefit. Their findings suggested that such interventions can utilize game mechanics to enhance user engagement and may facilitate positive psychological outcomes. However, the authors also emphasized the need for further research to better understand their effectiveness and to compare them with traditional approaches. [PERSON] et al. (2018) examined the use of VR telerehabilitation to improve balance and mobility in people with [PERSON]'s disease. Participants in the VR group trained at home using exergames with remote supervision, while a comparison group received traditional in-clinic balance training. Both groups showed overall improvements, but the VR group made greater gains in balance, while the in-clinic group showed more improvement in gait performance. These findings suggest that home-based VR exergame training can be a practical and cost-effective option for enhancing balance and mobility in [PERSON]'s patients, particularly when caregiver support is available. Focusing on improving older adults' physical functioning, [PERSON] et al. [114] conducted a systematic literature review of 13 related studies. In their study, they examined the most commonly used exergame interventions and assessment instruments.