Autonomic Nervous System Assessment During Physical Rehabilitation Serious Game

This study is aimed to analyze the correlations between heart rate variability (HRV) and a virtual reality (VR) serious game for physical rehabilitation. The possibility to use serious exergames as tools of ambient assisted living to promote physical activities during the COVID-19 pandemic lock-down period is considered appropriate to enhance patients' engagement in physical rehabilitation exercises performed at home. The analyzed data in this study provides HRV information collected from a small group of healthy volunteers that participated in two gameplay sessions of the VR serious exergame. Two levels of difficulty were considered. HRV parameters were calculated from the analysis of electrocardiograms (ECG) for an imposed protocol characterized by three different periods (rest, play and rest) The HRV analysis was based on time-domain and frequency-domain methods and the experimental results showed significant changes associated with different game sessions. Higher values of HF components and RMSSD were obtained for a less physical demanding gameplay session, whereas the predominance of LF components was observed for the game session with high level of difficulty. These findings suggested that this serious game had an important impact on both physical and cognitive stimulation, and therefore its implementation in home-based assisted environments can help increase weekly performance of physical activity, enhance balance and limbs mobility, help to reduce anxiety levels, and maintain high levels of HRV.