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Vol. LXII, No. 21
October 15, 2010

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Enter ‘Exer-gaming’
Can Virtual Reality Help Improve Public Health?

Virtual reality technologies aren’t just for recreation anymore. They have the potential to assist in positive health and lifestyle changes.

NIH recently held “Virtual Reality Technologies for Research and Education in Obesity and Diabetes,” a conference to discuss use of these technologies to address the obesity and diabetes epidemics.

Sponsored by several NIH components— NHLBI, NCI, NIDDK, NICHD, the Office of Research on Women’s Health and the Office of Behavioral and Social Sciences Research—and the Department of Defense’s Telemedicine and Advanced Technology Research Center in Frederick, Md., the conference brought together obesity and diabetes researchers with experts who develop and use virtual reality (VR) technologies for other applications.

America’s obesity and diabetes epidemics have become pressing public health concerns. With plate sizes growing and physical activity shrinking, it is increasingly important to understand what constitutes a healthy portion size and the nutritional content of the foods we consume.

Boy playing virtual video game

Dr. Geri Gay of Cornell University developed a game in which participants receive a cell phone and then select an avatar (a graphical computerized representation of a person or animal) that appears on the phone. Participants sent pictures, via cell phone, back to analysts who monitored the content and quantity of each participant’s diet. The avatar’s “mood” changed in response to the quality of the individual’s eating habits. For example, eating nutritious food produced a happy avatar, whereas poor eating habits yielded an unhappy avatar. Virtual reality enabled these participants to receive immediate positive reinforcement for their healthy eating habits, rather than dieting and having to wait 4 to 6 weeks to see a physical change.

In a system developed by Dr. Rachel Jones of the University of Utah College of Health, consumers navigate their way through a virtual grocery store where they can learn various facts about the foods they have selected, such as nutrients and water content. Jones explains, “This allows [for] a non-threatening environment to explore nutrients and foods.”

Her shopping simulation encourages consumers to pay attention to what they select and introduces new or forgotten foods. It’s a way for people to begin “adopting habits because it’s a no-pressure situation,” and can offer information that a real grocery store does not provide.

Virtual reality technology has even created a new lexicon. For example, the combination of exercise and virtual reality is called “exer-gaming.”

Presenter Dr. Ernie Medina of Medplay Technologies in Loma Linda, Calif., uses virtual reality games to engage kids who do not participate in traditional physical activity. “These kids don’t look at physical activity and exercise as fun,” he said, explaining that exer-gaming is another way to get children moving and exerting themselves without realizing they are exercising.

However, Medina clarifies, “Exer-gaming is not the same as being distracted from how boring [traditional] exercise is.” It has the added components of playfulness and challenge that appeal to most children.

Virtual reality has also provided access to a population that researchers and clinicians had difficulty reaching before.

Rehabilitation is another area in which virtual reality can motivate patients. In the future, physical therapy programs could be brought into homes through VR systems. This added convenience for patients might improve adherence to therapy routines. Virtual reality is also creating other worlds, other universes in which people—though physically thousands of miles apart—can interact. In addition to providing a place where like-minded people can find one another, these worlds offer another setting to implement behavioral interventions.

Dr. Walter Greenleaf of InWorld Solutions explains that virtual worlds can be used for a variety of issues ranging from treating post-traumatic stress disorder (PTSD) to teaching social skills to people with Asperger syndrome or even providing therapy for children who have been abused. The worlds can be manipulated to provide more realistic stimuli than role play or discussions of hypothetical situations.

The “Coming Home” project led by Dr. Jackie Morie of the University of Southern California addresses PTSD. In this project soldiers returning from combat use a virtual island to relax, enjoy enrichment activities and interact with others whose problems are similar. Such a virtual environment could also provide a sense of community, with social support and resources, for those with diabetes or obesity.

Organized by NHLBI’s Dr. Abby Ershow and co-chairs Drs. Skip Rizzo of the University of Southern California and Brian Wansink of Cornell University, the meeting showed that whether the problem is health, fitness or addiction, virtual reality can provide the motivation, means and foundation for healthy lifestyle changes.NIHRecord Icon

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