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Item Exploring actual and perceived levels of physical activity intensity during virtual reality active games(Frontiers Media, 2024-02-09) Naugle, Keith E.; Cervantes, Xzaliya A.; Boone, Carolyn L.; Wind, Brandon; Naugle, Kelly M.; Exercise & Kinesiology, School of Health and Human SciencesBackground: Research suggests that engaging in active virtual reality (VR) video games can elicit light to moderate levels of physical activity (PA), making it a novel and fun mode of exercise. Further research is needed to understand the influence of VR on perceptions of exertion and enjoyment during PA. Objective: The objectives of this study are (1) to compare actual and perceived exertion within and between active VR games with varying levels of difficulty and (2) to determine how playing active VR games influences PA enjoyment during gameplay. Methods: A total of 18 participants completed four separate study sessions, during which they engaged in either a 15-min bout of traditional exercise (stationary cycling) or played one VR game. Heart rate (HR) and ratings of perceived exertion (RPE) using the Borg CR10 scale were assessed during VR gameplay and cycling. Enjoyment was measured after gameplay. VR games included playing Holopoint at level 2 and level 3 and Hot Squat. Repeated measures ANOVAs were used to examine (1) changes in HR and RPE across time within games and (2) differences in actual and perceived levels of intensity and enjoyment between games. Bivariate correlations examined the relationship between the degree of change in actual intensity and the degree of change in perceived intensity during each VR game and cycling. Results: The analyses revealed that RPE and HR significantly increased from baseline during each condition and generally increased across the 15-min of gameplay. Hot Squat and cycling elicited a significantly higher percentage of heart rate reserve (%HRR) than Holopoint at levels 2 and 3. Holopoint level 3 elicited a higher %HRR than Holopoint level 2. The participants reported greater average and max RPE during Hot Squat and cycling compared with Holopoint at levels 2 and 3. The correlations revealed a significant positive correlation between the degree of change in HR and RPE for cycling, but no significant correlations were observed for any of the VR conditions. The physical activity during Holopoint at both levels was rated as more enjoyable than Hot Squat and cycling. Conclusion: Our data support the notion that VR has the potential to alter individuals' perceptions of exertion during PA and, in particular, may reduce their awareness of increases in actual exertion.Item Relationship between exercise intensity and stress levels among U.S. medical students(Taylor & Francis, 2022-12) Leuchter, Richard K.; Stuber, Margaret L.; McDonald, Austin L.; Croymans, Daniel M.; Emergency Medicine, School of MedicineBackground: Physical activity may protect the mental health of medical students, yet it is unknown which types and intensities of physical activity have the greatest potential to improve medical student well-being. Objective: We characterize the relationship between exercise intensity and stress levels of U.S. medical students, thereby informing the design of future well-being interventions. Design: Two cross-sectional validated surveys assessing stress and physical activity were administered one year apart at the David Geffen School of Medicine at UCLA. A total of 1,046 out of 1,392 medical students responded (75%). An ordered logistic regression was used to determine the association between stress and each level of exercise intensity (inactivity, moderate-activity, and health-enhancing physical activity [HEPA]). These exercise intensity groupings were compared to the CDC guidelines for aerobic exercise. Results: While achieving either moderate-activity or HEPA is compliant with the CDC guidelines for aerobic exercise, the additional intensity of exercise required to achieve HEPA was associated with a 26% increase in the probability of being in the lowest stress quartile and a 22% decrease in the probability of being in the highest stress quartile. Medical student physical activity levels were on-par with the national average per the CDC exercise guidelines (65% vs. 58%), but medical student HEPA levels were significantly lower than the national average (27% vs. 64%; OR 0.21; 95% CI 0.12-0.37). Conclusions: There is a large disparity in rates of the highest intensity physical activity (HEPA) between medical students and the age-adjusted national average, which has previously been overlooked by the binary CDC exercise guidelines. The fact that HEPA levels are not optimized and more strongly associated with lower stress levels relative to less intense forms of exercise makes it a promising new target for future well-being interventions among medical trainees.