Exploring the Integration of Immersive Virtual Reality With Adapted Neuromuscular Stimulation Rowing for Individuals With Spinal Cord Injury.

People with a spinal cord injury (SCI) are more susceptible to adopting a sedentary lifestyle, which increases the risk for further health complications such as cardiovascular disease. Exercise has proven beneficial for the improvement of overall health; however, options can be limited following SCI, especially for engaging paralyzed muscles. Using neuromuscular electrical stimulation (NMES) to produce contractions of the paralyzed musculature following SCI is one strategy for increasing physical work during exercise, but NMES can be disengaging. Previous reports indicate that the introduction of virtual reality games to exercise has the potential to improve perception, adherence, and physiological responses to exercise programs. Two individuals with complete paraplegia completed 4 bouts of NMES hybrid rowing exercise for 2 separate conditions, without VR and using an immersive VR task-oriented game. Cardiovascular measurements, rowing metrics, and ratings of engagement and perceived effort were collected. A tendency for a higher exercising heart rate was observed during the VR condition, which aligned with a higher perception of exercise effort. These pilot data suggest a tendency for increased cardiovascular response during VR exercise, which warrants further investigation in a larger trial to better understand the acute and chronic cardiovascular, metabolic, and exercise adherence impacts over time.