Virtual Exercise in Medicine: A Proof of Concept in a Healthy Population.

BACKGROUND: Science is beginning to establish the benefits of the use of virtual reality (VR) in health care. This therapeutic approach may be an appropriate complementary treatment for some mental illnesses. It could prevent high levels of morbidity and improve the physical health of patients. For many years, the literature has shown the health benefits of physical exercise. Physical exercise in a VR environment may improve the management of mild to moderate mental health conditions. In this context, we developed a virtual environment combined with an ergocycle (the augmented physical training for isolated and confined environments [APTICE] system). OBJECTIVE: This study aims to investigate the impact of physical exercise in a VR environment. METHODS: A total of 14 healthy participants (11 men and 3 women; mean age 43.28, SD 10.60 years) undertook 15 minutes of immersive physical exercise using the system. Measures included mindfulness and immersion disposition, subjective perceptions of sensory information, user experience, and VR experience (ie, psychological state, flow, and presence). RESULTS: First, the APTICE system appears to be a useful tool because the user experience is positive (subscales in the AttrakDiff questionnaire: pragmatic quality=0.99; hedonic quality-stimulation=1.90; hedonic quality-identification=0.67; attractiveness=1.58). Second, the system can induce a positive psychological state (negative emotion, P=.06) and an experience of flow and presence (P values ranging from <.001 to .04). Third, individual immersive and mindful disposition plays a role in the VR experience (P values ranging from <.02 to .04). Finally, our findings suggest that there is a link between the subjective perception of sensory information and the VR experience (P values ranging from <.02 to .04). CONCLUSIONS: These results indicate that the device is well accepted with positive psychological and exteroceptive outcomes. Overall, the APTICE system could be a proof of concept to explore the benefits of virtual physical exercise in clinical medicine.

Is Regular Physical Activity Practice During a Submarine Patrol an Efficient Coping Strategy?

Introduction: A nuclear-powered ballistic missile submarine (SSBN) is a singular professional environment, exposing personnel to isolation and confinement amidst sophisticated technology for the duration of a mission. Submariners see their mood and cognition deteriorate as their mission progresses. With regard to the benefits of physical activity (PA) on mental health, this study evaluates the impact of regular PA on the maintenance of thymia and sensory functioning during patrols. Method: This pragmatic exploratory cohort follow-up study included 29 volunteer submariners before, during and 1 month after return from patrol. PA practice was evaluated by a daily self-questionnaire. This allowed submariners to be classified into two groups according to the median of the total duration in minutes of a sport practiced during the patrol (PA practicing submariners and non-practicing). Changes in mood and psychological activation, health (including sleep), unipodal stability, and accommodation distances were compared between the two groups over the period of the patrol. Results: Overall thymic functioning deteriorated during the patrol. Submariners who practice PA maintain a stable level of activation unlike non-practicing PA submariners, but they exhibited both worse general health and sleep at recovery. For these personnel, postural control is better at the end of the patrol and far visual accommodation tends to be preserved. Conclusion: PA during patrol alone is not sufficient to compensate for the thymic dysregulation induced by the SSBN environment. Nevertheless, it seems to help in maintaining an exteroceptive functioning. This exploratory study suggests directions for possible future research on physical activity associated with sensory stimulation amongst submariners, and more generally amongst people working in isolated and confined environments.

Subsurface Confinement: Evidence from Submariners of the Benefits of Mindfulness.

OBJECTIVES: The subsurface ballistic missile nuclear submarine (SSBN) is an extreme professional environment in which personnel are both isolated and confined during patrols, which can last longer than 2 months. This environment is known to degrade submariners' mood and cognition. METHODS: This exploratory, empirical study followed a cohort of 24 volunteer submariners. Dispositional mindfulness was assessed with the Freiburg Mindfulness Inventory, in order to identify two groups (mindful and non-mindful) and compare change in emotional state, interoception, and health behaviors during the patrol. RESULTS: Overall, psychological health deteriorated during the patrol. However, mindful submariners demonstrated better psychological adaptation and interoception than the non-mindful group. This was associated with better subjective health behaviors (sleeping and eating). CONCLUSIONS: Dispositional mindfulness appears to protect against the negative effects of long-term containment in a professional environment, such as a submarine patrol. Our work highlights that mindfulness may help individuals to cope with stress in such situations. Developing mindfulness could also be an important preventive healthcare measure during quarantine imposed by the outbreak of a serious infectious disease.

Mindfulness, Interoception, and Olfaction: A Network Approach.

The fine-tuned interplay between the brain and the body underlies the adaptive ability to respond appropriately in the changing environment. Mindfulness Disposition (MD) has been associated with efficient emotional functioning because of a better ability to feel engaged by information from the body and to notice subtle changes. This interoceptive ability is considered to shape the ability to respond to external stimuli, especially olfaction. However, few studies have evaluated the relationships between interoception and exteroception according to MD. We conducted an exploratory study among 76 healthy subjects for first investigating whether MD is associated with better exteroception and second for describing the causal interactions network between mindfulness, interoception, emotion, and subjective and objective olfaction assessments. Results found that a high level of MD defined by clustering exhibited best scores in positive emotions, interoception, and extra sensors' acuity. The causal network approach showed that the interactions between the interoception subscales differed according to the MD profiles. Moreover, interoception awareness is strongly connected with both the MD and the hedonic value of odors. Then, differences according to MD might provide arguments for a more mindful attention style toward interoceptive cues in relation to available exteroceptive information. This interaction might underlie positive health.