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Z3VR is proposing the development of a virtual reality (VR) game that is capable of enhancing pre-existing physical maintenance routines, managing stress, and serving as a behavioral health countermeasure. We hypothesize that we can enhance the benefits of meditative respiration and exercise through visual biofeedback loops in integrated VR environments.

We plan to design an adaptive application with two complementary modules (exercise and meditation) built to enhance conscious control of the autonomic nervous system. The game will use real time biometric data (heart rate and respiration rate) to influence key game play properties (interactable objects, "non-playable character" (NPC) behavior, difficulty, intensity, lighting). In the exercise module, users will perform physically challenging tasks in order to increase their heart rate into a desired range. A user's ability to modulate their own heart rate will influence their performance in this module. Exercise is an effective tool for managing stress, anxiety, and depression (Paolucci et al., 2018, Gujral et al., 2017, and Craft and Perna, 2004). VR enables exercise variety, which has been shown to be an important factor in the adherence of physical maintenance routines. VR has also been shown to enhance the overall performance and impact of physical exercise (Gujral et al., 2017), and amplifies it s mood-boosting benefits. In the meditation module the game will use respiration rate data gathered from a microphone built into a VR head-mounted-display (HMD) in order to facilitate the optimal meditation session. In this module the properties of the user's environment (color palette, saturation, etc.). Specifically, the game will provide visual and auditory feedback toward successfully lowering heart rate. The game will also track the sessions of each individual player over time. The player's history and personalization preferences (e.g., target heart rate, session length) will be used to determine the difficulty and scoring of each session.

Paolucci T, Attanasi C, Cecchini W, Marazzi A, Capobianco SV, Santilli V. Chronic low back pain and postural rehabilitation exercise: a literature review. J Pain Res. 2018;12:95-107. Published 2018 Dec 20. https://doi.org/10.2147/JPR.S171729

Gujral S, Aizenstein H, Reynolds CF 3rd, Butters MA, Erickson KI. Exercise effects on depression: Possible neural mechanisms. Gen Hosp Psychiatry. 2017;49:2-10. https://doi.org/10.1016/j.genhosppsych.2017.04.012

Craft LL, Perna FM. The benefits of exercise for the clinically depressed. Prim Care Companion J Clin Psychiatry. 2004;6(3):104-111. https://doi.org/10.4088/pcc.v06n0301

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