The effect of active virtual reality gaming on physical activity behaviour and mental health in young men with mild to moderate depressive symptoms: a randomised controlled feasibility trial

TL;DR

A study found that active virtual reality gaming can boost physical activity and improve mental health in young men with mild to moderate depression.

Contribution

This is the first feasibility trial showing that home-based active virtual reality gaming increases physical activity and reduces depressive symptoms in young men.

Findings

High recruitment and retention rates were achieved in the trial.

Participants showed significant reductions in depression and stress scores.

Physical activity levels increased, with half meeting national guidelines by the end of the trial.

Abstract

Physical activity (PA) benefits mental health, yet uptake and adherence are challenging, particularly for those affected by depression. Active virtual reality gaming (AVRG) may provide an engaging route to increase PA.

To investigate the feasibility and acceptability of AVRG for increasing PA engagement and adherence in young men, and to explore effects on mental-health–related outcomes.

In a randomised controlled feasibility trial (n = 30), physically inactive males aged 18–29, reporting mild to moderate depressive symptoms were allocated to Active AVRG (n = 14) or Waitlist (WL) control (n = 16). The intervention ran for 8 weeks with a 4-week post-trial follow-up. Exploratory analysis of secondary outcomes compared pre- and post-AVRG scores using paired t-test (normal), or Wilcoxon Signed-Rank test (non-normal); correlations used Pearson’s or Spearman’s coefficients.

Both the feasibility and acceptability criteria were met with 67% of potentially eligible participants, and 100% of those who booked phone screening randomised and enrolled. Retention was high, with 93.3% completing the study, and 87.5% completing all data collection measures. Exploratory analysis of secondary outcomes, showed a significant reduction in both Patient Health Questionnaire- 9 (PHQ-9) scores mean difference (MD) −2.82, (p = 0.006) and Depression, Anxiety and Stress Scale- 21 (DASS-21) stress scores MD −3.56 (p = 0.049) over the intervention period, as well as a very strong (p = 0.001) negative correlation (r =–0.57) between PHQ-9 score and number of sessions, a strong (p = 0.01) negative correlation between PHQ-9 and number of sessions > 30 mins. In addition, a moderate (p = 0.03) negative correlation (r =–0.43) was found between post-intervention DASS-21 Depression score and number of sessions > 30 mins. PA increased over the course of the intervention with none of the participants meeting the Australian National PA Guidelines at baseline, increasing to 50% at end of trial.

This study found that a home-based AVRG intervention was feasible, acceptable, and safe for young men with mild–moderate depressive symptoms, with high recruitment, retention, and adherence. Exploratory findings indicate improvements in PA and favourable changes in mental-health measures. These results support progression to a fully powered trial.

This trial was registered with the Australia and New Zealand Clinical Trials Register (approved 22/12/2020, Registration number: ACTRN12620001372976).

The online version contains supplementary material available at 10.1186/s12888-026-07904-6.

Figures