Development and Evaluation of Virtual Reality Heart Rate Variability Biofeedback Application

Abstract: Background: Reduced heart rate variability is an important factor in evaluation of autonomic nervous system and diseases. Resonance frequency breathing is a non-invasive and effective training method for increasing heart rate variability. Turing this breathing exercise into a video game is an efficient way to reduce training time and vapidity. Though there has been a successful implementation in 3D game, the influence of virtue reality technology application and interaction elements still need to be explored. Objective: The main objective is to build and evaluate the virtue reality game. Applying appropriate game design and interaction elements will also be discussed. The correct and efficient training should be ensured. Also, recognizing the relationship between game elements and efficiency is also included in the task. By evaluating the impact in heart rate variability biofeedback, the understanding of breathing training game design will be broadened and deepened. Methods: A 3D virtue reality running game is designed with biofeedback framework. Development process is conducted in a user-centred way with interface test. The summative evaluation will be performed 10 participants in a controlled setting. (participant age and health state) Each participant will fill a post-test questionnaire about game experience. The sensor data will be stored on local device. Qualitative analyse of data will be done. Results: VR environment game has shown more significant effects in helping increase heart rate variability than normal game (P<0.05). Both modes have shown more than 50% increase in standard deviation of heart rate variability. A high immersion and positive effects along was reported by a Game Experience Questionnaire. Conclusion: The results have shown that the VR game has the potential to help increase HRV via the resonance breathing training. The game can also allow long-term study by increasing the motivation of participants. Evaluation with GEQ are presented, which will give insights about the usability of this game. Additionally, the new tracks for future study have been explored.