{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T20:21:27Z","timestamp":1778617287732,"version":"3.51.4"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Indepandent Research Projects of Logistics Research","award":["CWX23J016"],"award-info":[{"award-number":["CWX23J016"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    This study aimed to evaluate the efficacy of a virtual reality (VR)-based bicycle exercise in psychological distress (depression and anxiety) and selected biochemical parameters among patients receiving maintenance hemodialysis (MHD). A total of 70 patients from the dialysis station at Changzhou Medical District of the No. 904th Hospital were randomly allocated into study group(VR-based bicycle exercise, n\u2009=\u200935) and control group(routine nursing care, n\u2009=\u200935). The depression and anxiety levels were assessed by Self-rating Depression Scale (SDS), and Self-rating Anxiety Scale (SAS) respectively. Physiological indicators, including serum creatinine (Scr) and blood urea nitrogen (BUN) levels, were also analyzed. Following the intervention, the study group exhibited significant reductions in SDS and SAS scores (both\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.05). The levels of Scr and BUN in peripheral blood were also observed to be significantly decreased in study group (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.05). Correlation analysis revealed a significant positive correlation between SAS\/SDS scores with both Scr and BUN levels (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.05 or\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.01). Furthermore, regression models identified SAS scores as significant predictors of Scr and BUN levels, accounting for 27.8% and 31.9% of their variance, respectively (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.05 or\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.01). VR-based bicycle exercise can improve psychological well-being, and was associated with beneficial changes in pre-dialysis serum biomarkers (Scr and BUN) in MHD patients. This integrated intervention represents a promising non-pharmacological strategy to complement standard care in MHD patients.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-42972-4","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T19:59:04Z","timestamp":1778615944000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the psychological and physiological effects of a virtual reality-based bicycle exercise in hemodialysis patients: a randomized controlled trial"],"prefix":"10.1038","volume":"16","author":[{"given":"Jing","family":"Hu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheng","family":"Gong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingjing","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juanjuan","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoli","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lixia","family":"Yan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haoyue","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"issue":"15","key":"42972_CR1","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.1001\/jama.2024.0535","volume":"331","author":"CE Lok","year":"2024","unstructured":"Lok, C. E., Huber, T. S., Orchanian-Cheff, A. & Rajan, D. K. Arteriovenous access for hemodialysis: A review. JAMA 331(15), 1307\u20131317. https:\/\/doi.org\/10.1001\/jama.2024.0535 (2024).","journal-title":"JAMA"},{"issue":"4","key":"42972_CR2","first-page":"164","volume":"29","author":"Y Weng","year":"2023","unstructured":"Weng, Y. et al. Effects of high-flux hemodialysis with narrative care on clinical efficacy and prognostic quality of life of patients with chronic renal failure. Altern. Ther. Health Med. 29(4), 164\u2013169 (2023).","journal-title":"Altern. Ther. Health Med."},{"issue":"1","key":"42972_CR3","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1159\/000543214","volume":"50","author":"Z Fan","year":"2025","unstructured":"Fan, Z. et al. Serum irisin levels are positively correlated with physical activity capacity in hemodialysis patients. Kidney Blood Press. Res. 50(1), 105\u2013114. https:\/\/doi.org\/10.1159\/000543214 (2025).","journal-title":"Kidney Blood Press. Res."},{"key":"42972_CR4","doi-asserted-by":"publisher","first-page":"1721","DOI":"10.2147\/JMDH.S503669","volume":"18","author":"L Zhang","year":"2025","unstructured":"Zhang, L., Zhang, S. & Tang, X. The association between lifestyle and all-cause mortality in patients undergoing maintenance hemodialysis: A 3-year prospective, observational study. J. Multidiscip. Healthc. 18, 1721\u20131729. https:\/\/doi.org\/10.2147\/JMDH.S503669 (2025).","journal-title":"J. Multidiscip. Healthc."},{"issue":"4","key":"42972_CR5","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1097\/PHM.0000000000002348","volume":"103","author":"X Lu","year":"2024","unstructured":"Lu, X. et al. Effect of exercise on fatigue in patients receiving maintenance hemodialysis treatment: A systematic review and network meta-analysis. Am. J. Phys. Med. Rehabil. 103(4), 293\u2013301. https:\/\/doi.org\/10.1097\/PHM.0000000000002348 (2024).","journal-title":"Am. J. Phys. Med. Rehabil."},{"issue":"3","key":"42972_CR6","first-page":"503","volume":"31","author":"P Amici","year":"2019","unstructured":"Amici, P. The humor in therapy: The healing power of laughter. Psychiatr. Danub. 31(3), 503\u2013508 (2019).","journal-title":"Psychiatr. Danub."},{"issue":"11","key":"42972_CR7","first-page":"1310","volume":"57","author":"L Ye","year":"2022","unstructured":"Ye, L. et al. Effects of virtual reality-based interventions on reducing preoperative anxiety in adult patients: A meta-analysis. Chin. J. Nurs. 57(11), 1310\u20131323 (2022).","journal-title":"Chin. J. Nurs."},{"issue":"2","key":"42972_CR8","first-page":"230","volume":"57","author":"KR Wang","year":"2022","unstructured":"Wang, K. R. et al. The effect of immersive virtual reality cognitive training on patients with cognitive impairment: A systematic review. Chin. J. Nurs. 57(2), 230\u2013236 (2022).","journal-title":"Chin. J. Nurs."},{"issue":"11","key":"42972_CR9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0311113","volume":"19","author":"W Liu","year":"2024","unstructured":"Liu, W., McDonough, D. J. & Gao, Z. Comparing college students\u2019 mood states among immersive virtual reality, non-immersive virtual reality, and traditional biking exercise. PLoS ONE 19(11), e0311113. https:\/\/doi.org\/10.1371\/journal.pone.0311113 (2024).","journal-title":"PLoS ONE"},{"key":"42972_CR10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctcp.2022.101669","volume":"49","author":"JS Brito","year":"2022","unstructured":"Brito, J. S. et al. Bicycle ergometer exercise during hemodialysis and its impact on quality of life, aerobic fitness and dialysis adequacy: A pilot study. Complement. Ther. Clin. Pract. 49, 101669. https:\/\/doi.org\/10.1016\/j.ctcp.2022.101669 (2022).","journal-title":"Complement. Ther. Clin. Pract."},{"issue":"1","key":"42972_CR11","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-39709-y","volume":"13","author":"A Turo\u0144-Skrzypi\u0144ska","year":"2023","unstructured":"Turo\u0144-Skrzypi\u0144ska, A. et al. Impact of virtual reality exercises on anxiety and depression in hemodialysis. Sci. Rep. 13(1), 12435. https:\/\/doi.org\/10.1038\/s41598-023-39709-y (2023).","journal-title":"Sci. Rep."},{"issue":"1","key":"42972_CR12","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-58522-9","volume":"14","author":"RN Moorthi","year":"2024","unstructured":"Moorthi, R. N. et al. Plasma metabolites and physical function in patients undergoing hemodialysis. Sci. Rep. 14(1), 8427. https:\/\/doi.org\/10.1038\/s41598-024-58522-9 (2024).","journal-title":"Sci. Rep."},{"issue":"1","key":"42972_CR13","doi-asserted-by":"publisher","first-page":"154","DOI":"10.62641\/aep.v53i1.1628","volume":"53","author":"S Yan","year":"2025","unstructured":"Yan, S. et al. Psychological intervention for depression and anxiety in hemodialysis patients: A meta-analysis. Actas Esp. Psiquiatr. 53(1), 154\u2013164. https:\/\/doi.org\/10.62641\/aep.v53i1.1628 (2025).","journal-title":"Actas Esp. Psiquiatr."},{"issue":"2","key":"42972_CR14","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.78921","volume":"17","author":"R Shaik","year":"2025","unstructured":"Shaik, R. et al. Neuroendocrine effects of short-bout aerobic exercises in individuals with alcohol use disorder: A quasi-experimental study. Cureus 17(2), e78921. https:\/\/doi.org\/10.7759\/cureus.78921 (2025).","journal-title":"Cureus"},{"issue":"3","key":"42972_CR15","doi-asserted-by":"publisher","first-page":"62","DOI":"10.12677\/ap.2025.153129","volume":"15","author":"HY Wang","year":"2025","unstructured":"Wang, H. Y. et al. Effectiveness of virtual reality technology on exercise adherence on maintenance hemodialysis patients during dialysis. Adv. Psychol. 15(3), 62\u201368. https:\/\/doi.org\/10.12677\/ap.2025.153129 (2025).","journal-title":"Adv. Psychol."},{"issue":"3","key":"42972_CR16","doi-asserted-by":"publisher","first-page":"588","DOI":"10.3904\/kjim.2017.020","volume":"34","author":"SY Rhee","year":"2019","unstructured":"Rhee, S. Y. et al. Intradialytic exercise improves physical function and reduces intradialytic hypotension and depression in hemodialysis patients. Korean J. Intern. Med. 34(3), 588\u2013598. https:\/\/doi.org\/10.3904\/kjim.2017.020 (2019).","journal-title":"Korean J. Intern. Med."},{"issue":"2","key":"42972_CR17","first-page":"317","volume":"13","author":"J Wu","year":"2020","unstructured":"Wu, J. et al. Coexistence of micro-inflammatory and macrophage phenotype abnormalities in chronic kidney disease. Int. J. Clin. Exp. Pathol. 13(2), 317\u2013323 (2020).","journal-title":"Int. J. Clin. Exp. Pathol."},{"issue":"3","key":"42972_CR18","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1016\/j.jshs.2024.02.002","volume":"13","author":"B Luo","year":"2024","unstructured":"Luo, B. et al. The anti-inflammatory effects of exercise on autoimmune diseases: A 20-year systematic review. J. Sport Health Sci. 13(3), 353\u2013367. https:\/\/doi.org\/10.1016\/j.jshs.2024.02.002 (2024).","journal-title":"J. Sport Health Sci."},{"issue":"2","key":"42972_CR19","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1589\/jpts.34.110","volume":"34","author":"M Noguchi","year":"2022","unstructured":"Noguchi, M. et al. Effects of an additional resistance training intervention in hemodialysis patients performing long-term ergometer exercise during dialysis. J. Phys. Ther. Sci. 34(2), 110\u2013114. https:\/\/doi.org\/10.1589\/jpts.34.110 (2022).","journal-title":"J. Phys. Ther. Sci."},{"issue":"15","key":"42972_CR20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1017\/S0033291724002381","volume":"54","author":"X Huang","year":"2024","unstructured":"Huang, X. et al. Association of cardiovascular-kidney-metabolic health and social connection with the risk of depression and anxiety. Psychol. Med. 54(15), 1\u20139. https:\/\/doi.org\/10.1017\/S0033291724002381 (2024).","journal-title":"Psychol. Med."},{"key":"42972_CR21","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1009-587X.2025.01.010","author":"ML Cao","year":"2025","unstructured":"Cao, M. L. et al. Analysis of influencing factors for anxiety in patients with chronic kidney disease: A multicenter study in inner Mongolia. Chin. J. Integr. Trad. West Med. Nephrol. https:\/\/doi.org\/10.3969\/j.issn.1009-587X.2025.01.010 (2025).","journal-title":"Chin. J. Integr. Trad. West Med. Nephrol."},{"key":"42972_CR22","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.1016578","volume":"13","author":"L Ge","year":"2022","unstructured":"Ge, L. et al. Psychological stress in inflammatory bowel disease: Psychoneuroimmunological insights into bidirectional gut-brain communications. Front. Immunol. 13, 1016578. https:\/\/doi.org\/10.3389\/fimmu.2022.1016578 (2022).","journal-title":"Front. Immunol."},{"issue":"6","key":"42972_CR23","doi-asserted-by":"publisher","first-page":"889","DOI":"10.2215\/CJN.18441120","volume":"16","author":"Z Zhang","year":"2021","unstructured":"Zhang, Z. et al. Association of depressive symptoms with rapid kidney function decline in adults with normal kidney function. Clin. J. Am. Soc. Nephrol. 16(6), 889\u2013897. https:\/\/doi.org\/10.2215\/CJN.18441120 (2021).","journal-title":"Clin. J. Am. Soc. Nephrol."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-42972-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-42972-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-42972-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T19:59:06Z","timestamp":1778615946000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-42972-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,12]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["42972"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-42972-4","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,12]]},"assertion":[{"value":"4 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"All patients had signed informed consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Clinical trial registration number is ChiCTR-OOC-16007994. Date of registration: 2016\/02\/25.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial registration number"}}],"article-number":"14805"}}