{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:25:07Z","timestamp":1787840707313,"version":"build-2784847793"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8]]},"abstract":"\n Background:<\/jats:title>\n Walking, important for cardiovascular health and autonomic regulation, is often done on a treadmill.<\/jats:p>\n <\/jats:sec>\n \n Aim:<\/jats:title>\n This study compared the physiological responses of treadmill and virtual reality walking, focusing on their effects on the autonomic nervous system, recovery, and perceived exertion.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This study included 40 sedentary participants, assigned to a treadmill group (TG) or a virtual reality group (VRG). Both groups performed 20-minute treadmill walking, with the VRG additionally using the Wii Fit program. Autonomic assessments with the Polar H10 measured heart rate (HR), parasympathetic nervous system (PNS), sympathetic nervous system (SNS), stress index (SI), and the LF\/HF ratio. At the same time, perceived exertion was assessed using the OMNI scale. Physiological responses were measured at baseline (T0), post exercise (T1), and at 10 (T2) and 30 minutes (T3) of recovery.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The study showed significant differences in HR (\n P<\/jats:italic>\n = 0.040) and LF\/HF (\n P<\/jats:italic>\n = 0.038) between T0-T1 in the TG. In the VRG, significant changes were found in HR (\n P<\/jats:italic>\n = 0.016), SNS (\n P<\/jats:italic>\n = 0.010), SI (\n P<\/jats:italic>\n = 0.014), and LF\/HF (\n P<\/jats:italic>\n = 0.020) between T0-T1, with an additional difference in LF\/HF at T0-T2 (\n P<\/jats:italic>\n = 0.032). OMNI scores significantly differed at all time points (\n P<\/jats:italic>\n < 0.05). No significant differences were found between groups in autonomic parameters or OMNI scores (\n P<\/jats:italic>\n > 0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Although perceived exertion was similar, the VR group showed greater SNS activation due to immersion, while recovery was identical for both methods. This understanding could contribute to developing rehabilitation strategies considering autonomic VR responses.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/njcp.njcp_121_25","type":"journal-article","created":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T11:00:29Z","timestamp":1756551629000},"page":"969-977","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Do Autonomic Nervous System and Perceived Exertion Responses Differ Between Walking and Virtual Reality-Engaged Walking?"],"prefix":"10.4103","volume":"28","author":[{"given":"G","family":"Demircioglu","sequence":"first","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Atlas University, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Ozkan","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy, Faculty of Health Sciences, 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