Evidence map›Paper›PMID 42485396›Full record

ArticlePLOS digital health2026

Integrated virtual reality and musical biofeedback for intensity-guided training on stationary cycling: A comparative feasibility study.

Tania Olmo-Fajardo, Prithvi Ravi Kantan, Ana Rojo, Clara B Sanz-Morère, Erika G Spaich, Sofia Dahl, Juan C Moreno

Abstract read
In one paragraph

Article in PLOS digital health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Tania Olmo-FajardoBioRobotics Group, Center for Automation and Robotics, Spanish National Research Council, Madrid, Spain.ORCID https://orcid.org/0009-0009-6236-7039
Prithvi Ravi KantanDepartment of Architecture, Design and Media Technology, Aalborg University, Aalborg, Denmark.
Ana RojoDepartamento de Tecnologías de la Información, Escuela Politécnica Superior, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain.
Clara B Sanz-MorèreBioRobotics Group, Center for Automation and Robotics, Spanish National Research Council, Madrid, Spain.
Erika G SpaichDepartment of Health Science and Technology, Aalborg University, Aalborg, Denmark.
Sofia DahlDepartment of Architecture, Design and Media Technology, Aalborg University, Aalborg, Denmark.
Juan C MorenoBioRobotics Group, Center for Automation and Robotics, Spanish National Research Council, Madrid, Spain.ORCID https://orcid.org/0000-0001-9561-7764

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Motor rehabilitation requiring sustained physical exercise faces poor adherence in neurological populations due to insufficient supervision and monotony. While virtual reality and musical biofeedback independently improve engagement and motivation, their comparative and combined impact on intensity control strategies during high-intensity interval training (HIIT) remains unexplored. Thirty healthy adults (16 males, 14 females; mean age 27.5±7.2 years) were sequentially assigned to three feedback modalities (n = 10 each) during intensity-guided stationary cycling: visual-only (position-based), musical-only (speed-based), and combined audiovisual (position-based). Participants completed two 9-minute moderate-to-high intensity sessions (Set 1 and Set 2) maintaining pedaling speed within a target speed zone. Performance distinguished control strategy from effectiveness: stability via target zone exits, correction capacity via recovery time and sustained deviations, and overall effectiveness via time in zone. Heart rate (HR) assessed physiological intensity; usability and cognitive workload were evaluated via e-Rubric and NASA-TLX. Distinct regulation strategies emerged. Musical-only showed significantly lower stability (Set 1: 14.52 exits/min vs. 1.48 visual and 1.79 combined; corrected p < 0.0167) but superior correction (0.21s recovery vs. 2.48s and 1.06s; p < 0.0001) with minimal sustained deviations. Combined feedback achieved highest Set 2 effectiveness (98.13% vs. 95.17% time in zone; corrected p < 0.0167) but elevated physical demand (corrected p < 0.0167). HR variability was comparable (p = 0.85), confirming consistent cardiovascular workload despite differing strategies. Satisfaction was high, with slight preference for musical feedback; cognitive workload did not differ. Musical biofeedback promotes reactive control with frequent but rapidly corrected oscillations, maintaining physiological safety and engagement. Visual feedback ensures stable target adherence at the cost of compensatory physical effort. The combined modality did not demonstrate clear synergistic benefits in this implementation, increasing demand without improving effectiveness. These preliminary findings reveal a trade-off between stability and correction agility, supporting tailored modality selection in future clinical applications: musical feedback could be particularly appropriate for unsupervised rehabilitation prioritizing engagement, rapid error correction, and sustainable effort, while visual feedback may better suit supervised protocols requiring stable preventive control and precise adherence quantification.

Identifiers

PMID42485396
PMCPMC13390863

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.