Virtual reality as means to improve physical fitness of individuals at a severe level of intellectual and developmental disability.

Lotan et al. (2010) tested a VR exercise game called IREX/GX with adults who have severe intellectual and developmental disabilities.

Caregivers ran the 12-week program. The team then checked resting heart rate against a no-exercise group.

Resting heart rate dropped a tiny but measurable amount. The authors warn the change is too small to matter for real fitness.

Perrot et al. (2021) later used Wii exergames with adults who have Down syndrome. They saw clear gains in fitness and mobility, showing the VR idea can work when the tool fits the user.

Cavalcante Neto et al. (2026) moved the concept to children with developmental coordination disorder. Eight weeks of Wii play produced large improvements in heart-rate variability, a sharper cardiac effect than the small adult drop Meir found.

Andrews et al. (2024) tried sprint-interval training in older adults with ID. They boosted physical performance but saw no change in resting heart-rate variability, echoing Meir’s modest cardiac result and hinting that resting measures may simply respond slowly in this group.

If you support adults with severe IDD, VR games can add movement variety, but don’t bank on big fitness leaps from heart rate alone. Track step counts, mobility, or perceived exertion instead. Pair short VR bouts with strength or balance work as later trials do, and keep sessions playful to maintain caregiver buy-in.