Virtual sailing exercise enhances motor performance while maintaining stable mental and neurochemical profiles in healthy adults: a pilot study

Objectives: While virtual exercise is emerging as a new approach for clinical application, little is known about its roles in mental health management and neuroplasticity. We conducted the first exploratory investigation evaluating the multimodal effects of a virtual sailing (VSail) program in healthy adults with the long-term goal of establishing its feasibility for mental health management. Methods: simulator. Pre- and post-intervention assessments included motor function (hand grip strength, balance, and inertia) and mental health and clinical functioning self-report questionnaires (Beck Depression Inventory, Beck Anxiety Inventory, Perceived Stress Scale, Flanagan Quality of Life, Global Assessment of Functioning, and Health of the Nation Outcome Scales). Magnetic resonance spectroscopy analysis was performed in the ventromedial prefrontal cortex to evaluate the response of key neurometabolites gamma-aminobutyric acid (GABA) and glutamate to the VSail exercise program. Results: We found that the VSail program significantly enhanced grip strength in both dominant and non-dominant hands, and body balance. Hand inertial measurements across three axes showed no significant changes, indicating stable motor control and complexity. Mental health, clinical functioning, and neurometabolite levels remained stable, reflecting ceiling effects typical of healthy populations. Together, the results demonstrate that VSail effectively enhances motor performance while maintaining psychological and neurometabolic stability in healthy adults. Conclusions: Our findings indicate that virtual reality (VR)-based exercise, such as VSail, possesses strong potential as a safe, engaging, and scalable digital exercise strategy for future clinical applications, paving the way for understanding the role of virtual exercise in the muscle-brain axis.