Comparison of the Immediate Effects of Virtual Reality-guided Meditation and Cardiovascular Exercise on Cognitive Function in Healthy Young Adults – A Counterbalanced Crossover Pre–poststudy

Abstract Background: Both cardiovascular exercise and mindfulness meditation have been shown to influence cognitive performance, particularly executive functions such as attention, inhibitory control, and cognitive flexibility. Virtual reality-guided meditation (VRM) is an emerging intervention that combines mindfulness techniques with immersive technology and may enhance engagement compared to conventional meditation. However, limited research has compared the immediate cognitive and physiological effects of VRM with those of acute cardiovascular exercise in healthy young adults. Methodology: This counterbalanced crossover pre–poststudy included 28 healthy undergraduate medical students (14 males and 14 females; mean age: 21.36 ± 1.45 years). Participants completed two interventions on separate days: VRM and cardiovascular exercise using the Harvard Step Test (HST), with a washout period of 5–7 days between sessions. Cognitive performance was assessed before and after each intervention using computerized Go/No-Go and task-switching paradigms, measuring reaction time, inhibitory control, sustained attention, and cognitive flexibility. Heart rate was recorded as a physiological indicator of arousal, and perceived exertion was assessed using Borg’s Rating of Perceived Exertion scale. Data were analyzed using 2 × 2 repeated-measures analysis of variance with intervention (HST and VRM) and time (pre and post) as within-subject factors. Results: A significant intervention × time interaction was observed for heart rate ( P < 0.001), with a substantial increase following HST, whereas no significant change was observed following VRM. In the task-switching paradigm, significant main effects of time were observed for reaction time in repeat trials ( P < 0.001), switch trials ( P < 0.001), and average switch cost ( P = 0.012), indicating improved processing speed following both interventions. Accuracy for repeat trials showed significant main effects of intervention ( P = 0.022) and time ( P = 0.016), with slightly higher accuracy during the VRM condition. In contrast, Go/No-Go task measures, including accuracy, sustained attention, response inhibition, and reaction time, did not show significant changes across interventions or time. Conclusion: Both cardiovascular exercise and VRM were associated with improvements in reaction time-based measures of executive function, although these changes were largely time-dependent and not intervention-specific. While cardiovascular exercise produced the expected physiological activation, VRM elicited comparable cognitive changes without a significant increase in heart rate. These findings suggest that VRM may represent a feasible nonphysical alternative for supporting aspects of cognitive performance in situations where physical exercise is not feasible. Further research is needed to evaluate long-term effects and underlying mechanisms.