Discussion
hypotension, hypertension, BP reduction
HYPERTENSION
The first purpose of the study was to investigate whether the intensity of the VR exergame was appropriate for older patients with hypertension to exercise within their individually calculated moderate load intensity of 40% to 60% during the VR exergame.It was determined that a higher load intensity was achieved in the VR-SET than in the VR-ET. In addition, significantly more participants reached the individual moderate exercise zone of 40 to 60% in the “main part” of the VR-SET. In relation to the main question, it can be seen that individuals with the developed VR exergame had limited ability to train in their individual moderate load intensity. The reasons for this could be that the non-personalized number of exercises, the number of repetitions and the number of sets performed are not equally appropriate for all participants to achieve moderate training loads. The speed of exercise execution and breaks, due to initially long exercise explanations, may also have led to a reduction in load intensity. Especially in the case of endurance training, the exercise explanations in the "main part" were significantly longer than for the strength endurance training, which might have led to different load intensities between the two VR sessions. In addition, there were two to three participants who were unable to perform each exercise accurately due to shoulder movement limitations, which may also have resulted in lower loading intensities. In other studies that collected HR measurements during the exergame with older participants, similar [The second aim was to evaluate whether VR exergames can have an impact on BP reduction among elderly patients with hypertension. In both VR sessions, systolic BP was significantly reduced after training. Significant main effects were also recorded for diastolic BP. Despite the determined lower load intensity of the participants, a positive influence on BP could be found, which was characterized by a postexercise hypotension for both VR sessions. Higher mean differences were found for the VR-ET, especially for the time point 10 min post. Thus, the VR-ET displayed a stronger post-exercise hypotension. This clinically relevant phenomenon has already been studied numerous times and could also be found in conventional training methods for endurance or strength endurance [With regard to the RPE, the present values almost corresponded to the conditions of Löllgen's recommendations or the ACSM exercise guidelines for adults with hypertension, which define moderate intensity as 11–13 on the Borg scale [Another point is that according to the recommendations of cardiac societies, persons with hypertension should participate in endurance training five times a week for 30 min [