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An adaptive AI-based virtual reality sports system for adolescents with excess body weight: a randomized controlled trial

Ji-Hong Wang, Yiming Qin, Qian Wu, Dian Zeng, Xiao-Jing Gao, Qin-Yi Wang, Zhen Li, Y. Ni et al.

Nature Medicine, 2025

227 participants · 51 citations

Abstract

Adolescents with obesity face numerous health risks and encounter barriers that lead to physical inactivity. We developed a virtual reality sports system, named REVERIE (Real-World Exercise and VR-Based Exercise Research in Education), which used deep reinforcement learning to train transformer-based virtual coaching agents, offering immersive and effective sports guidance, with biomechanical performance comparable to real-world physical sports. We integrated REVERIE into a randomized controlled trial involving an 8-week intervention in adolescents with excess body weight (n = 227). Participants were randomized (1:1:1:1:1) to physical table tennis, physical soccer, REVERIE table tennis, REVERIE soccer or control. REVERIE sports intervention was effective in reducing primary outcome fat mass (mean −4.28 kg (95% confidence interval (CI) −6.35 to −2.22), relative to control), with no significant difference compared with physical sports (mean −5.06 kg (95% CI −7.13 to −2.98), relative to control). For secondary outcomes, decreases in liver enzymes and low-density lipoprotein cholesterol levels were found in physical and REVERIE sports groups compared to control. Physical and REVERIE sports showed improvements in physical fitness, psychological well-being and sports willingness after an 8-week intervention, which remained at the 6-month follow-up in the REVERIE sports group. REVERIE sports demonstrated superior cognitive enhancements compared to physical sports in exploratory…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 227 participants or records.

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