Introduction:
The implementation of virtual reality (VR) technology in the context of hemodialysis represents a groundbreaking approach that has the potential to greatly enhance patients' motivation to engage in physical exercise. Physical exercise during hemodialysis has a positive impact on chronic inflammation, well-being, muscle mass and strength, and the risk of cardiovascular diseases. The aim of this study was to comprehensively evaluate the impact of regular physical activity using virtual reality during hemodialysis sessions on plasma concentrations of myostatin and FOXO proteins, with particular emphasis on enhancing training attractiveness and patient motivation.

Material and methods:
The study was conducted at the Department of Nephrology, Transplantology, and Internal Diseases in Szczecin (Polnad). The study group was tasked with engaging in training sessions utilizing the NefroVR system prototype. In contrast, patients in the control group did not participate in any intervention. To assess the concentration of FOXO1, FOXO2, FOXO3 and myostatin parameters, blood was collected from the subjects twice: on the day of the study and after 3 months of its duration.

Results:
A total of 102 patients were selected for participation in the study. The study group showed lower FOXO-1 values ​​compared to the control group at measurement 2 (p = 0.041). In the study group, a statistically significant correlation was observed between measurements 1 and 2 in the FOXO1 measurement (p = 0.045).

Conclusions:
The findings of the study suggest that that training performed 3 times a week for 3 months through virtual reality (VR) could reduce FOXO-1 protein levels.