• Jeremy Likness

My Top 5 Quest 2 VR Fitness Game Picks for Parkinson's Disease

Updated: Nov 25, 2020

My left lens is starting to fog slightly as my face heats up. A trickle of sweat slides down the side of my nose. I'm too focused to try to remove my mask and do anything about it, and I'm thankful because without the bandana I'm wearing it would be far worse. My Polar heart rate monitor relays my heart beat to a fitness app called ("Why you are fit") and the heads-up-display (HUD) shows I'm in a high intensity zone of over 140 beats per minute. My arms ache. I can barely keep them lifted, let alone deliver the powerful punch demanded by the glowing orbs that fly at me in rapid succession. I'm 800 moves into a "streak" and about to break my goal of hitting 1000.

Just then, a tilted platform appears, forcing me to lunge to the side. Then it's a glowing orb (punch) followed by a half orb (hook) that is trailed by another one that is angled slightly down. Too late, I try to change the trajectory of my swing only to deliver a glancing blow. The point counts, but the power is too weak and my streak is broken. The streak counter resets to 0 and I grit my teeth, determined to build a new streak and finally break the record.

As I wrote many times on this blog, virtual reality offers a unique opportunity to enjoy playing games in alternate universes that encourage you to swing, swipe, punch, squat and lunge your way through a digital world. Just because it is so addictively fun doesn't prevent it from helping shape and condition your body while burning calories. I might burn 500 calories during a five-kilometer (3.2 mile) plod through my hilly neighborhood. On days like today when it is cold outside and raining, I'd rather "suit up" and play VR. Fortunately, a similar duration session in VR may burn just as many calories... while working more of my body and helping me combat the symptoms of Parkinson's Disease (PD) at the same time!

I've been working out in VR for several months now and have worked my way through a variety of apps and games. In this blog post, I will review some popular titles and let you know what I think are the best not only for general fitness, but specifically for people with Parkinson's Disease. Why is there a difference?

I'll get there in a minute. I am not a doctor. This is not medical advice. For those of you with balance issues, VR may put you at increased risk of falling or bumping into objects. Always check with your doctor before starting a new program. These thoughts are my own based on personal experience. I was formerly a certified fitness trainer and specialist in performance nutrition and studied physical therapy. I tap into that experience to design my exercise routines.

I believe that training for PD should involve extra focus on certain factors that aren't always prioritized in general fitness programs. Specifically:

  • Parkinson's Disease usually impacts one side of the body more than the other. For this reason, I favor unilateral (single-sided) exercises so I can pinpoint problem areas.

  • PD affects balance, so exercises for balance, like squats and lunges, are beneficial, as are variations like one-legged squats.

  • PD affects the brain and you can exercise your brain just like the rest of your body. I believe activity that involves fast reactions, pattern recognition and recall all help reinforce neural connections that PD wants to break.

  • A tremor has a certain frequency and can interfere with your ability to modulate. This is why hand and foot tapping are part of the PD assessment (see a sample test here). Exercise that requires rhythm helps me focus on timing movements on my terms, not the disease's.

With that in mind, I reviewed the apps that I am personally familiar with and rated them based on a variety of factors. I also recorded sample sessions to show you what the mechanics look like and to capture my heart rate and calories burned for the session. The factors I used to rank the apps are:

  1. Fun factor - how much do I enjoy playing? Some games are so addictive I can't wait to play, while others are... meh?

  2. Complexity - how hard is it to master the game? Sometimes complexity can be rewarding, but other times it can be frustrating and block progress rather than facilitate it.

  3. Calories - at what rate does the game help you burn calories? A higher rate means more fat cells banished in a shorter period of time.

  4. Movement - how much movement is involved? Is it just upper body or does it involve squatting and lunging too?

  5. Cognitive - does the game challenge your mind as well as your body? Are there complex patterns you need to recognize and emulate in order to be successful?

  6. Value (based on cost) - how valuable is the game relative to its cost?

I scored each category on a scale from one to five and then averaged the scores for a grand total. I also recorded a session in each game so you can see how the mechanics work - both in game and out. Finally, I hooked up my Polar heart rate monitor to the app so you can see the stats for each workout!

NOTE: the calories per minute in these reviews are based on averages I calculated over several months. The sample stats shown for each game are from a single short session and don't represent a "typical" session. I usually train for about an hour at a time. Also note that the rate of calories burned is based on my personal experience. For example, Beat Saber burns far more calories on "expert+" level than basic levels, but it takes time and focus to reach that level. Some games like Supernatural may burn significantly more calories at more advanced levels I haven't reached, so the burn rate will be higher for more advanced users.

Respectful Mention: Dance Central and FitXR "Dance Mode"

Before I jump into the main reviews, I have two "respectful mentions." I love dancing. I've even been told I can "cut a rug." But I can't for the life of me get into the various dancing games that are available. "Dance Central" is a cool concept and I even tried to record a video, only to find out they restrict any captures of their app. I don't have the patience to cast it and record it outside of the headset. The concept is simple: you pair up with someone (virtual dance partners included), pick a song and try to knock out the canned moves. The moves are choreographed quite nicely, but I just can't get into copying a mirror image and being constrained by the moves. You are rated based on how well you mimic the move, down to rhythm, range of motion and turning, and even whether or not your hand is open or closed (based on gripping the triggers or not).

Back during my breakdance days it annoyed me when people asked, "Can you do the Roger Rabbit?" I prefer a fluid, freestyle approach and never learned the names of most moves (it was kind of hard to avoid "moonwalking," "The Hammer" and "The Worm"). The apps feel way to constrained to me and overthinking how I do the moves is more stressful than fun.

FitXR, formerly known as "BoxVR" recently introduced dance workouts based on the same concept. I tried one and I hated it the first time. I recently tried another workout and enjoyed it more, so I may change my mind. The FitXR interface seems more forgiving than Dance Central but is also more fitness-oriented with jumping jacks, squats, and kicks. I haven't tried enough sessions to give it a fair review but it's intriguing enough to mention here.

OK, onto my 6th runner up: an honorable mention for a cool concept that I believe is just way too overpriced.

Honorable Mention: Supernatural


Cost: $179.00 (year)

Average kcal/min: 6.5

Value: ⭐⭐

Cognitive: ⭐⭐⭐⭐

Movement: ⭐⭐⭐⭐⭐

Calories: ⭐⭐

Fun Factor: ⭐⭐⭐

Complexity: ❌❌❌❌❌

Pros: Hundreds of workouts to choose from, current music, beautiful 3D locations, virtual coaches. Multiple profiles support.

Cons: Recurring cost (subscription model), complicated movements, no customization of playlists, lack of any real AI in the virtual coaches.

Supernatural is a title I wanted to work. I really did. It looked amazing from the demo: workouts in beautiful high-resolution 3D locations, a combination of upper and lower body, the latest music tracks and coaches. I was intrigued and signed up for a year membership that provides a 30-day trial. Then I tried my first workout. And my second. And I just couldn't get into it. I was moving a lot, but maybe the price was stuck in the back of my mind?

In all fairness, I may be biased because I'm so used to the other games. It's difficult learning new moves and controls. I just couldn't get into swinging bats. I mean, the alternative is beams of laser light that cut through anything! And what's up with the swirly thing that you're supposed to follow but ends up in weird places? "Easy" felt too easy, but hard had me spinning and squatting and lunging in ways that didn't feel syncopated but rather forced. So, I threw in the towel. For a one-time fee, I'd hang onto it. But recurring? No way. $20/month is $240 a year... or, in VR terms, a half dozen other games.

Here's my attempt at a round, followed by stats. As an unintentional bonus, you can see my tremor in action at the start of the clip. (Notice how it stabilizes once I have work to focus on).

Session stats
Heart rate and calories

5️⃣ SynthRiders


Cost: $24.99 (one time)

Average kcal/min: 3.8

Value: ⭐⭐⭐⭐

Cognitive: ⭐⭐⭐⭐

Movement: ⭐⭐⭐⭐


Fun Factor: ⭐⭐⭐⭐

Complexity: ❌❌❌❌

Pros: Multiple virtual stages, multiple songs, innovative interface and pattern matching, music variety.

Cons: More of a fun dance marathon than a focused workout, big jump between normal and hard, song randomizer not so random and interface isn't straightforward to jump between songs.

One of the first games I picked up on the Quest 2 was SynthRiders. This game really taps into your VR experience. You move through vast digital landscapes (there are different stages you can swap out or randomize) with a glowing red and blue ball attached to your hands. The rules are simple: when you see a matching ball, hit it with the correct hand. Sometimes there are pipes through the balls. Keep your hand on these "rails" and you get bonus points. The complexity comes from learning the special colors. When you see a set of green balls, you can pick either hand and must use the same hand throughout the series. Yellow balls mean both hands together.

The patterns have you reaching and crossing with barriers to duck and dodge, so you are certainly challenged to move. Cognitively it takes some focus to adapt to the special sequences and some of the patterns that require different rhythms in your left and right arms. This game is fun, and I only have a few negative marks. One is the interface (there are extra steps in between levels to pick your next song, unless you choose "random" which I find repeats the same songs too often). The other is calories. As much fun as I have in this game, I can never seem to burn enough calories to make it feel like a workout. It's a great way to keep moving but I choose this option more often as a relaxing VR trip before bed than an invigorating morning workout.

Here's what SynthRiders looks like! If you look carefully, you can see the virtual fitness watch on my left arm.

Session stats
Heart rate and calories

4️⃣ Audio Trip


Cost: $19.99 (one time)

Average kcal/min: 9.8

Value: ⭐⭐⭐⭐

Cognitive: ⭐⭐⭐⭐

Movement: ⭐⭐⭐⭐

Calories: ⭐⭐⭐

Fun Factor: ⭐⭐⭐⭐

Complexity: ❌❌❌

Pros: Virtual "dance partner" to show moves, intuitive interface, lots of movement, stretching, lunging and squatting, more intuitive, variation of moves (drums, shells), comfort level settings.

Cons: Limited song selection.

I admit that I was skeptical when I discovered Audio Trip. On the surface, it appeared to be just another SynthRiders with and orange and purple multi-sided fist instead of a sphere. I decided to try it anyway and I'm glad that I did! There are several reasons why I prefer it and consistently come back. Although the song list feels limited, I enjoy all of the titles. Options range from high energy to pulsating house to relaxing trance. The levels are very immersive. The game challenges you to be ready at any moment to switch from connecting with a shape to banging on a drum, riding a rail or tapping a "shell." Barriers force you to squat and lunge your way through each level.

I really enjoy the open VR environment with distant features passing by (SynthRiders does a great job of this, too). For certain songs, you can set up a virtual "dance partner" that appears in front of you and demonstrates a very fluid approach to completing the level. Although it's not my first pick for a heavy workout, I often find I want to just take a break, enjoy some nice music and dance. The levels are choreographed to make this possible and I haven't found a song I don't like. Here is an example audio trip. (The floating panel is my heads-up fitness display showing my heart rate, session duration, calories burned and squats).

Session stats
Heart rate and calories

🥉 Thrill of the Fight


Cost: $9.99 (one time)

Average kcal/min: 12.9

Value: ⭐⭐⭐⭐⭐

Cognitive: ⭐⭐⭐

Movement: ⭐⭐⭐

Calories: ⭐⭐⭐⭐

Fun Factor: ⭐⭐⭐⭐

Complexity: ❌❌❌

Pros: Immersive boxing experience, plenty of levels and variations, high intensity with rounds.

Cons: Bouts can be extremely taxing, needs a little more space to maneuver, doesn't do much for lower body.

Thrill of the Fight is an addictive, fun, and incredibly taxing game. I hadn't played in a while so I recorded a video with the "sparring partner" or lowest level. Unfortunately, it made for a short video. Apparently, my time in other boxing games I'll review later in this blog post improved my skills enough to knockout my opponent every round (in the past I'd typically only make it to one knockout). If the example video makes it look too easy, please take my word that the AI for more advanced fighters makes it far more challenging. I don't think I've made it past the third level opponent yet.

The game starts with having you step on a "scale" to "weigh in" and face the camera. This is a clever way to use the position of your feet and angle of your headset when you stare at the camera to compute your height. You have options to engage with a punching bag or speed bag in addition to entering sparring matches and official fights. I find I am drenched in sweat and panting for breath just moments into the game as I punch, dodge, upper cut and side hook my way to victory. It's easy to get caught up in the moment and lose track of where you are in the real world, so I recommend additional space.

I usually limit my time in this game to 10 - 20 minutes because it's so intense, then move onto something else. At $9.99 it's a no-brainer to purchase. Although it's not cognitively challenging and doesn't work out the lower body as much as the upper, the fun factor and calorie burn place this high on my list of favorited fitness games. Here's my triple knockout bout!

Session stats
Heart rate and calories

🥈 Beat Saber


Cost: $29.99 (one time)

Average kcal/min: 8.7

Value: ⭐⭐⭐⭐

Cognitive: ⭐⭐⭐⭐⭐

Movement: ⭐⭐⭐⭐

Calories: ⭐⭐½

Fun Factor: ⭐⭐⭐⭐⭐

Complexity: ❌❌❌❌

Pros: Fun, multiple levels to choose from, large selection of music (especially if customized), lots of learning options (slow song, never fail, etc.), multiplayer mode.

Cons: Almost all arms. Some levels have squatting and dodging but it's easy to just move your head and arms.

You will have a hard time finding anyone familiar with VR who has not heard of the epic game, Beat Saber. This game has all the elements necessary for addictive fun: you get to swipe and slash light sabers to dance-worthy sound tracks in rhythm with the challenge of not only having to hit in a particular direction, but also different patterns and even cross-overs for each arm and mines and barriers to avoid. The first time I played was at a VR Cafe for a technology event and I enjoyed it so much, I bought a PC-based VR headset. I was happy to learn it is on the Quest and Quest 2.

The calories make this rank a bit lower, but that's just my experience. I have friends who swear by it as a fitness app and have lost dozens of pounds that they attribute to swiping blue and red cubes. I don't deny that a few songs in and I'm dripping sweat; it just doesn't quite burn calories at the rate of my other apps. Movement is decent: on certain maps you have to side step and squat to dodge barriers. To get a good workout means advancing to the Expert and Expert+ levels, but I found even then that getting better means being more efficient so you solve more complex levels with less effort.

What I really want to emphasize about this particular game is how positive an impact it has on my Parkinson's Disease symptoms. Part of the challenge is losing control over one side. The complex patterns that I must either react to quickly or memorize as patterns both benefit my ability to train my brain to take control back. I don't have scientific evidence (yet) to support this, but it just makes sense to me. The test to score the severity of symptoms involves tapping with one side and just like weight training, exercising the ability to move my arms independently improves my skills over time (to see just how much my scores improved, check out Lucky Number Seven).

The latest version also has multiplayer. This is quite fun. Microphones are muted so there's no random talk from some anonymous user you don't know. The playing field features a lane per player that meets in the middle so you truly "face off." The top player also has their avatar projected to a huge hologram in the center of the field that you may learn a few tricks from. Calories and reaction times aside, this game is pure fun and here's proof with me tackling one of my favorite songs, "Sandstorm."

Session stats
Heart rate and calories

🏆🥇 BoxVR (FitXR)


Cost: $29.99 (one time)

Average kcal/min: 16.2

Value: ⭐⭐⭐⭐

Cognitive: ⭐⭐⭐⭐

Movement: ⭐⭐⭐⭐⭐

Calories: ⭐⭐⭐⭐⭐

Fun Factor: ⭐⭐⭐⭐⭐

Complexity: ❌❌❌❌

Pros: Tons of workouts with different song types, lengths, and intensity levels. AI coaches for those in interested. "Multiplayer" for competition. Uses your entire body to punch, squat, swing and lunge. Multiple profiles support.

Cons: Once you've cycled through workouts the only option is to buy packs. New workouts are added but not on a very regular basis.

The game I purchased months ago to try something different from Beat Saber was called BoxVR. When they rebranded to FitXR I knew they were planning to expand the franchise and, indeed, they recently updated the app with an alternate workout style using dance moves and calisthenics. The boxing game is even better in the new app and takes the concepts I love about Beat Saber, like music and waving my arms to the beat, and makes them more fitness-worthy by turning them into punches, lunges and squats.

The basic concept is that you have half-spheres of different colors coming at you, typically in sync with a music track. You have to punch the flat face. Ones that look like circles are coming straight at you and deserve a straight punch, while others are face down (upper jab) or sideways (hook) or even slightly down. Flat platforms force you to squat and tilted ones to lunge to the side. If that's not enough, there's a twist: you not only have to hit the spheres, but you have to smash them with power. A light tap taunts you with a lame popping sound as if you barely flicked it, gives you a lower score and resets your power streak. The "power streak" is the number of moves (punches, squats, blocks, and dodges) you do with power in a row. Miss a punch or hit too soft? You lose the power streak.

The power streak is added to your score at the end. It is effective: I noticed I work out much harder and don't "cheat" by landing weak punches. I've made a streak as high as 950 but have not hit my goal of 1,000 yet. It's not hard as the workouts come in different lengths from three-minute single song workouts to 40+ minute boxing marathons. I usually start with a 30 - 40-minute workout then "cool down" with another 15 minutes of Beat Saber. I've played so long sometimes I just drop my arms and ignore the incoming spheres because it hurts too much to keep them raised.

Some of the workouts come with coaches. The AI is simple, but slightly more customized than Supernatural's. For example, some coaches give you different compliments every time you hit a new milestone for your streak (like 100, 150, etc.) and will cheer you on when you strike a particularly forceful blow. You can buy extension packs but I've had enough variety with the built-in sessions that I've yet to get an extension. There are still some longer levels I haven't tried.

Finally, the new update adds even more options. You can join true multiplayer sessions with live coaches and workouts (I haven't tried that yet). By default, you are paired with opponents that I believe are recordings of other player sessions. You compete against their performance and can see a line of virtual heads and boxing gloves working out to the same song. See if you can spot my virtual opponents in the video (hint: it's closer to the end)! I love the leaderboard and enjoy pushing my way to first place. Without further ado, here I am punching my way through my favorite VR workout!

Session stats
Heart rate and calories

Parting Thoughts

Virtual reality is exciting and fun. It is also a great way to move. For me, it solves two problems. The first is how to burn calories during the wet, cold, and dark months I don't feel like going for runs. The second is how to have something consistently fun that burns calories and is available wherever you go. I take my VR headset with me on trips and as long as I can carve out a small space, I am able to enjoy a great workout. These are ratings based on my experience, but your mileage may vary. I encourage you to try out various games and take advantage of the Oculus return policy when you want to "kick the tires."

If you have PD and are reading this, I hope I may have given you a new possibility for something both fun and therapeutic. My PD scores have improved the last two visits to my movement disorder specialist. What's been consistent for me is alternating body weight workouts with VR cardio sessions. I do believe the mental exercise is just as powerful as the physical. As always, I welcome your thoughts, feedbacks, and any experiences you may wish to share. Feel free to use the commenting feature to drop me a line!


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