Virtual Reality Biking Reduces Cortisol Levels and Repetitive Behaviors in Adults with Autism Spectrum Disorder

Objectives Individuals with autism spectrum disorder (ASD) report experiencing stress, which increases with age. Few studies have included the biological stress response for measuring stress. While aerobic exercise can lower stress and repetitive behaviors, motivating adults with disabilities to exercise can be challenging. This study examined whether virtual reality (VR) exercise would improve behavior and stress physiology. Methods Seven males with ASD participated. This study employed a single subject withdrawal design, using a baseline phase, followed by alternating intervention (i.e., VR biking) and withdrawal (i.e., no exercise) conditions. Frequency and/or duration of repetitive behaviors were assessed. Pre-post intervention hair cortisol and salivary cortisol for each phase were collected. Results Overall, repetitive behaviors were lower in the final phase ( M = 24.28, SD = 2.42) compared to baseline ( M = 36.68, SD = 5.33). There was no significant difference in basal T1 cortisol levels across phases (χ 2 (6) = 2.571, p