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Major Depressive Disorder (MDD) is a prevalent and chronic psychiatric disorder associated with substantially reduced quality of life. However, current mental health management strategies- particularly for non-pharmacological interventions-to reduce this burden are limited in their efficacy. This pilot trial will, for the first time, assess if simulated sailing, combining virtual reality with recreational exercise, is a promising exercise-based therapeutic approach to reducing depression and improving the quality of life for people with MDD.

To evaluate the effectiveness of virtual sailing on MDD, 58 adults aged between 18 and 64 who have a diagnosis of MDD and can consent and participate in virtual sailing exercises will be recruited for the trial. Exclusion criteria include suicidality, severe mental illness, ongoing psychiatric treatment, and life circumstances that would hinder participation. After the pre-exercise screening, eligible participants will participate in simulated sailing sessions (30 min per session, one session per week) over six weeks. The primary outcome measurements include the evaluation of depression, anxiety, stress, quality of life, clinical improvement, and overall functioning as well as motor coordination. The second aim is to investigate if the virtual sailing program results in neuroplastic changes in the brain that restore altered resting-state functional connectivity and metabolites in MDD using Magnetic Resonance Imaging. Participants will be assessed at baseline and after the last sailing session.

The findings of this pilot study will inform a new therapeutic approach aimed at reducing depression and improving the quality of life for people with MDD.