The Effects of Virtual Reality-Based Task-Oriented Movement on Upper Extremity Function in Healthy Individuals: A Crossover Study

Abstract

Background and Objectives: Although virtual reality (VR) has been shown to be effective in rehabilitation through motor learning principles, its impact on upper extremity function, particularly in the context of console use, remains unclear. Materials and Methods: This study aimed to investigate the effects of VR-based task-oriented movement on the upper extremity of healthy individuals. A total of 26 healthy individuals performed task-oriented movements in both real and virtual environments in a randomized order. All participants completed a single session of task-oriented movements using a VR Goggle system in a virtual setting. Physiotherapists designed immersive VR-based experiences and 3D screen-based exergames for this study. Upper extremity function was assessed using several measures: joint position sense (JPS) of the wrist and shoulder was evaluated using a universal goniometer, reaction time was measured via a mobile application, and gross manual dexterity was assessed using the box-and-block test (BBT). Evaluations were conducted before and after the interventions. Results: The results showed that JPS remained similar between conditions, while BBT performance improved in both groups. However, the reaction time increased significantly only after VR intervention (p < 0.05). No significant period or carryover effects were observed across the parameters. These findings suggest that VR-based task-oriented training positively influences reaction time and supports hand function. Moreover, VR systems that simulate joint position sense similar to real-world conditions may be beneficial for individuals with musculoskeletal motor deficits. Conclusions: These results highlight the potential for integrating VR technology into rehabilitation programs for patients with neurological or orthopedic impairments, providing a novel tool for enhancing upper extremity function and injury prevention strategies.

Keywords: joint position sense; reaction time; task-oriented; upper extremity; virtual reality.

Figure 1

CONSORT flow diagram illustrating the crossover structure of the study. Participants were randomly assigned to either receive the real environment condition first (f-RP) or the virtual reality condition first (f-VR), with a 24 h washout period between sessions.

Figure 2

Technical features of the Oculus Quest 2 VR system.

Figure 3

(A) General view, where A1 is the place of sitting, A2 is the ball pool, and A3 is the target pool, and (B) view of participant in the virtual environment before throwing.

Figure 4

Comparison of the change in outcome measurements in all individuals. The bars represent the mean changes (Δ1 and Δ2) in shoulder joint position sense (SJPS), wrist joint position sense (WJPS), reaction time test (RTT), and box-and-block test (BBT) scores. Darker shades indicate Δ2 values.