Acute Effect of Immersive VR Technology on Postural Control and Reaction Time in Young Adults: a Randomized Controlled Trial

This study investigates the acute effects of short-term immersive virtual reality (VR) exposure on sensory organization and reaction time in young adults aged 18-25 years. It is designed as a randomized controlled trial.

Participants are eligible if they provide written informed consent, complete all study questionnaires, are aged 18-25 years, are able to maintain an upright standing posture, have non-professional athletic status, have no neurological or psychiatric disorders, use a phone or computer for at least 1 hour per day, and do not take medication affecting the nervous system. Exclusion criteria include age outside the 18-25 range, pregnancy, disability, metal implants, epilepsy, inability to provide consent, frequent migraines, balance disorders, recent surgery or injury (within 6 months), uncorrected visual impairment, skin conditions or allergies preventing device use, acute illness on the day of testing, shift work causing circadian rhythm disruption, prior regular VR use, claustrophobia or anxiety related to enclosed spaces or simulated movement, and intensive physical activity within 24 hours before testing.

Eligible participants are randomly allocated in a 1:1 ratio using sequentially numbered, sealed, opaque envelopes to either a VR intervention group or a control group.

All participants are assessed at baseline and after a 20-minute interval. In the VR group, post-assessment is performed immediately after VR exposure, while in the control group it follows a matched resting period. All measurements are conducted by a single trained examiner at a similar time of day using a standardized protocol. Anthropometric measurements (height and body mass) are obtained barefoot using a medical scale (Charder MS4971, Taiwan), and body mass index (BMI) is calculated.

Postural control and reaction time are assessed using computerized dynamic posturography with the NeuroCom Balance Manager system. Two standardized protocols are used: the Sensory Organization Test (SOT) and the Limits of Stability (LOS). The SOT evaluates the integration of somatosensory, visual, and vestibular inputs for postural control across six sensory conditions involving variations in platform and visual stability. The LOS assesses voluntary control of the center of gravity toward visual targets without loss of balance, providing measures of movement accuracy and reaction time from movement initiation to target acquisition.

The primary outcome is the composite SOT score. Secondary outcomes include SOM, VIS, VEST, and PREF parameters derived from the SOT, as well as reaction time measured in the LOS protocol.

The experimental group undergoes a 20-minute VR intervention using the HTC VIVE Cosmos. The intervention consists of a gamified motor coordination task ("Adventure Climb") requiring continuous postural adjustments, rapid visuomotor responses, and whole-body movement coordination in a standing position. The task is designed to stimulate visual-motor integration and dynamic balance control. The control group remains at rest for the same duration and does not receive any active intervention, allowing isolation of the effects of VR exposure. Due to the nature of the intervention, blinding of participants, assessors, and intervention providers is not feasible.

After the intervention or rest period, all participants repeat the SOT and LOS assessments under identical conditions to evaluate the acute effects of VR exposure on postural control and reaction time.