Virtual Reality-Based Functional Mobility Tests in Older Adults

January 15, 2026 updated by: Mehmet Kaan ALTUNOK, Selcuk University

Validity, Reliability, and Clinical Correlates of Virtual Reality Adaptations of the 4-meter Walk Test, Five Times Sit-to-stand Test, and Timed up and go Test in Older Adults

Objective assessment of mobility, balance, and lower extremity function in older adults is of great importance in both clinical practice and scientific research. For this purpose, performance-based tests that can be administered in a short time, are easily repeatable, and have high clinical practicality are widely preferred. These tests provide valuable information about older adults' ability to perform activities of daily living, levels of functional independence, and risk of falls, thereby contributing significantly to both diagnostic processes and treatment planning.

One of these tests, the 4-Meter Walk Test (4MWT), is among the simplest and most reliable methods used to assess walking speed in older adults. Gait speed is considered a strong indicator of functional capacity and overall health status in older individuals and is also used as a critical parameter for predicting mortality, morbidity, hospitalization rates, and duration of independent living. Therefore, due to its short administration time, high repeatability, and clinical validity, the 4MWT has become one of the standard assessment tools in the field of geriatrics.

Another frequently used assessment tool, the Five-Times Sit-to-Stand Test (5xSTS), is based on measuring the time required for an individual to consecutively stand up from and sit down on a chair five times. This test is closely associated with lower extremity muscle strength, functional independence, and the ability to maintain activities of daily living. In addition, the 5xSTS test is an important clinical tool for identifying muscle weakness and mobility limitations in older adults with a history of falls. Owing to its short administration time, lack of requirement for specialized equipment, and ease of understanding, it is widely used in both clinical settings and field studies.

In addition, the Timed Up and Go (TUG) test is considered one of the gold standard methods for the assessment of functional mobility. The test is simple to administer: the time required for an individual to stand up from a chair, walk a specified distance, turn around, and return to sit down is measured. The TUG test not only assesses mobility but is also a reliable and valid method for predicting balance impairments and fall risk. Given that falls represent a major health concern in older adults, data obtained from the TUG test provide valuable guidance for both clinicians and researchers.

In recent years, virtual reality (VR)-based assessment methods have attracted increasing attention due to their potential to provide a safe, motivating, and standardized environment, particularly for older adults. In this study, the Meta Quest 3 virtual reality headset and controllers will be used to implement VR-based functional tests. The Meta Quest 3 device features a resolution of 2064 × 2208 pixels per eye, a maximum refresh rate of 120 Hz, and a six-degrees-of-freedom (6 DoF) inside-out tracking system. The device tracks participants' head and body movements in real time and accurately reflects them within the virtual environment. This system does not require external sensors and automatically provides positional tracking in the virtual space. Previous studies have demonstrated that VR applications can produce valid and reliable outcomes when used as digital adaptations of functional tests. However, the validity and reliability of VR adaptations of the 4MWT, 5xSTS, and TUG tests in older adults have not yet been systematically investigated.

The rationale of this study is to determine whether VR-based short performance tests can serve as a safer, more easily repeatable, and potentially more accessible alternative to conventional clinical assessments. The findings of this study are expected to provide important evidence supporting the use of VR technology in clinical practice for the assessment of mobility and balance in older adults.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Estimated)

70

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Turkey (Türkiye)
    • Selcuklu
      • Konya, Selcuklu, Turkey (Türkiye), 42130
        • Selcuk University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Community-dwelling adults aged 65 years and older who are able to ambulate independently (with or without assistive devices) and can communicate and follow test instructions.

Description

Inclusion Criteria:

  • Aged 65 years or older,
  • Ability to ambulate independently (assistive devices permitted),
  • Cognitive ability sufficient to communicate and follow instructions,
  • Provision of written informed consent.

Exclusion Criteria:

  • Acute cardiopulmonary disease,
  • Uncontrolled hypertension,
  • History of lower extremity surgery or fracture within the past 6 months,
  • Severe cognitive impairment preventing cooperation with testing procedures,
  • Determination by a healthcare professional that participation is unsafe for safety-related reasons.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Older Adults
Older adults undergoing conventional and virtual reality-based assessments of functional mobility, balance, and lower extremity function, including the 4-Meter Walk Test, Five-Times Sit-to-Stand Test, and Timed Up and Go Test, to evaluate validity, reliability, and clinical correlates.
Other: Clinical Assessments
Participants will perform virtual reality-based adaptations of the 4-Meter Walk Test, Five-Times Sit-to-Stand Test, and Timed Up and Go Test using an immersive virtual reality application developed for the Meta Quest 3 platform. The virtual environment digitally replicates the conventional test setups and protocols, and performance outcomes are automatically recorded by the system. Virtual reality-based assessments will be compared with conventional clinical tests and repeated to evaluate validity, reliability, and clinical correlates.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
4-Meter Walk Test - Virtual Reality (4MWT-VR)
Time Frame: Baseline and 5-7 days
This outcome measure will be used to assess gait speed using a virtual reality-based adaptation of the 4-Meter Walk Test. Walking speed will be automatically calculated by the system. Validity will be evaluated by comparison with the conventional 4-Meter Walk Test, and reliability will be assessed using repeated measurements performed 5-7 days apart.
Baseline and 5-7 days
Five-Times Sit-to-Stand Test - Virtual Reality (5xSTS-VR)
Time Frame: Baseline and 5-7 days
This outcome measure will be used to assess lower extremity functional performance using a virtual reality-based adaptation of the Five-Times Sit-to-Stand Test. Test duration will be automatically recorded. Validity and reliability will be evaluated by comparison with the conventional test and repeated measurements.
Baseline and 5-7 days
Timed Up and Go Test - Virtual Reality (TUG-VR)
Time Frame: Baseline and 5-7 days
This outcome measure will be used to assess functional mobility using a virtual reality-based adaptation of the Timed Up and Go test. Test completion time will be automatically recorded by the system. Validity and reliability will be examined through comparison with the conventional Timed Up and Go test and repeated measurements.
Baseline and 5-7 days

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
4-Meter Walk Test - Conventional
Time Frame: Baseline
The conventional 4-Meter Walk Test will be administered to assess gait speed and will be used as a reference measure for concurrent validity analyses.
Baseline
Five-Times Sit-to-Stand Test - Conventional
Time Frame: Baseline
The conventional Five-Times Sit-to-Stand Test will be used to assess lower extremity muscle strength and functional mobility and will serve as a reference for validity analyses.
Baseline
Timed Up and Go Test - Conventional
Time Frame: Baseline
The conventional Timed Up and Go test will be administered to assess functional mobility and fall risk and will be used as a reference for concurrent validity analyses.
Baseline
Lower Extremity Muscle Strength
Time Frame: Baseline
Lower extremity muscle strength will be measured using standardized clinical methods and will be examined for its relationship with virtual reality-based performance test outcomes.
Baseline
Physical Activity Level (International Physical Activity Questionnaire - Short Form, IPAQ-SF)
Time Frame: Baseline
Physical activity level will be assessed using the International Physical Activity Questionnaire - Short Form (IPAQ-SF) and will be analyzed as a clinical correlate of virtual reality-based functional performance tests.
Baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Selcuk University

Investigators

  • Study Chair: Gülşah ÖZSOY, Assist. Prof. Dr., Selcuk University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Konya, Türkiye
  • Study Chair: Zehra KORKUT, Assist. Prof. Dr., Selcuk University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Konya, Türkiye
  • Study Chair: İsmail ÖZSOY, Assoc. Prof. Dr., Selcuk University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Konya, Türkiye
  • Study Chair: Mehmet A GÜLER, PhD, Selcuk University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Konya, Türkiye
  • Study Chair: Yasemin GEDİKLİ ERTÜRK, MSc. in PT, Selcuk University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Konya, Türkiye
  • Study Chair: Muhammed İ KODAK, Assist. Prof. Dr., Kırşehir Ahi Evran University, School of Physical Therapy and Rehabilitation, Kırşehir, Türkiye
  • Study Chair: Ahmet ÇİZMECİOĞLU, Assoc. Prof. Dr., Selcuk University, Faculty of Medicine, Department of Internal Medicine, Konya, Türkiye

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

February 2, 2026

Primary Completion (Estimated)

June 30, 2026

Study Completion (Estimated)

July 30, 2026

Study Registration Dates

First Submitted

January 15, 2026

First Submitted That Met QC Criteria

January 15, 2026

First Posted (Actual)

January 23, 2026

Study Record Updates

Last Update Posted (Actual)

January 23, 2026

Last Update Submitted That Met QC Criteria

January 15, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • SelcukU_PT_OP_VR_ADAPTATION_1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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