Acute Effect of Immersive VR Technology on Postural Control and Reaction Time in Young Adults

This study evaluates 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 and complete all study questionnaires, are aged between 18 and 25 years, are able to maintain an upright standing posture, have non-professional athletic status, have no diagnosed neurological or psychiatric disorders, use a phone or computer for at least 1 hour per day, and do not use medication affecting the nervous system. Exclusion criteria include age under 18 or over 25 years, pregnancy, disability, metal implants, epilepsy, inability to provide informed consent, frequent migraines, balance disorders, surgery or injury within the previous 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 use of VR technology, claustrophobia or anxiety related to enclosed spaces or simulated movement, and intensive physical activity within 24 hours prior to 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 again after a 20-minute interval. In the VR group, the post-assessment is conducted immediately after VR exposure, whereas in the control group it follows a matched resting period. All measurements are performed by a single trained examiner at a similar time of day using a standardized protocol. Anthropometric data, including height and body mass, are collected barefoot using a medical scale (Charder MS4971, Taiwan), and body mass index (BMI) is calculated.

Postural control and reaction time are evaluated using computerized dynamic posturography with the NeuroCom Balance Manager system, applying two standardized protocols: the Sensory Organization Test (SOT) and the Limits of Stability (LOS). The SOT assesses integration of somatosensory, visual, and vestibular inputs for postural control through six conditions (fixed or sway-referenced platform and vision), each repeated three times, conducted according to manufacturer guidelines with participants standing in a safety harness and standardized foot positioning aligned to the platform's axis of rotation. The LOS protocol evaluates voluntary control of the center of gravity toward visual targets without losing balance, providing measures of movement accuracy and reaction time from initiation of weight shift to target acquisition.

The primary outcome is the composite SOT score, while 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 completes a 20-minute VR-based intervention using the HTC VIVE Cosmos, consisting of a gamified motor coordination task ("Adventure Climb") that requires 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 immersive VR exposure without additional sensory or motor stimulation. Due to the nature of the intervention, blinding of participants, assessors, and the intervention provider is not feasible.

After the intervention or rest period, all participants repeat the SOT and LOS assessments under identical conditions, enabling comparison of baseline and post-condition performance and evaluation of the acute effects of VR exposure on postural control and reaction time.