Accepted for/Published in: JMIR Serious Games
Date Submitted: Dec 20, 2024
Date Accepted: Apr 6, 2025
Influence of Virtual Reality Illusions on Balance Performance and Immersive User Experience in Young Adults: A Within-Subject Experimental Study
ABSTRACT
Background:
Rehabilitation interventions to improve standing balance are often tedious and complex limiting user engagement and increasing the burden of the clinicians delivering them. Virtual Reality (VR) has been incorporated into such practices as a solution and VR illusions have emerged as a method for perturbing balance within interventions. However, the influence of VR illusions on balance performance, such as Centre of Pressure (CoP), and user experience metrics remains under explored.
Objective:
This study aimed to evaluate the impact of the VR illusions on standing balance and immersive user experience in young adults.
Methods:
Young healthy adults (n=15, age: 18-35) played a VR table tennis game while standing on a force plate and were provided with eight directional and magnitude-based VR illusions scaled according to participants’ heights. VR illusions were generated by offsetting the position of the playing hand in VR and were provided through eight trials for each participant. Each VR illusion was delivered throughout final 50 seconds of each 70-second trial. Absolute CoP displacements, directional tendency of CoP displacement and game performance were analysed to evaluate the impact of the VR illusions. Responses to the User Experience Questionnaire, Slater-Usoh-Steed Presence Questionnaire, NASA Task Load Index, and Virtual Reality Sickness Questionnaire were analysed to assess the immersive user experience.
Results:
Both VR illusion magnitude and changes in VR illusion direction led to significantly greater CoP displacements with high illusion magnitudes, anterior and posterior directional illusions associated with higher CoP displacements. Conversely, those illusion magnitudes and directions were associated with low game performance. The directional tendency of the CoP displacements was varying across the illusion directions but showed a significant association with the illusion directions. Questionnaire responses showed that participants had moderate to high immersive user experience within the VR illusion paradigm.
Conclusions:
This study provides a novel approach for future developments of more effective VR-based balance rehabilitation interventions. The results provide inspiration for the development of future VR-based exergames that can perturbate CoP direction and magnitude. By adjusting the difficulty level through directional and magnitude changes in VR illusions, exergames can provide a personalized rehabilitation experience.
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