Accepted for/Published in: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Nov 28, 2025
Date Accepted: May 5, 2026
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Validity and Reliability of an Immersive Virtual Reality System for Multidimensional Assessment of Cervical Sensorimotor Control:A Cross-Sectional Study
ABSTRACT
Background:
Cervical sensorimotor control (SMC) is often disrupted in individuals with chronic neck pain (CNP), contributing to persistent symptoms and functional limitations. Traditional cervical SMC assessments are limited by complex setups, single-domain testing, and examiner dependency. Virtual reality (VR) technology offers a promising platform for multidimensional, standardized, and user-friendly assessment.
Objective:
To develop and evaluate the validity and reliability of a VR-based system for assessing cervical SMC in healthy adults.
Methods:
A cross-sectional observational study was conducted in 30 healthy adults (18–60 years). The custom-developed VR system (HP Reverb G2 Omnicept Edition, Unity engine) incorporated five SMC tests: cervical range of motion (ROM), joint position error (JPE), head tilt response (HTR), figure of eight (FOE), and postural sway (PS). Test–retest reliability was assessed across two sessions, separated by one week, using intraclass correlation coefficients (ICC). Concurrent validity was examined by comparing VR-based measures with gold-standard optical motion capture or established clinical tools using Pearson correlation coefficients.
Results:
The VR system demonstrated good to excellent test–retest reliability across domains in most outcome measures (p < 0.05). The ICC for cervical ROM ranged from 0.851 to 0.968 across movement directions. The ICC for JPE in each direction ranged from 0.813 to 0.827. The ICC for the FOE test’s deviation frequency and task duration were 0.810 and 0.913, respectively. The ICC for the HTR was 0.742, and for the PS ranged from 0.720 to 0.843 under both visual conditions. The results of the VR-based assessment showed strong correlations with reference measures (r = 0.723–0.980, p <.001), supporting concurrent validity.
Conclusions:
This VR-based assessment system provides a valid, reliable, and user-friendly multidimensional evaluation of cervical SMC. It offers a standardized, integrated, and clinically feasible alternative to conventional assessments, with potential applications in both clinical diagnostics and rehabilitation monitoring. Clinical Trial: ClinicalTrials.gov NCT06474130
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.