JMIR Publications

ABSTRACT

Background:

Individuals with mild intellectual disabilities (ID) often exhibit significant deficits in motor proficiency, coordination, and reaction time, which negatively impact their functional independence. While virtual reality (VR) exergames offer a highly immersive and motivating environment for physical activation, objective evidence regarding their impact on specific motor scales in this population remains limited. Previous research has established a structured teaching methodology (WISH and WON protocols) to achieve gameplay independence. However, there is a need to quantify the physiological and motor benefits resulting from such interventions. By utilizing standardized tools like the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) and specialized reaction time measures, we can evaluate how systematic VR-based training influences motor control and cognitive processing speed.

Objective:

The primary objective of this study was to evaluate the effectiveness of a 16-session structured VR exergame intervention (based on WISH and WON protocols) in improving motor proficiency and shortening simple reaction time among adolescents with mild intellectual disabilities.

Methods:

This pilot study used a multisession, single-group pre-test/post-test research design involving 8 adolescents with mild ID (mean age 17.63 years, SD 1.77). The intervention consisted of 16 VR exergame sessions using the "OhShape!" game, conducted according to the WISH and WON protocols during physical education classes. Motor proficiency was assessed at pre-test and post-test) using the short form of the BOT-2, covering eight subtests including bilateral coordination, balance, and strength. Simultaneously, simple reaction time (SRT) to light and sound stimuli was measured using a standardized Alfa-Electronics reaction time meter.

Results:

Total BOT-2 scores significantly improved from a baseline mean of 69.25 (SD 6.80; range 55–74) to 80.50 (SD 5.50; range 72–88) at the post-test (P < .05; r = 0.74). Based on the standardized 5-point proficiency scale, the group mean rose from 1.88 (SD 0.64; range 1–3; below average) at baseline to 2.88 (SD 0.35; range 2–3; average) post-intervention (P < .01; r = .89). Similarly, the mean SRT decreased from 426.50 ms (SD 52.3; range 350–510) to 392.10 ms (SD 38.4; range 340–450) at the final assessment (P < .05; r = .72).

Conclusions:

This pilot study suggests that the structured WISH and WON training protocols for VR exergames may effectively enhance motor proficiency and cognitive processing in adolescents with mild ID. The observed gains, significantly exceeding MCID thresholds, provide preliminary evidence that immersive VR can serve as a potent supportive tool in special education. Further large-scale research is warranted to confirm these long-term functional benefits.