Potential Use of Immersive Virtual Reality for Upper Extremity Rehabilitation: Commercially Available Games

Immersive virtual reality (IVR) is an emerging tool in neurorehabilitation, offering interactive, motivating experiences that promote motor and cognitive engagement. However, most IVR games are not designed for therapeutic use, and evidence on age- and gender-based responses remains limited.

This study aimed to evaluate upper extremity movement patterns and cardiovascular responses elicited by commercially available IVR games in typically developing children and adults, with attention to age and gender differences.

In Phase I, six Meta Quest 2 IVR games were analyzed for their therapeutic potential by physical therapy professionals. Five games (Fruit Ninja, Beat Saber, Bowling, Baseball, and Tennis) were selected for Phase II testing. Sixty-seven healthy participants (40 children aged 5-12, 27 adults aged 20-34) played each game for 3 minutes while seated. Arm movements were video-coded, and heart rate was continuously monitored. Participants completed usability and satisfaction questionnaires post-play.

Fruit Ninja and Beat Saber elicited the highest number of total, unilateral, bilateral, and multidirectional arm movements and produced the greatest cardiovascular responses. Adults demonstrated more total reaches, while children exhibited higher heart rate responses and more forward/backward reaches. Gender differences were observed in reach direction and heart rate. Boys reported higher simulator sickness scores, while males reported higher overall satisfaction.

IVR games, particularly Fruit Ninja and Beat Saber, show promise for upper extremity rehabilitation by promoting motor and cardiovascular engagement. Age- and gender-related differences should inform individualized therapeutic applications. Future studies should explore these games in clinical populations.