Game changer? Cognitive-motor effects of VR exergaming compared to video-based training

Virtual reality (VR) exergaming enhances several cognitive domains through multisensory engagement. Acute cognitive benefits of VR are established, but evidence for direct comparisons with non-immersive controls is limited. This study aimed to determine whether VR exercise provides additional cognitive and cognitive-motor benefits beyond a matched non-immersive active stick-fight video (SFV) intervention, and whether effects persist after training.

In this randomized quasi-experimental study, N = 55 healthy adults (VR: n = 30; SFV: n = 25; 25.5 ± 7.1 years; 41.8% female) completed an 8-week program (2 × 30 min/week), of VR or SFV matched in movement patterns, frequency, intensity and duration. Measurements included reaction time (RT), Stroop Test (versions 1-3), Letter Cancellation Test (LCT), Trail Making Test (TMT), Trail Walking Test (TWT) and Fitts task (difficulty level 1-4). Data were analyzed using mixed-design ANOVAs.

Improvements were observed in Stroop reading (F(1,53) = 14.84, p < .001, η² = 0.219), Stroop inhibition (F(1,53) = 10.99, p = .002, η² = 0.172), and LCT (F(1,53) = 4.57, p = .037, η² = 0.079). A time × group interaction was found for TMT (F(1,53) = 6.55, p = .031, η² = 0.110), indicating greater changes following VR training. Both groups improved cognitive-motor performance (TWT: F(1,25) = 55.32, p < .001, η² = 0.689; Fitts3: F(1,53) = 44.97, p < .001, η² = 0.459), with greater gains for VR in Fitts3 (p = .006).

Eight weeks of VR and SFV enhanced cognitive and cognitive-motor performance. VR provided domain-specific advantages in executive function, but these effects were not uniformly persistent. SFV sustained more improvements in real-world-relevant cognitive-motor tasks.