Effects of virtual reality and traditional exercise on cognitive and physical performance in sedentary adults: a randomised controlled trial

Sedentary lifestyles have become increasingly prevalent in modern society, negatively affecting physical and cognitive functioning. Although traditional exercise programs are widely used to improve health outcomes, maintaining long-term motivation and adherence remains challenging. VR-based exercise has emerged as an innovative approach that combines physical activity with cognitive engagement. This study aimed to compare the effects of VR-based and traditional exercise interventions on concentration, reaction time, balance, and flexibility in sedentary adults.

A randomized controlled trial with a pre-test-post-test design was conducted involving 33 sedentary adults randomly allocated to a VR exercise group, a traditional exercise group, or a control group (n = 11 per group). The intervention groups participated in supervised exercise programs three times weekly for eight weeks, whereas the control group maintained their usual lifestyle. Outcome measures included concentration, hand and foot reaction time, flexibility, and multidirectional balance. Data were analyzed using mixed-design repeated-measures ANOVA, followed by baseline-adjusted ANCOVA and Benjamini-Hochberg false discovery rate corrections.

Significant Group × Time interaction effects were observed for concentration, hand reaction time, foot reaction time, and flexibility (all q ≤ 0.021), but not for bilateral, dominant-leg, or non-dominant-leg balance (all q > 0.05). Concentration and hand reaction time improved most in the VR group, which outperformed both the traditional exercise and control groups, with the traditional exercise group also outperforming control (p < 0.05). Foot reaction time improved similarly in the VR and traditional exercise groups (p < 0.05), both outperforming control, with no significant difference between the two intervention groups (p > 0.05). Flexibility was maintained in the intervention groups, whereas a decline was observed in the control group (p < 0.05).

VR-based exercise appears effective for enhancing concentration and reaction performance in sedentary adults and may help preserve flexibility during physical inactivity. While balance outcomes remained unchanged, VR-based exercise showed significantly greater improvement than traditional exercise in concentration and hand reaction time in this sample; however, given the small sample size and exploratory nature of the trial, these comparative findings should be interpreted with caution and require confirmation in adequately powered trials.

ClinicalTrials.gov NCT07567144, registered on 2026-04-21, retrospectively registered.