Clinical Research Directory

Virtual Reality-Based Five-Repetition Sit-to-Stand Test in Young Adults

Lower extremity muscle strength is a fundamental determinant of an individual's ability to maintain functional mobility, preserve balance, and perform activities of daily living independently. One of the methods used for the comprehensive evaluation of these functions is the Five-Repetition Sit-to-Stand (5STS) test, which is considered an effective tool for assessing lower extremity strength, balance, and functional mobility in both healthy individuals and various clinical populations. In this test, participants are required to consecutively stand up from and sit down on a chair five times without using their arms, and the completion time is recorded in seconds to objectively evaluate functional capacity. Due to its simplicity, low cost, and high reliability, the 5STS test is widely used in clinical and research settings. However, functional tests administered in conventional clinical environments may be insufficiently standardized due to factors such as examiner-related variability, measurement errors, and environmental influences. This limitation makes it difficult to detect small performance differences and restricts test repeatability. In recent years, rapidly advancing virtual reality (VR) technology has contributed to overcoming these limitations by offering the potential to digitally standardize measurement processes. VR systems, which recreate real-life scenarios in a three-dimensional and interactive manner, allow for a more comprehensive and objective assessment of motor performance. In addition, by increasing user interaction and reducing observer-related errors, VR enhances clinical validity. One study has reported that the most important advantage of VR in clinical balance assessments is its ability to provide a fully controllable, repeatable, and standardized environment. Similarly, a systematic review found that VR-based exercises resulted in significant improvements in motor skills, balance, and cognitive function, while increasing user engagement and motivation and thereby contributing to more effective rehabilitation outcomes. Current literature indicates that VR technology is increasingly being utilized in physiotherapy and exercise sciences. In one study, the validity and feasibility of a VR adaptation of the Wingate Anaerobic Test were investigated, and it was reported that the VR version produced performance outcomes comparable to the conventional test, while participant satisfaction was significantly higher with the VR-based method. Likewise, another study demonstrated that the VR adaptation of the Six-Minute Pegboard and Ring Test exhibited high levels of validity and reliability. Together, these studies indicate that VR-based functional tests are both feasible and clinically consistent. Despite this, no studies to date have examined the validity and reliability of the Five-Repetition Sit-to-Stand test in an immersive VR environment for assessing lower extremity function. Therefore, the present study aims to determine the validity, reliability, and feasibility of a virtual reality-based Five-Repetition Sit-to-Stand test (5STS-VR) developed on the Meta Quest 3 platform in asymptomatic young adults. Additionally, convergent validity will be evaluated by analyzing the relationships between performance data obtained from the virtual environment and outcomes of the Y-Balance Test and lower extremity muscle strength measurements.

Virtual Reality-Based Timed Up and Go Test in Young Adults

Functional mobility encompasses the essential motor skills required for individuals to perform activities of daily living independently and safely. One of the most commonly used methods for assessing this parameter is the Timed Up and Go (TUG) test. The TUG test involves standing up from a chair, walking, turning, walking back three meters, and sitting down, and it is a measurement tool that has demonstrated high sensitivity and reliability in clinical practice for evaluating lower extremity function, mobility, and fall risk. However, tests conducted in conventional clinical settings have limitations in terms of standardization due to examiner-related variability, environmental influences, and measurement subjectivity. These factors may lead to measurement errors, particularly when detecting small performance differences. Advances in virtual reality (VR) technology offer an innovative approach to the assessment and training of motor performance by recreating real-life scenarios in a three-dimensional and interactive manner. VR-based systems allow simultaneous observation of motor and cognitive processes while enhancing user motivation and engagement, thereby making the assessment process more dynamic. Recent studies have demonstrated that VR applications are effective tools in neurological rehabilitation, particularly in conditions such as multiple sclerosis (MS), for improving balance, walking speed, and functional mobility. A review of the existing literature reveals that studies evaluating the validity and reliability of VR-based functional tests are limited. Moreover, to date, no study has specifically focused on the validity and reliability of the TUG test in an immersive VR environment for assessing lower extremity functional mobility. Therefore, this study aims to address a significant gap in the literature by being one of the first investigations to examine the validity and reliability of a VR-based version of the TUG test. This study aims to determine the feasibility, validity, and reliability of the TUG test administered in an immersive VR environment in asymptomatic young adults aged 18-30 years. Additionally, the relationships between VR-based TUG outcomes and the 4-Meter Walk Test, the Four Square Step Test, and lower extremity muscle strength measurements will be examined.

Virtual Reality-Based Functional Mobility Tests in Older Adults

Objective assessment of mobility, balance, and lower extremity function in older adults is of great importance in both clinical practice and scientific research. For this purpose, performance-based tests that can be administered in a short time, are easily repeatable, and have high clinical practicality are widely preferred. These tests provide valuable information about older adults' ability to perform activities of daily living, levels of functional independence, and risk of falls, thereby contributing significantly to both diagnostic processes and treatment planning. One of these tests, the 4-Meter Walk Test (4MWT), is among the simplest and most reliable methods used to assess walking speed in older adults. Gait speed is considered a strong indicator of functional capacity and overall health status in older individuals and is also used as a critical parameter for predicting mortality, morbidity, hospitalization rates, and duration of independent living. Therefore, due to its short administration time, high repeatability, and clinical validity, the 4MWT has become one of the standard assessment tools in the field of geriatrics. Another frequently used assessment tool, the Five-Times Sit-to-Stand Test (5xSTS), is based on measuring the time required for an individual to consecutively stand up from and sit down on a chair five times. This test is closely associated with lower extremity muscle strength, functional independence, and the ability to maintain activities of daily living. In addition, the 5xSTS test is an important clinical tool for identifying muscle weakness and mobility limitations in older adults with a history of falls. Owing to its short administration time, lack of requirement for specialized equipment, and ease of understanding, it is widely used in both clinical settings and field studies. In addition, the Timed Up and Go (TUG) test is considered one of the gold standard methods for the assessment of functional mobility. The test is simple to administer: the time required for an individual to stand up from a chair, walk a specified distance, turn around, and return to sit down is measured. The TUG test not only assesses mobility but is also a reliable and valid method for predicting balance impairments and fall risk. Given that falls represent a major health concern in older adults, data obtained from the TUG test provide valuable guidance for both clinicians and researchers. In recent years, virtual reality (VR)-based assessment methods have attracted increasing attention due to their potential to provide a safe, motivating, and standardized environment, particularly for older adults. In this study, the Meta Quest 3 virtual reality headset and controllers will be used to implement VR-based functional tests. The Meta Quest 3 device features a resolution of 2064 × 2208 pixels per eye, a maximum refresh rate of 120 Hz, and a six-degrees-of-freedom (6 DoF) inside-out tracking system. The device tracks participants' head and body movements in real time and accurately reflects them within the virtual environment. This system does not require external sensors and automatically provides positional tracking in the virtual space. Previous studies have demonstrated that VR applications can produce valid and reliable outcomes when used as digital adaptations of functional tests. However, the validity and reliability of VR adaptations of the 4MWT, 5xSTS, and TUG tests in older adults have not yet been systematically investigated. The rationale of this study is to determine whether VR-based short performance tests can serve as a safer, more easily repeatable, and potentially more accessible alternative to conventional clinical assessments. The findings of this study are expected to provide important evidence supporting the use of VR technology in clinical practice for the assessment of mobility and balance in older adults.