Effects of a Virtual Reality-Based Physical Activity Program Using Three Levels of Immersion on Postural Control and Motor Skills in Children With Developmental Disability

Children with developmental disabilities (DD) exhibit low postural control and increased body sway, leading to delays in motor skill development. This study examined the effects of a virtual reality-based physical activity program with three immersion levels (non-, semi-, and fully immersive) on postural control and motor skills in children with DD. Twenty-four children with DD were randomly assigned to experimental and control groups. The 12-week program (twice/week and 60 min) used Action Floor, Xbox, and Oculus Quest 2. Postural stability and limits of stability were measured using the Balance System SD, and motor skills were assessed with the Test of Gross Motor Development-3. The experimental group showed greater improvement than the control group in gross motor skills ( p  p  < .001). These findings suggest that a virtual reality-based physical activity program using multiple immersion levels may enhance the limits of stability and motor skills in children with DD.