The purpose of this pilot randomized controlled study is to evaluate the effects of an immersive virtual reality (IVR)-based physical intervention program on reaction time in secondary school students. Participants will be randomly assigned to either an experimental group, which will complete an immersive virtual reality training program using the Rezzil Player platform, or a control group that will continue their usual activities without virtual reality exposure. The intervention will be conducted over eight weeks and will include progressive reaction-based tasks performed in immersive virtual reality environments. Outcomes will be assessed before and after the intervention through visual and auditory reaction time tests and the Symbol Digit Modalities Test (SDMT), a validated measure of cognitive processing speed and attention. The study aims to determine whether immersive virtual reality training can improve reaction performance and cognitive processing in adolescents and provide preliminary evidence regarding its feasibility and effectiveness as an educational and physical training tool.
Reaction time is a key component of motor performance and is closely associated with perceptual, cognitive, and decision-making processes. The ability to rapidly detect, process, and respond to external stimuli is particularly important during adolescence, a developmental stage characterized by significant cognitive and motor maturation. Emerging evidence suggests that immersive virtual reality (IVR) may provide an effective environment for training perceptual-motor skills due to its capacity to simulate dynamic and interactive scenarios while maintaining high levels of engagement and motivation. Despite the increasing use of virtual reality in sport and physical activity settings, evidence regarding its effects on reaction time in adolescents remains limited. Therefore, this pilot study seeks to evaluate the effectiveness of an immersive virtual reality-based intervention program in improving reaction times among secondary school students. The study will employ a randomized controlled design. Participants will be secondary school students aged between 12 and 16 years. Following baseline assessments, participants will be randomly allocated to either an experimental group or a control group. The experimental group will complete an 8-week intervention consisting of immersive virtual reality sessions using the Rezzil Player application. Training tasks will require participants to identify and respond as quickly as possible to visual stimuli presented in virtual environments of increasing complexity and spatial demands. The control group will not participate in any virtual reality-related activity during the intervention period. Outcome measures will be collected before and after the intervention. Primary outcomes will include visual reaction time, auditory reaction time, and cognitive processing speed assessed through the Symbol Digit Modalities Test (SDMT). Secondary outcomes may include performance indicators related to physical and sport-specific activities. Safety and participant experience during the intervention will be monitored through validated questionnaires assessing simulator sickness symptoms and user experience. The primary hypothesis is that participation in the immersive virtual reality intervention will improve reaction time performance and cognitive processing speed compared with the control condition. This pilot study will provide preliminary evidence regarding the feasibility, safety, and potential effectiveness of immersive virtual reality interventions for enhancing perceptual-motor performance in adolescents.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
24
The intervention consisted of a structured eye-hand coordination training program delivered through immersive virtual reality using the Rezzil Player: MicroWall exergame and a Meta Quest 2 head-mounted display with handheld controllers. Participants completed one familiarization session followed by 13 training sessions over 8 weeks (two sessions per week). During each session, participants were required to identify and touch randomly appearing red visual targets as quickly as possible using the controllers. Training difficulty was progressively increased by modifying the spatial configuration of the virtual panels (3×3, 60°, 180°, and 360°). Each training trial lasted 1 minute, and performance was quantified according to the number of targets successfully reached and response speed.
Participants continued their standard handball training routines under the supervision of their coaches according to normal club practice. No specific experimental intervention, placebo treatment, or virtual reality-based training was administered during the study period.
Club de Balonmano Teucro
Pontevedra, Pontevedra, Spain
Visual Reaction Time
Visual Reaction Time (milliseconds) Visual reaction time was assessed using the Fast Reflex smartphone application. Participants were instructed to touch the screen as quickly as possible when it changed color from red to green. Response times were automatically recorded by the application and expressed in milliseconds. Three familiarization trials were completed before testing, and the subsequent three trials were recorded for analysis.
Time frame: 8 weeks
Auditory Reaction Time
Auditory Reaction Time (milliseconds) Auditory reaction time was assessed using the Fast Reflex smartphone application. Participants were instructed to touch the screen as quickly as possible upon hearing an auditory signal emitted by the device. Response times were automatically recorded in milliseconds. Following three familiarization trials, the next three trials were recorded and used for analysis.
Time frame: 8 weeks
Cognitive Processing Speed
Cognitive Processing Speed (SDMT score) Cognitive processing speed was assessed using the Symbol Digit Modalities Test (SDMT). Participants were required to match a series of symbols with their corresponding numbers as quickly and accurately as possible according to a predefined key. The outcome measure was the total number of correct responses completed within 90 seconds. The number of errors committed during task performance was also recorded.
Time frame: 8 weeks
Tactical Effectiveness Index
Tactical Effectiveness Index (TEI; 0-100 points) Tactical effectiveness was assessed using a composite Tactical Effectiveness Index (TEI) derived from official competition statistics. The index incorporated positive performance indicators (goals scored, shooting percentage, 7-m throws earned, ball recoveries, defensive blocks, saves, and save percentage) and negative performance indicators (7-m throws conceded, turnovers, 2-min suspensions, and disciplinary sanctions). All variables were standardized using z-scores. For negative indicators, z-scores were multiplied by -1 so that higher values consistently reflected greater tactical effectiveness. Standardized scores were summed to obtain a raw score and subsequently transformed to a 0-100 scale using min-max normalization. Higher scores indicate greater tactical effectiveness.
Time frame: 8 weeks
Simulator Sickness Questionnaire
Simulator Sickness Questionnaire (SSQ score) The safety and tolerability of the immersive virtual reality intervention were evaluated using the Simulator Sickness Questionnaire (SSQ). The questionnaire assesses symptoms associated with cybersickness, with higher scores indicating greater symptom severity.
Time frame: 8 weeks
Game Experience Questionnaire - Post-Game Module
Game Experience Questionnaire - Post-Game Module (GEQ score 0-100) Participants' subjective experience with the virtual reality system was evaluated using the Game Experience Questionnaire - Post-Game Module (GEQ). This instrument assesses dimensions related to the user experience following interaction with the virtual reality environment.
Time frame: 8 weeks
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