Test-Retest Reliability of Immersive Virtual Reality Measures of Perceptual-Motor Performance

Abstract

Background: The duration, accuracy, and consistency of responses to various types of stimuli are widely accepted as indirect indicators of the efficiency of brain information processing, but current clinical tests appear to lack sufficient sensitivity to detect subtle impairments. Purpose: Immersive virtual reality (VR) offers a new means to acquire measures of perceptual-motor responses to moving visual stimuli that require rapid conflict resolution, but their test-retest reliability has not yet been demonstrated. Research Design: Repeated measures. Study Sample: We analyzed data from 19 healthy young adults who performed a 40-trial VR test on three consecutive days. Data Collection and Analysis: We focused on response time (RT) and perceptual latency (PL) for eye, neck, arm, and whole-body step displacements involved in executing a reaching/lunging movement in a right or left direction toward a peripherally located virtual target. Measures of RT and PL included a 40-trial mean, an intra-individual variability (IIV) value, and a rate correct score (RCS) that incorporated both response duration and accuracy. Results: Most mean and IIV values for PL and RT demonstrated a positive distributional skew that was substantially reduced by natural logarithm transformation. While a learning effect was evident between sessions 1 and 2 for 7 of 8 mean PL and RT measures, 3-session intraclass correlation coefficient (ICC) values were moderate to excellent for 15 of 16 transformed PL and RT measures (range: .618 to .922). The composite RCS metric did not require transformation for either PL or RT, whose respective 3-session ICC values were .877 and .851. Conclusions: This moderate to excellent test-retest reliability for various VR measures of perceptual-motor function, combined with evidence of their validity from both past and future research, suggest that these measures can advance clinical detection of impaired brain processing and longitudinal assessments of potentially modifiable performance deficiencies.

Assessment and Training of Perceptual-Motor Function: Performance of College Wrestlers Associated with History of Concussion

“…We assessed the speed-accuracy trade-off through the calculation of a rate correct score (RCS) derived from the number of correct responses divided by the 40-trial sum of the elapsed time for arm movements (higher values represent better performance) for both the PL (PL-RCS) and RT (RT-RCS). Intra-class correlation coefficients demonstrating acceptable test-retest reliability has previously been documented for the various neck, arm, and step VR metrics, with the PL-Avg and RT-Avg values ranging from 0.837 to 0.922, the PL-IIV and RT-IIV values ranging from 0.693 to 0.836, and the PL-RCS and RT-RCS values of 0.851 and 0.887, respectively [28].…”

Concussion history and virtual reality metrics predict core or lower extremity injury occurrence among high school athletes

“…The 40-trial immersive VR test presented eight different combinations of stimulus initial position, stimulus type, and movement direction. The validity of the test for discrimination between individuals with and without a lifetime history of concussion has been established ( 47 ) and documentation of moderate to excellent test–retest reliability for the various measurements derived from the test ( 50 ).…”