Jochmann Elisabeth, Jochmann Thomas, Weber Maximilian, Weigel Karolin, Klingner Carsten
Department of Neurology, Jena University Hospital, Jena, Germany.
Department of Computer Science and Automation, Technische Universität Ilmenau, Ilmenau, Germany.
J Neuroeng Rehabil. 2025 Jul 3;22(1):143. doi: 10.1186/s12984-025-01677-x.
Virtual reality (VR) technology offers immersive and interactive experiences and is increasingly being explored for rehabilitation therapies. However, concerns about side effects such as nausea and dizziness-collectively referred to as VR sickness-are holding back clinical translation. Sensorimotor mismatches, while potentially beneficial for motor learning, may exacerbate these effects. The age groups in VR applications differ, with younger users common in gaming and older adults prevalent in rehabilitation. This study investigated whether sensorimotor mismatches in a VR-based motor task make the experience more uncomfortable and whether older adults are more affected by these mismatches.
We conducted a randomized controlled trial with 104 healthy right-handed adults, including elderly participants up to 84 years old, to cover the relevant demographics for rehabilitation. Participants were divided into three intervention groups and performed a VR ball-throwing task using an Oculus Rift S head-mounted display. The groups differed in task difficulty and exposure to deliberately induced sensorimotor mismatches. The design avoided visual-vestibular conflicts typically responsible for VR sickness and instead introduced proprioceptive mismatches during hand-object interaction. VR sickness was measured using the Simulator Sickness Questionnaire (SSQ), and user experience was assessed through a self-developed questionnaire. Statistical analysis was performed using rank-transformed ANOVA, ordinal logistic regression, and Spearman's rho with FDR correction for multiple comparisons.
Results indicated no significant differences in SSQ scores among the three intervention groups, suggesting that sensorimotor mismatches do not increase VR sickness. However, the Mismatch group reported higher levels of exhaustion and frustration compared to the Error-based and Errorless groups, indicating the impact of cognitive strain and task difficulty on user experience. Interestingly, younger participants reported higher (worse) SSQ scores, while older participants experienced weaker symptoms.
VR environments with sensorimotor mismatches during hand-object interaction tasks may be feasible for rehabilitation, as they did not lead to significant discomfort in this setting. Moreover, despite concerns about age-related susceptibility to dizziness, older adults showed high tolerance to VR, supporting its potential for broader applications in rehabilitation settings. This study was reported in accordance with the CONSORT guidelines. It was registered in the German Clinical Trials Register (DRKS00034901).
虚拟现实（VR）技术提供沉浸式和交互式体验，并且越来越多地被用于康复治疗的探索。然而，对诸如恶心和头晕等副作用（统称为VR病）的担忧阻碍了其临床转化。感觉运动不匹配虽然可能对运动学习有益，但可能会加剧这些影响。VR应用中的年龄组各不相同，年轻用户在游戏中较为常见，而老年人在康复领域更为普遍。本研究调查了基于VR的运动任务中的感觉运动不匹配是否会使体验更加不舒服，以及老年人是否更容易受到这些不匹配的影响。
我们对104名健康的右利手成年人进行了一项随机对照试验，其中包括年龄最大84岁的老年参与者，以涵盖康复所需的相关人口统计学特征。参与者被分为三个干预组，并使用Oculus Rift S头戴式显示器执行VR投球任务。各组在任务难度和故意诱发的感觉运动不匹配程度上有所不同。该设计避免了通常导致VR病的视觉-前庭冲突，而是在手部与物体交互过程中引入本体感觉不匹配。使用模拟器晕动病问卷（SSQ）测量VR病，并通过自行开发的问卷评估用户体验。使用秩转换方差分析、有序逻辑回归和经FDR校正的Spearman等级相关进行多重比较的统计分析。
结果表明，三个干预组之间的SSQ分数没有显著差异，这表明感觉运动不匹配不会增加VR病。然而，与基于错误和无错误组相比，不匹配组报告的疲惫和沮丧程度更高，表明认知压力和任务难度对用户体验的影响。有趣的是，年轻参与者报告的SSQ分数更高（更差），而老年参与者的症状较轻。
在手部与物体交互任务中存在感觉运动不匹配的VR环境可能适用于康复，因为在这种情况下它们不会导致明显不适。此外，尽管担心年龄相关的头晕易感性，但老年人对VR表现出高耐受性，这支持了其在康复环境中更广泛应用的潜力。本研究按照CONSORT指南进行报告。它已在德国临床试验注册中心（DRKS00034901）注册。
