The Effects of Virtual Reality Nonphysical Mental Training on Balance Skills and Functional Near-Infrared Spectroscopy Activity in Healthy Adults

Abstract

Context: Athletic skills such as balance are considered physical skills. However, these skills may not just improve by physical training, but also by mental training. The purpose of this study was to investigate the effects of mental training programs on balance skills and hemodynamic responses of the prefrontal cortex. Design: Randomized controlled trial. Methods: Fifty-seven healthy adults (28 females, 29 males), aged between 18–25 years, participated in this study. Participants were randomly assigned to 3 groups: virtual reality mental training (VRMT) group, conventional mental training (CMT) group, and control group. The training program included action observation and motor imagery practices with balance exercise videos. The VRMT group trained with a VR head-mounted display, while the CMT group trained with a non-immersive computer screen, for 30 minutes, 3 days per week for 4 weeks. At baseline and after 4 weeks of training, balance was investigated with stabilometry and Star Excursion Balance Test (SEBT). Balance tests were performed with simultaneous functional near-infrared spectroscopy (fNIRS) imaging to measure prefrontal cortex oxygenation. Results: For the stabilometry test, at least 1 variable improved significantly in both VRMT and CMT groups but not in the control group. For SEBT, composite reach distance significantly increased in both VRMT and CMT groups but significantly decreased in the control group. For separate directional scores, reach distance was significantly increased in both mental training groups for nondominant leg posterolateral and posteromedial directions, and dominant leg posterolateral direction, while nondominant posteromedial score was significantly increased only in the VRMT group. Between-group comparisons showed that dominant leg posteromedial and posterolateral score improvements were significantly higher than control group for both mental training groups, while nondominant leg improvements were significantly higher than control group only for the VRMT group. The fNIRS oxyhemoglobin levels were not significantly changed during stabilometry tests. However, oxyhemoglobin levels significantly reduced only in the control group during SEBT. Conclusions: Our findings suggest that both mental training interventions can significantly improve balance test results. Additionally, VRMT may have some advantages over CMT. These findings are promising for the use of mental training in prevention and rehabilitation for special populations such as athletes and older adults.

The Arrival of the Metaverse in Neurorehabilitation: Fact, Fake or Vision?

“…Motor imagery and action observation are two clear examples of training opportunities that are more powerful when boosted by immersive virtual reality, both for motor recovery after stroke, [ 33 ] and improving the motor control of a body powered prosthesis [ 34 ]. Moreover, coordination and skill transfer (two important components in sports and in neuromotor rehabilitation) can also be better trained through mental training performed with immersive virtual reality [ 35 , 36 ]…”

Virtual training, real effects: A narrative review on sports performance enhancement through interventions in virtual reality

“…More research and evidence from applied practice, however, is required to further clarify the advantages of using VR; and whether the virtual environment is evoking experiences and psychological states that are the same as, or at least similar to, the real world. Furthermore, evidence of the neuroscientific basis of potential VR training benefits (i.e., in terms of neural plasticity) is largely missing (with notable recent exceptions, e.g., Köyağasıoğlu et al, 2022) .…”

“…Due to its 360-degree nature and responsiveness to head movements, VR is more immersive than videos watched on screens (Pagé et al, 2019), which is currently the most common way to assist athletes in imagery interventions (Bedir & Erhan, 2021). Assuming an enhanced sense of presence is beneficial to imagery (Bedir & Erhan, 2021;Köyağasıoğlu et al, 2022), athletes should be able to image more effectively using VR.…”

“…These results show that VR-assisted imagery training can be an effective method of improving sports-related psychological skills, including both cognitive performance and mental strategies. It should also be noted that the program received very positive feedback from both players and coaches, as reflected in the high compliance rate.Conducting a randomized controlled trial,Köyağasıoğlu et al (2022) investigated the effects of VR training on balance skills and prefrontal hemodynamic responses (assessed via functional near-infrared spectroscopy; fNIRS). 28 females and 29 males were randomly assigned to one of three groups: virtual reality mental training (VRMT), conventional mental training (CMT), and a control group.…”

Construction and Application of Virtual Reality-Based Sports Rehabilitation Training Program

“…In a virtual exercise experiment comparing the training benefits of virtual exercise from different perspectives, this study found that the more immersive first-view training significantly enhanced trainers' motivation and riding speed [ 11 ]. The experiment used virtual opponents for virtual obstacle running training, and virtual training was found to improve trainers' decision-making ability and enhance athletic performance by rating speed, stride count, and decision-making ability [ 12 ].…”