Exercise & Training

Game changer? Cognitive-motor effects of VR exergaming compared to video-based training.

TL;DR

Eight weeks of VR and SFV enhanced cognitive and cognitive-motor performance, with VR providing domain-specific advantages in executive function, but SFV sustaining more improvements in real-world-relevant cognitive-motor tasks.

Key Findings

Both VR and video-based stick-fight training improved Stroop reading performance over 8 weeks.

  • Main effect of time for Stroop reading: F(1,53) = 14.84, p < .001, η² = 0.219
  • Improvement was observed across both groups without a significant group × time interaction, indicating neither intervention was superior for this measure
  • N = 55 healthy adults (VR: n = 30; SFV: n = 25; mean age 25.5 ± 7.1 years; 41.8% female)
  • Training program consisted of 2 × 30 min/week for 8 weeks

Both groups improved Stroop inhibition performance, indicating gains in cognitive inhibition regardless of training modality.

  • Main effect of time for Stroop inhibition: F(1,53) = 10.99, p = .002, η² = 0.172
  • No significant group difference was reported for this measure, suggesting equivalent inhibition benefits across VR and SFV
  • Stroop inhibition (version 3) measures the ability to suppress automatic responses, reflecting executive function

Both groups improved Letter Cancellation Test (LCT) performance, reflecting gains in selective attention and processing speed.

  • Main effect of time for LCT: F(1,53) = 4.57, p = .037, η² = 0.079
  • Effect size was small (η² = 0.079) compared to other measures
  • No significant group × time interaction was reported, indicating similar LCT improvement for both modalities

VR training produced greater improvements in Trail Making Test (TMT) performance compared to stick-fight video training.

  • Significant time × group interaction for TMT: F(1,53) = 6.55, p = .031, η² = 0.110
  • This indicates VR provided domain-specific advantages in executive function (cognitive flexibility/set-shifting) over the non-immersive control
  • The TMT measures cognitive flexibility and the ability to alternate between sets, a key executive function domain
  • Effect size was moderate (η² = 0.110)

Both groups showed substantial improvements in cognitive-motor performance on the Trail Walking Test (TWT).

  • Main effect of time for TWT: F(1,25) = 55.32, p < .001, η² = 0.689
  • Effect size was very large (η² = 0.689), indicating robust cognitive-motor gains from both interventions
  • The TWT is described as a real-world-relevant cognitive-motor task
  • No significant group difference was reported for TWT overall improvement

Both groups improved on the Fitts task (difficulty level 3), with VR showing greater gains.

  • Main effect of time for Fitts3: F(1,53) = 44.97, p < .001, η² = 0.459
  • VR group showed significantly greater gains in Fitts3 compared to SFV: p = .006
  • The Fitts task measures speed-accuracy tradeoff in motor targeting, with level 3 representing a specific difficulty condition
  • Large effect size (η² = 0.459) for the main time effect

VR-related advantages in executive function were not uniformly persistent, while SFV sustained more improvements in real-world-relevant cognitive-motor tasks.

  • The study included post-training follow-up measurements to assess persistence of effects
  • VR provided domain-specific but non-uniformly persistent advantages in executive function
  • SFV sustained more improvements in real-world-relevant cognitive-motor tasks despite VR's acute/short-term advantages in some domains
  • This suggests the modality of training may differentially influence retention of cognitive versus cognitive-motor skills

The study design matched VR and stick-fight video conditions on movement patterns, frequency, intensity, and duration to isolate the effect of immersiveness.

  • Randomized quasi-experimental design with N = 55 participants assigned to VR (n = 30) or SFV (n = 25)
  • Both conditions involved 2 × 30 min sessions per week for 8 weeks
  • Matching on movement patterns, frequency, intensity, and duration was used to control for exercise-related confounds
  • Mixed-design ANOVAs were used to analyze outcome data across time and group factors

What This Means

This research suggests that both virtual reality (VR) exergaming and watching and following along with a non-immersive stick-fight video can improve thinking and movement skills in healthy young adults after 8 weeks of twice-weekly 30-minute sessions. Both approaches led to measurable gains in reading speed, the ability to suppress automatic responses (cognitive inhibition), attention, and combined thinking-and-movement tasks. The study was carefully designed so that both groups did the same types of movements for the same amount of time, meaning any differences between the groups could be attributed to the immersive VR experience itself rather than just the exercise. Where VR showed an edge was in executive function — specifically, the ability to flexibly switch between tasks (measured by the Trail Making Test) and a targeting motor task at a specific difficulty level. However, these VR advantages were not consistent across all follow-up measurements, suggesting the benefits may not always last. Interestingly, the non-immersive stick-fight video group maintained more improvements in tasks that resemble everyday real-world movement challenges, raising questions about which format is actually better for long-term practical benefit. This research suggests that immersive VR exercise is not necessarily superior across the board to simpler, cheaper video-based exercise programs. While VR may offer unique short-term boosts in certain executive functions, non-immersive video training can be comparably effective — and possibly more durable — for real-world cognitive-motor skills. These findings are relevant for designing exercise interventions and rehabilitation programs, particularly for settings where VR technology may be costly or inaccessible.

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Citation

Herden M, Grospr&#xea;tre S, Eon P, Bischoff L, Wollesen B. (2026). Game changer? Cognitive-motor effects of VR exergaming compared to video-based training.. Annals of medicine. https://doi.org/10.1080/07853890.2026.2713245