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Hill steepness and distance estimation tasks are widely used to assess the influence of physiological and psychological factors on visuospatial perception, but their test\u2013retest reliability and measurement error are unknown. Such information is important to contextualise repeated measures study designs and understanding individual level differences. We aimed to evaluate the test\u2013retest reliability and establish the smallest\u00a0real\u00a0difference (SRD) of three commonly used visuospatial perception tasks (ascending and descending hill steepness estimation, the distance-on-hill task) in healthy controls (<jats:italic>n<\/jats:italic>\u2009=\u200933) and people with painful knee osteoarthritis (<jats:italic>n<\/jats:italic>\u2009=\u200933). All participants completed the virtual reality visuospatial perception tasks two times, one week apart. Intraclass correlation coefficients (ICC), Bland\u2013Altman plots, and SRD were used to evaluate the tasks. Our results revealed that both hill steepness estimation tasks are suitable for repeat administration in both populations given excellent reliability (uphill ICC\u2009=\u20090.80 to 0.85; downhill ICC\u2009=\u20090.89 to 0.90) and high sensitivity to change (uphill SRD\u2009=\u200917.7 to 18.9 degrees; downhill SRD\u2009=\u200912.1 to 14.7 degrees). The distance-on-hill task may have limited utility due to its poor reliability (ICC\u2009=\u20090.29 to 0.38) and low sensitivity to change (SRD\u2009=\u20096.20 to 8.5\u00a0m). Our findings provide methodological support for the use of hill steepness tasks as a measure of visuospatial perception in embodied perception research.<\/jats:p>","DOI":"10.1007\/s00426-025-02125-0","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T15:21:57Z","timestamp":1747754517000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessing visuospatial perception in clinical and healthy populations: Test\u2013retest reliability and smallest real difference of hill steepness estimation and the distance-on-hill task in virtual reality"],"prefix":"10.1007","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3556-233X","authenticated-orcid":false,"given":"Erin","family":"MacIntyre","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4889-1319","authenticated-orcid":false,"given":"Mirinda M.","family":"Whitaker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6676-026X","authenticated-orcid":false,"given":"Felicity A.","family":"Braithwaite","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4238-2951","authenticated-orcid":false,"given":"Jeanine K.","family":"Stefanucci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7106-4456","authenticated-orcid":false,"given":"Tasha R.","family":"Stanton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,5,20]]},"reference":[{"issue":"1","key":"2125_CR1","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1111\/j.2517-6161.1991.tb01812.x","volume":"53","author":"M Aitkin","year":"1991","unstructured":"Aitkin, M. 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All study participants gave informed consent prior to their inclusion in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"EM is supported by the University of South Australia Post Graduate Award (USAPA) and by a National Health & Medical Research Council Project Grant to TRS (ID1161634). FAB is supported by the John Stuart Colville Fellowship via the Arthritis Foundation of South Australia. FAB has received speaker fees for providing lectures related to pain and blinding in clinical trials.\u00a0MMW is supported by the National Institute Of Arthritis And Musculoskeletal And Skin Diseases of the National Institutes of Health under Award Number F31 AR083815. TRS receives book royalties and speaker fees for lectures relating to pain and rehabilitation. 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