{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T21:14:39Z","timestamp":1792271679323,"version":"4.4.0"},"reference-count":41,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Although virtual reality (VR) has been shown to be effective in rehabilitation through motor learning principles, its impact on upper extremity function, particularly in the context of console use, remains unclear. Materials and Methods: This study aimed to investigate the effects of VR-based task-oriented movement on the upper extremity of healthy individuals. A total of 26 healthy individuals performed task-oriented movements in both real and virtual environments in a randomized order. All participants completed a single session of task-oriented movements using a VR Goggle system in a virtual setting. Physiotherapists designed immersive VR-based experiences and 3D screen-based exergames for this study. Upper extremity function was assessed using several measures: joint position sense (JPS) of the wrist and shoulder was evaluated using a universal goniometer, reaction time was measured via a mobile application, and gross manual dexterity was assessed using the box-and-block test (BBT). Evaluations were conducted before and after the interventions. Results: The results showed that JPS remained similar between conditions, while BBT performance improved in both groups. However, the reaction time increased significantly only after VR intervention (p &lt; 0.05). No significant period or carryover effects were observed across the parameters. These findings suggest that VR-based task-oriented training positively influences reaction time and supports hand function. Moreover, VR systems that simulate joint position sense similar to real-world conditions may be beneficial for individuals with musculoskeletal motor deficits. Conclusions: These results highlight the potential for integrating VR technology into rehabilitation programs for patients with neurological or orthopedic impairments, providing a novel tool for enhancing upper extremity function and injury prevention strategies.<\/jats:p>","DOI":"10.3390\/medicina61040668","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T08:46:20Z","timestamp":1744274780000},"page":"668","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The Effects of Virtual Reality-Based Task-Oriented Movement on Upper Extremity Function in Healthy Individuals: A Crossover Study"],"prefix":"10.3390","volume":"61","author":[{"given":"Tuba","family":"Maden","sequence":"first","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gaziantep University, 27050 Gaziantep, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halil \u0130brahim","family":"Ergen","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gaziantep University, 27050 Gaziantep, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1659-2157","authenticated-orcid":false,"given":"Zarife","family":"Pancar","sequence":"additional","affiliation":[{"name":"Department of Physical Education and Sport, Faculty Sport Science, Gaziantep University, 27310 Gaziantep, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0616-9726","authenticated-orcid":false,"given":"Antonio","family":"Buglione","sequence":"additional","affiliation":[{"name":"Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4254-3105","authenticated-orcid":false,"given":"Johnny","family":"Padulo","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health, Universit\u00e0 degli Studi di Milano, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7144-7403","authenticated-orcid":false,"given":"Gian Mario","family":"Migliaccio","sequence":"additional","affiliation":[{"name":"Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Rome Open University, 00166 Rome, Italy"},{"name":"Athlete Physiology, Psychology and Nutrition Unit, Maxima Performa, 20126 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1902-4830","authenticated-orcid":false,"given":"Luca","family":"Russo","sequence":"additional","affiliation":[{"name":"Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Carnevale, A., Mannocchi, I., Sassi, M.S.H., Carli, M., De Luca, G., Longo, U.G., Denaro, V., and Schena, E. (2022). Virtual reality for shoulder rehabilitation: Accuracy evaluation of Oculus Quest 2. Sensors, 22.","DOI":"10.3390\/s22155511"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s12984-020-00801-3","article-title":"Immersive virtual reality health games: A narrative review of game design","volume":"18","author":"Tao","year":"2021","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Greco, G., Centrone, C., Poli, L., Silva, A.F., Russo, L., Cataldi, S., Giustino, V., and Fischetti, F. (2024). Impact of coastal walking outdoors and virtual reality indoor walking on heart rate, enjoyment levels, and mindfulness experiences in healthy adults. J. Funct. Morphol. Kinesiol., 9.","DOI":"10.20944\/preprints202311.1631.v1"},{"key":"ref_4","first-page":"165","article-title":"Non-immersive virtual reality rehabilitation applied to a task-oriented approach for stroke patients: A randomized controlled trial","volume":"38","author":"Lee","year":"2020","journal-title":"Restor. Neurol. Neurosci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e00526","DOI":"10.1016\/j.heliyon.2018.e00526","article-title":"ReHabgame: A non-immersive virtual reality rehabilitation system with applications in neuroscience","volume":"4","author":"Esfahlani","year":"2018","journal-title":"Heliyon"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Pillai, A., Sunny, M.S.H., Shahria, M.T., Banik, N., and Rahman, M.H.J.A.S. (2022). Gamification of upper limb rehabilitation in mixed-reality environment. Appl. Sci., 12.","DOI":"10.3390\/app122312260"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"81","DOI":"10.5114\/pq.2021.111210","article-title":"Impact of virtual reality program on upper limb function post-stroke: A randomized controlled trial","volume":"30","author":"Hegazy","year":"2022","journal-title":"Physiother. Q."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"725","DOI":"10.23736\/S1973-9087.17.04489-6","article-title":"Factors enhancing activities of daily living after stroke in specialized rehabilitation: An observational multicenter study within the Sunnaas International Network","volume":"53","author":"Langhammer","year":"2017","journal-title":"Eur. J. Phys. Rehabil. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"136814","DOI":"10.1016\/j.neulet.2022.136814","article-title":"Involvement of visual signals in kinaesthesia: A virtual reality study","volume":"786","author":"Dupraz","year":"2022","journal-title":"Neurosci. Lett."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3157","DOI":"10.1007\/s00221-021-06207-4","article-title":"Two senses of human limb position: Methods of measurement and roles in proprioception","volume":"239","author":"Proske","year":"2021","journal-title":"Exp. Brain Res."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Kaneko, F., Blanchard, C., Lebar, N., Nazarian, B., Kavounoudias, A., and Romaigu\u00e8re, P. (2015). Brain regions associated with a kinesthetic illusion evoked by watching a video of one\u2019s own moving hand. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0131970"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1016\/j.neuroscience.2007.07.028","article-title":"Kinesthetic illusory feeling induced by a finger movement movie: Effects on corticomotor excitability","volume":"149","author":"Kaneko","year":"2007","journal-title":"Neuroscience"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2402","DOI":"10.1080\/09593985.2021.1941458","article-title":"Effectiveness of virtual reality-based rehabilitation versus conventional therapy on upper limb motor function of chronic stroke patients: A systematic review and meta-analysis of randomized controlled trials","volume":"38","author":"ElSerougy","year":"2022","journal-title":"Physiother. Theory Pract."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Aman, J.E., Elangovan, N., Yeh, I.-L., and Konczak, J. (2015). The effectiveness of proprioceptive training for improving motor function: A systematic review. Front. Hum. Neurosci., 8.","DOI":"10.3389\/fnhum.2014.01075"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"De Santis, D., Zenzeri, J., Casadio, M., Masia, L., Riva, A., Morasso, P., and Squeri, V. (2015). Robot-assisted training of the kinesthetic sense: Enhancing proprioception after stroke. Front. Hum. Neurosci., 8.","DOI":"10.3389\/fnhum.2014.01037"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1017\/S0263574714002252","article-title":"A new method for evaluating kinesthetic acuity during haptic interaction","volume":"32","author":"Zenzeri","year":"2014","journal-title":"Robotica"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1186\/s12984-020-00727-w","article-title":"Robotics-assisted visual-motor training influences arm position sense in three-dimensional space","volume":"17","author":"Khoshnam","year":"2020","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.apmr.2020.09.395","article-title":"Effects of virtual reality vs conventional balance training on balance and falls in people with multiple sclerosis: A randomized controlled trial","volume":"102","author":"Molhemi","year":"2021","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1080\/17518423.2017.1368730","article-title":"Use of virtual reality intervention to improve reaction time in children with cerebral palsy: A randomized controlled trial","volume":"21","author":"Pourazar","year":"2018","journal-title":"Dev. Neurorehabil."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1089\/cpb.2006.9997","article-title":"Functional balance and dual-task reaction times in older adults are improved by virtual reality and biofeedback training","volume":"10","author":"Bisson","year":"2007","journal-title":"Cyberpsychol. Behav."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1037\/h0022634","article-title":"Premotor and motor components of reaction time","volume":"71","author":"Botwinick","year":"1966","journal-title":"J. Exp. Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1093\/geronj\/20.1.60","article-title":"The locus of reaction time change with set, motivation, and age","volume":"20","author":"Weiss","year":"1965","journal-title":"J. Gerontol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1007\/s12283-019-0299-0","article-title":"Training using virtual reality improves response behavior in karate kumite","volume":"22","author":"Petri","year":"2019","journal-title":"Sports Eng."},{"key":"ref_24","first-page":"2014-0309","article-title":"Interrater and intrarater reliability and validity of three measurement methods for shoulder-position sense","volume":"25","author":"Vafadar","year":"2016","journal-title":"J. Sport Rehabil."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1080\/08990220.2019.1644998","article-title":"An investigation of upper extremity function in patients with multiple sclerosis, and its relation with shoulder position sense and disability level","volume":"36","author":"Ozkan","year":"2019","journal-title":"Somatosens. Mot. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1016\/j.apmr.2023.12.004","article-title":"The effect of proprioceptive training on hand function and activity limitation after open carpal tunnel release surgery: A randomized controlled study","volume":"105","author":"Ergen","year":"2024","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s12995-024-00430-9","article-title":"The impact of fine motor activities like playing musical instruments on the thickness and strength of the flexor digitorum muscle","volume":"19","author":"Ioannou","year":"2024","journal-title":"J. Occup. Med. Toxicol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"386","DOI":"10.5014\/ajot.39.6.386","article-title":"Adult norms for the Box and Block Test of manual dexterity","volume":"39","author":"Mathiowetz","year":"1985","journal-title":"Am. J. Occup. Ther."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Tornero-Aguilera, J.F., Jimenez-Morcillo, J., Rubio-Zarapuz, A., and Clemente-Su\u00e1rez, V. (2022). Central and peripheral fatigue in physical exercise explained: A narrative review. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19073909"},{"key":"ref_30","unstructured":"Zakharov, A.V., Kolsanov, A.V., Khivintseva, E.V., Pyatin, V.F., and Yashkov, A.V. (2021). Proprioception in Immersive Virtual Reality, IntechOpen."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1080\/1363849021000039344","article-title":"Benefits of a virtual play rehabilitation environment for children with cerebral palsy on perceptions of self-efficacy: A pilot study","volume":"5","author":"Reid","year":"2002","journal-title":"Pediatr. Rehabil."},{"key":"ref_32","first-page":"26","article-title":"Video games: Utilization of a novel strategy to improve perceptual motor skills and cognitive functioning in the non-institutionalized elderly","volume":"4","author":"Drew","year":"1986","journal-title":"Cogn. Rehabil."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1037\/0090-5550.46.3.296","article-title":"The application of virtual reality technology in rehabilitation","volume":"46","author":"Schultheis","year":"2001","journal-title":"Rehabil. Psychol."},{"key":"ref_34","first-page":"62","article-title":"Virtual environment training: A new tool for neurorehabilitation","volume":"26","author":"Holden","year":"2002","journal-title":"J. Neurol. Phys. Ther."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1161\/01.STR.31.6.1210","article-title":"Treatment-induced cortical reorganization after stroke in humans","volume":"31","author":"Liepert","year":"2000","journal-title":"Stroke"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s12984-016-0125-x","article-title":"Effects of virtual reality-based rehabilitation on distal upper extremity function and health-related quality of life: A single-blinded, randomized controlled trial","volume":"13","author":"Shin","year":"2016","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_37","first-page":"CD008349","article-title":"Virtual reality for stroke rehabilitation","volume":"11","author":"Laver","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/1743-0003-8-27","article-title":"Robotically facilitated virtual rehabilitation of arm transport integrated with finger movement in persons with hemiparesis","volume":"8","author":"Merians","year":"2011","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1007\/s10439-014-1218-y","article-title":"Virtual immersion for post-stroke hand rehabilitation therapy","volume":"43","author":"Tsoupikova","year":"2015","journal-title":"Ann. Biomed. Eng."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Witte, K., Droste, M., Ritter, Y., Emmermacher, P., Masik, S., B\u00fcrger, D., and Petri, K. (2022). Sports training in virtual reality to improve response behavior in karate kumite with transfer to real world. Front. Virtual Real., 3.","DOI":"10.3389\/frvir.2022.903021"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Pumpho, A., Kaewsanmung, S., Keawduangdee, P., Suwannarat, P., and Boonsinsukh, R. (2023). Development of a mobile application for assessing reaction time in walking and TUG duration: Concurrent validity in female older adults. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1076963"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/4\/668\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:10:29Z","timestamp":1760029829000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/4\/668"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,4]]},"references-count":41,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["medicina61040668"],"URL":"https:\/\/doi.org\/10.3390\/medicina61040668","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,4]]}}}