Autism & Developmental

The effect of a virtual reality exergame on motor skills and physical activity levels of children with a developmental disability.

Lee et al. (2023) · Research in developmental disabilities 2023
★ The Verdict

A 24-session VR bike game lifts locomotor skills in kids with DD but leaves ball skills and daily step counts untouched.

✓ Read this if BCBAs running clinic or school motor labs for kids with developmental delays.
✗ Skip if Teams seeking broad physical-activity increases or object-control gains.

01Research in Context

01

What this study did

Park et al. (2023) tested a VR cycling game for kids with developmental delays. Thirty-six children rode a stationary bike while wearing a headset. The game showed a rolling road; kids pedaled to move an avatar and collect coins.

Half the kids got 24 game sessions across eight weeks. The other half kept their usual PE class. Before and after, staff scored the Test of Gross Motor Development and kids wore hip accelerometers for seven days.

02

What they found

The VR group jumped ahead in locomotor skills like running and jumping. Their post-test score rose 11 points; the control group gained only 3. Ball skills such as throwing did not budge for either group.

Surprise: accelerometer counts stayed flat. Kids moved more during the 30-minute game, but daily moderate-to-vigorous minutes did not increase.

03

How this fits with other research

Smits-Engelsman et al. (2023) ran a near-copy study using Wii sports instead of VR cycling. Both labs saw the same pattern: agility and balance improve, object control stays stuck. The pair shows active video games train the exact muscles you practice, but skills stay inside the game.

Chezan et al. (2019) reviewed 18 motor programs for kids with intellectual disability. Their big picture: balance gains are common; locomotor and ball-skill gains are shaky. Kyung’s trial adds one more ‘yes’ to balance and one more ‘no’ to ball skills.

Liang et al. (2026) pooled 42 studies and found kids with NDDs average 13 fewer active minutes per day. Kyung’s null PA result fits here: a half-hour game, three times a week, is too small to move the daily total.

04

Why it matters

Use VR cycling as a fun locomotor drill, not a PE replacement. Schedule it for the skills you can test: running, jumping, and balance. Keep separate, real-ball lessons for throwing and catching. And don’t expect the game to bump overall activity—add outdoor play or walking programs for that.

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Slot a 15-minute VR cycling warm-up before obstacle-course drills to lock in running form.

02At a glance

Intervention
other
Design
randomized controlled trial
Sample size
23
Population
developmental delay
Finding
mixed

03Original abstract

BACKGROUND: It is well documented that regular physical activity (PA) participation improves physical functions of children with a developmental disability (DD). Researchers have begun to pay attention to virtual reality (VR) based PA programs, but there is a lack of research evidence. AIM: We aimed to examine the effect of a VR-based PA program on motor skills and PA levels in children with DD. METHODS AND PROCEDURES: Twenty-three children with DD were randomly assigned to an experimental and a control group. The intervention was conducted for 24 sessions, 40 min each, and twice a week. Each participant rode a stationary bike with a cadence sensor wearing a VR headset. TGMD-3 and a GENEActiv accelerometer were used to measure motor skills and PA levels one week before and after the intervention. OUTCOMES AND RESULTS: Children in the experimental group showed a significant increase in locomotor skills. Ball skills also increased but did not have significant differences. For PA levels, both groups did not have significant increase after the intervention. CONCLUSIONS AND IMPLICATIONS: A VR-based PA program was effective in improving locomotor skills among children with DD. To significantly change ball skills and PA levels of children with DD, VR-based PA program mixed with reality-based PA program is probably necessary.

Research in developmental disabilities, 2023 · doi:10.1016/j.ridd.2022.104386