Education, Neurorehabilitation, Physical Therapy, Virtual Reality
Conditions
Keywords
Neurorehabilitation, Immersive virtual reality, Objective Structured Clinical Examination, Digital health education
Brief summary
This randomized controlled trial evaluated the effectiveness of immersive virtual reality (VR)-based instruction compared with traditional face-to-face teaching for delivering the Bobath concept in physiotherapy education. Third-year physiotherapy students were randomly assigned to either VR-based or conventional instruction and completed standardized theoretical and practical assessments immediately after training and again two weeks later. While both instructional methods resulted in comparable short-term learning outcomes, the VR group demonstrated superior retention of practical skills at follow-up. Findings suggest that immersive VR is a feasible and effective educational approach for enhancing motor skill learning in neurophysiological rehabilitation training.
Detailed description
This two-arm, parallel-group, single-blind randomized controlled trial aims to investigate whether immersive virtual reality (VR)-based education can enhance learning and retention of the Bobath concept among undergraduate physiotherapy students. The Bobath approach, widely used in neurorehabilitation, requires learners to integrate postural control principles, movement facilitation techniques, and sensorimotor strategies-skills traditionally taught through face-to-face lectures and hands-on demonstrations. Given the increasing integration of digital technologies in health professions education, immersive VR may offer an alternative through interactive, high-fidelity, and repeatable learning experiences. Students will be randomized to receive either a standardized face-to-face instructional session or an immersive 360° VR-based session of equivalent duration and content. Both groups will be exposed to theoretical explanations and practical demonstrations focusing on trunk control strategies, alignment principles, and facilitation techniques. Practical components in both groups will be reinforced through structured small-group practice following the instructional session. To ensure methodological rigor, two independent evaluators blinded to group allocation will assess student performance through a multiple-choice knowledge test and a three-station Objective Structured Clinical Examination (OSCE), administered two days after training and again two weeks later to evaluate retention. Inter-rater reliability will be calculated to ensure consistency of scoring across evaluators.
Interventions
DEVICEImmersive VR headset instruction
The study interventions consisted of two educational delivery methods used to teach the Bobath concept in physiotherapy training. Both interventions provided identical learning objectives, theoretical content, and practical demonstration elements related to postural control strategies. The instructional materials were standardized in duration, sequencing, and educational objectives to ensure equivalence across groups. Delivery differed only in format, with one method provided through traditional in-person instruction and the other through immersive virtual reality technology. All students practiced the demonstrated techniques following the instructional component, and no additional instructional materials were provided beyond the assigned modality
OTHERTraditional instruction
This intervention delivers Bobath concept education through conventional face-to-face teaching methods. The instructional session includes faculty-led theoretical explanations and live demonstrations delivered in a traditional classroom or laboratory setting. Students receive the standardized content through direct instructor interaction, consistent with customary physiotherapy training practices. All participants subsequently engage in supervised practice to apply the demonstrated concepts.
Sponsors
Kocaeli Sağlık ve Teknoloji Üniversitesi
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Outcomes Assessor)
Masking description
This study used a single-blind design in which outcome assessors were blinded to group allocation. Participants, care providers, and investigators were not blinded due to the nature of the educational intervention.
Intervention model description
This study used a two-arm, parallel-group, single-blind randomized controlled trial design comparing immersive virtual reality-based instruction with traditional face-to-face education for teaching the Bobath concept to physiotherapy students. Participants were randomly allocated in a 1:1 ratio, and blinded evaluators conducted all theoretical and practical assessments at post-test and retention time points.
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
Yes
Inclusion criteria
* Third-year undergraduate physiotherapy students. * First-time enrollment in the Neurophysiological Approaches II course. * No prior training or formal exposure to the Bobath concept. * System Usability Scale (SUS) score classified as A+ (96-100 percentile). -Ability to participate in VR or face-to-face instruction as assigned.- Voluntary participation with provision of written informed consent.-
Exclusion criteria
* History of medical conditions contraindicating VR use (e.g., vestibular disorders, migraine, epilepsy). * Prior experience, certification, or coursework related to the Bobath concept. * Failure to provide informed consent. * Any condition that may limit safe participation in the educational session or assessments.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Theoretical Knowledge Score | Post-test at 2 days and retention test at 2 weeks after the intervention | Description: The theoretical outcome measure assesses students' understanding of Bobath-based postural control strategies using a 10-item multiple-choice examination. Each correct response is awarded 1 point. Raw scores (0-10) are converted to a 0-100 scale. Score Range: 0-100 Direction: Higher scores indicate better theoretical knowledge. The same standardized test is administered at both assessment points to evaluate learning and retention under the two instructional modalities. |
| Practical Performance Score (OSCE) | Post-test at 2 days and retention test at 2 weeks after the intervention | Practical skill performance is evaluated using a three-station Objective Structured Clinical Examination (OSCE) assessing Bobath-based postural control strategies. Each station uses a standardized 3-point checklist (0 = not performed, 1 = partially performed, 2 = correctly performed). The combined station scores are converted to a 0-100 scale. Score Range: 0-100 Direction: Higher scores indicate better practical performance. All assessments are video-recorded and independently scored by two blinded evaluators using the same scoring rubric. This metric evaluates both immediate skill acquisition and subsequent retention. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Inter-Rater Reliability of Practical Performance Scores | At post-test (2 days) and retention (2 weeks) | Inter-rater reliability of OSCE practical performance scores is assessed using the Intraclass Correlation Coefficient (ICC, two-way random effects, absolute agreement) and Cohen's kappa for pass/fail classification. These metrics evaluate the consistency and agreement between the two blinded evaluators scoring the practical examinations. |
| Pass/Fail Classification Based on Combined Score | Post-test at 2 days and retention test at 2 weeks | Students' overall performance is classified as pass or fail based on a predefined threshold of ≥70% from combined theoretical and practical scores. Pass rates are compared between groups to assess competency achievement in each instructional modality. |
Countries
Turkey (Türkiye)
Outcome results
None listed