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Pediatric Rehabilitation

The Impact of Virtual Reality on Locomotor Performance in Neurodivergent Children

Friday, October 24, 2025
8:00 AM - 9:15 AM MT
Location: Original Research Theater

    Primary Author(s)

  • Noah D. Chernik, Other

    Student
    New York Institute of Technology College of Osteopathic Medicine
    Bay Shore, New York

    • Co-Author(s)

  • SG

    Santiago Gonzalez, Other

    Doctor of Occupational Therapy
    Mount Sinai Health System (MSM), New York

  • AL

    Alexander Lopez, Other

    Associate Professor
    New York Institute of Technology College of Osteopathic Medicine
    Old Westbury, New York

Disclosure(s):
Noah D. Chernik, Other: No financial relationships to disclose
Background and/or Objectives: To assess whether virtual reality (VR) based interventions could boost physical activity without raising perceived exertion in children with autism spectrum disorder (ASD) during treadmill sessions. It also examined whether VR could lead to increased motivation, reduced anxiety, and improved flow, potentially contributing to more engaging and effective therapy approaches for children with developmental disabilities.

Design: Repeated-measures study with two treadmill sessions: one with VR (experimental) and one without VR (control).

Setting : Autism spectrum disorder (ASD) rehabilitation facility.

Participants : Twenty individuals aged 8-19, all clinically diagnosed with Level 1 severity autism spectrum disorder.

Interventions: Locomotor costs were collected using open flow respirometry during continuous steady-state walking. Rate of perceived exertion was assessed at the 0, 2, 4, and 6 minute mark of each trial. Two walking trials were conducted in random order: the control trial without a VR headset and no interactive VR game, and the VR trial where the participant wore a VR headset and played a VR game.

Main Outcome Measures: We assessed how both locomotor costs and rate of perceived exertion changed with and without the use of the virtual reality headset during walking trials.

Results: Comparing the control trial to the VR trial, participants had a statistically significant increase in metabolic cost in the VR trial. Statistically significant increases in cost of locomotion and cost of transport occurred in the VR trial. There was no statistically significant difference in the RPE between the two trial settings.

Conclusions: Our study demonstrates the potential of VR to promote physical activity among children with ASD. The significant increase in energy expenditure during VR-based treadmill sessions, indicates that VR can enhance the effects of exercise and training without changing the perceived exertion level of the participants. This research highlights the positive impact and potential of VR exercise and its feasibility and efficacy for neurodivergent rehabilitation.