A Preliminary Study of a Virtual Reality Design Framework for Motor Training Integrating Proactive and Reactive Task Constraints and Augmented Auditory Feedback

After neurological injury, individuals often undergo physical therapy to regain motor function, which can be supplemented with use of virtual reality (VR). Rehabilitation commonly employs methods that encourage movement variability to promote functional gains, such as perturbations. Rehabilitation also commonly integrates additional sensory modalities for guidance and cognitive engagement to the protocol. In this exploratory, proof-of-concept study, neurotypical participants were trained on a custom tracing task with targeted dynamic shifting to induce movement variability, under both expected (proactive) and unexpected (reactive) conditions, with and without added auditory feedback. Participants significantly (p < 0.05) improved performance (tracing accuracy) after training with audio feedback. Participants trained without audio feedback showed decreased electrodermal activity (EDA), a measure of physiological engagement. Audio feedback during reach training with complex objectives (e.g., dynamic shifting) can promote performance improvements and cognitive engagement.