Immersive virtual reality vs. traditional instruction for short-term learning and follow-up outcomes in the Bobath concept: a randomized controlled trial

Abstract

Although virtual reality has increasingly been incorporated into health professions education, its effectiveness for teaching structured neurorehabilitation frameworks within physiotherapy remains insufficiently explored. Purpose: This study aimed to compare immersive virtual reality–based instruction with traditional education by evaluating theoretical knowledge and practical skills at short-term (2 days) and follow-up (2 weeks) assessments following Bobath concept instruction among physiotherapy students. Methods: In this assessor-blinded randomized controlled trial, 20 third-year physiotherapy students (mean age: 21.3 ± 1.1 years) were randomly assigned to immersive virtual reality–based instruction or traditional instruction. Both groups received standardized 45-minute training on postural control strategies within the Bobath concept. Learning outcomes were assessed using a multiple-choice theoretical test and a practical examination at 2 days (short-term) and 2 weeks (follow-up) after instruction. Results: Both groups showed a decrease in theoretical scores from the short-term to the follow-up assessment, with no significant between-group difference in change scores (p = 0.817). In contrast, between-group comparison of practical change scores showed a significant difference favoring the virtual reality group (p = 0.017, r = 0.54), with a median difference of + 15 points (95% CI: +5 to + 30). Within-group analyses indicated a significant decline in the traditional instruction group (p = 0.011, r = 0.81), whereas no significant change was observed in the virtual reality group (p = 0.666, r = 0.14). Practical scores increased by approximately 3% in the virtual reality group but decreased by 17% in the traditional instruction group from short-term to follow-up assessment. Conclusion: These findings suggest that immersive virtual reality may support the preservation of practical performance over time in physiotherapy education and may represent a promising instructional approach for teaching complex neurorehabilitation skills. ClinicalTrials.gov identifier: NCT07270107 (retrospectively registered on December 8, 2025).