Table 1.

Studies using VR in sport-related concussion management.

Study	Concussion cohort	Timepoints	VR assessment	Findings
Slobounov et al., 2006 [17]	10 collegiate athletes	Baseline, days 3, 10, 30 following concussion	“Moving room” postural control assessment with AP translation and lateral roll	Subjects were unable to maintain postural control while viewing the “moving room” on day 3 post-injury; coupling between visual motion and postural control was diminished on day 10 post-injury
Slobounov et al., 2006 [24]	8 collegiate athletes	Baseline, days 3, 10, 30 following concussion	“Moving room” postural control assessment with AP translation and lateral roll	Postural control deficits induced by visual field motion were present up to 30 days post-injury
Slobounov et al., 2007 [25]	38 collegiate athletes, 9 experienced a second concussion within 1 year	Baseline, days 10, 17, 30 following concussion	“Moving room” postural control assessment with AP translation and lateral roll	Rate of recovery of sensorimotor integration was slower after the second concussion
Nolin et al., 2012 [34]	25 adolescent athletes with concussion, 25 adolescent athletes with no concussion	Within 2 years following concussion	ClinicaVR: Classroom-CPT	The concussion group performed worse on the virtual version of the CPT but not on the computerized version
DeMatteo et al., 2014 [33]	24 youth (ages 9-18 years)	Within 1 year following concussion	Nintendo Wii Ultimate Party Challenge and Wii Fit	Wii Gameplay was not a valid measure of postural control following concussion
Murray et al., 2014 [31]	9 athletes with concussion, 9 athletes with no concussion	Within 48-72 h following concussion	Nintendo Wii Fit Soccer Heading Game	The concussion group had a greater number of Gaze Deviations from center than control group. There were no group differences for Percentage Time on Center or Soccer Game Score
Teel and Slobounov, 2015 [26]	28 collegiate athletes with concussion, 94 college students with no concussion	Within 7-10 days following concussion	HeadRehab postural control testing	The concussed group performed worse on all measures
Teel et al., 2016 [27]	27 collegiate athletes with concussion, 94 collegiate athletes with no concussion	Within 7-10 days following concussion	HeadRehab postural control testing	The postural control module has high sensitivity (85.7%) and specificity (87.8%)
Teel et al., 2016 [35]	24 collegiate athletes with concussion, 128 collegiate athletes with no concussion	Within 7-10 days following concussion	HeadRehab neuropsych. testing	Spatial navigation (sensitivity 95.8%/specificity 91.4%), whole body reaction time (sensitivity 95.2%/specificity 89.1%) and combined VR modules (sensitivity 95.8%/specificity 96.1%) had high sensitivity/specificity
Murray et al., 2017 [32]	56 collegiate athletes with concussion, 79 physically active college students with no concussion	Within 24-48 h following concussion	Nintendo Wii Fit Basic Balance Test	The total number of levels completed (sensitivity 39.2/specificity 82.1%), time to complete level 1 (sensitivity 87.5%/specificity 25.3%), and level 5 completion (sensitivity 80.4%/specificity 39.2%) had weak predicative capability (AUC<0.7)
Wright et al., 2017 [30]	11 collegiate athletes with concussion, 56 physically active college students with no concussion	Within 3 months following concussion	VETS	The concussion group performed worse on the VETS. The VETS had 91.0% accuracy and ROC AUC of 0.865
Wright et al., 2017 [29]	14 college students with concussion, 58 college students with no concussion	Within 6 months following concussion	VETS	The dynamic scene conditions, i.e., DYN-Foam and DYN-Firm, were the most discriminating conditions with and 85.9% and 87.3% accuracy, respectively

VR: Virtual reality, SRC: Sport-related concussion, ER: Extended reality, AR: Augmented reality, MR: Mixed reality, ROC: Receiver operating characteristic, AUC: Area under the curve