Validity and reliability of immersive virtual reality for shoulder range of motion measurement using two different head-mounted devices

Methods A cross-sectional study was conducted with a total of 33 healthy subjects. Six joint movements were evaluated: shoulder flexion (SF), internal shoulder rotation (IR), external shoulder rotation (ER), shoulder abduction (SA), shoulder extension (SE), and elbow flexion (EF). Convergent validity, level of agreement within head mounted device (HMD) and reliability for the two IVR-HMD Meta Quest 2®(MQ2) and Meta Quest 3®(MQ3) were analyzed.Results For convergent validity, MQ2 and MQ3 showed a moderate to strong correlation (r = 0.638–0.958) for SF,ER,SA, and SE. However, we found poor correlation for IR and EF. Limits of agreement (LoA) were delineated by Bland-Altman plots suggesting high agreement boundaries for SE and ER, nevertheless lower LoA was found for EF and IR for MQ2, and MQ3. For reliability, MQ2 and MQ3 shows a good to excellent ICC for SF,ER, IR, SA and SE (ICC = 0.763–0.998). The standard error of measurement ranged from 0.4%-11.24% for MQ2 and, from 0.35%-6.27% for MQ3. Minimal detectable change ranged from 1.69–19.670 and, from 1.77–18.600 for MQ3.Conclusions Reach Shoulder Health (RSH), using both MQ2 and MQ3 IVR-HMD, is a valid and reliable tool for measuring shoulder ROM, except for EF and IR. IVR-based ROM evaluation offers a promising venue for dynamically and ecological measurement over traditional assessment methods.