Beat Saber Exergaming and Isometric Strength in Youth Basketball Players

This was a three-month, two-arm, individually randomized controlled trial conducted at the physiotherapy clinic of the OH Sport Complex in Cluj-Napoca, Romania.

Participants were healthy, physically active male basketball players aged 10 to 12 years. A total of 87 children were assessed for eligibility. Seven were excluded before randomization: one did not meet the inclusion criteria and six declined participation. The remaining 80 participants were randomly allocated in a 1:1 ratio to either the structured Beat Saber group or the self-selected virtual reality gaming group.

Both groups completed three approximately 60-minute basketball training sessions per week. Each session included a warm-up, technical and shooting drills, one-on-one and small-sided game activities, and full-team basketball play.

After basketball training, both groups completed three 30-minute virtual reality sessions per week for three months. Virtual reality exposure was matched between groups for frequency and session duration.

Participants assigned to the experimental group completed a standardized Beat Saber program using a Meta Quest 3 headset. Beat Saber required repeated rapid upper-limb movements together with trunk and lower-limb actions, including squatting and side-stepping.

Participants assigned to the active comparison group completed self-selected virtual reality games. The games were not standardized according to title, movement pattern, or physical demand. The main difference between the groups was therefore the structure and movement demands of the virtual reality activity rather than the amount of virtual reality exposure.

Peak isometric force was assessed at baseline and after three months using the MAT Muscle Meter dynamometer. Five efficacy outcomes were evaluated: peak isometric deadlift force and peak isometric shoulder force during flexion, extension, abduction, and adduction. Three maximal voluntary isometric contractions were completed for each movement, and the highest value was retained for analysis.

No single primary outcome was prospectively designated. The five force outcomes were treated as an exploratory family of efficacy outcomes. Harm outcomes included dizziness, intervention-related injuries, and discontinuation because of adverse events.

All 80 randomized participants completed the intervention and post-intervention testing. Mild, temporary dizziness was reported by six participants during the first week of virtual reality exposure. No serious adverse events, intervention-related injuries, withdrawals, or losses to follow-up occurred.

Inclusion criteria

• Male children aged 10 to 12 years
• Clinically healthy, with no known underlying disease or medical condition
• Regular participation in basketball training
• Physically able to safely complete the basketball training, virtual reality sessions, and strength assessments
• Written informed consent provided by a parent or legal guardian
• Written assent provided by the participant

Exclusion criteria

• Absence of written parental or legal guardian consent
• Absence of participant assent
• Any medical, neurological, musculoskeletal, or other condition that could limit participation in physical activity or prevent safe completion of the study procedures