Evaluating the Number of Trials for Stable Virtual Reality-Based Subjective Visual Vertical Measurement in Healthy Adults.

Virtual reality-based subjective visual vertical (VR-SVV) has attracted attention as a potential solution to equipment-related limitations of conventional SVV testing. This study investigated the test-retest reliability and adequate trial number for stable assessment of vertical perception using VR-SVV in healthy adults. Participants performed 10 trials in a VR-SVV test and repeated the assessment after one week. SVV orientation and SVV variability were calculated. Test-retest reliability was evaluated using the intraclass correlation coefficient (ICC [1,2]), standard error of measurement (SEM), and minimal detectable change at the 95% confidence level (MDC95). The minimum number of trials required for stable assessment was examined by comparing results from fewer trials with those obtained from all 10 trials. SVV orientation and variability were -0.14° and 0.79°, respectively. ICC, SEM, and MDC95 were 0.62, 0.64°, and 1.76°, respectively. No adverse events occurred. SVV metrics derived from 6-9 trials differed by less than 10% from those obtained from 10 trials. VR-SVV is feasible and demonstrates moderate test-retest reliability. Six trials may be adequate for practical assessment of vertical perception.