Virtual Reality Stimulants of Motor Ability through

the Virtual Reality-based Game

Erwani Merry Sartika

, Novie Theresia Br. Pasaribu

, Richard Setiawan

Reynaldy Felicius Gunawan

, Dion Melvern Siswanto

, Che-Wei Lin

and Febryan Setiawan

Bachelor Program in Electrical Engineering, Universitas Kristen Maranatha, Jl. Prof. drg. Suria Sumantri, MPh no 65,

Bandung, Indonesia

Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan 701, Taiwan

aldy.fg45@gmail.com, sebasdion11@gmail.com, lincw@mail.ncku.edu.tw, febryans2802.wtmh@gmail.com

Keywords: Virtual Reality, Bilateral Movement, Alternating Movement.

Abstract: To improve the physical body, the motor function of the non-dominant hand also needs to be considered to

increase productivity. Virtual Reality is widely used as a video game, but it is widely used as a means of doing

physical exercise. In this research, the improvement of non-dominant motor skills through VR-based games

used bilateral and alternating movement methods. The game “Rowing movements” represents the bilateral

movements methods which is considered the most relevant to be implemented, while the game “Climbing”

represents the alternating movements method. The game design process that is carried out is setting the VR

on Unity, making the environment, making game objects, player, time display, game object position,

movement of game objects. Hitbox design is also designed, with the aim of knowing the performance of the

rowing game, while the performance of the climbing game uses the integral difference between the dominant

and non-dominant hand climbing movements of the research subject which is scaled in a cartesian field. The

results show that the use of VR stimulates user interest so that it improves motor skills if done regularly both

for movement using the bilateral method and alternating movement.

1 INTRODUCTION

Hands are an important part of the human body. This

is the main reason for physical or motor training on

the hands to take precedence over other parts of the

body. Basically, humans have one dominant hand

which is used to carry out various activities.

However, the motor function of the non-dominant

hand also needs to be considered to increase one's

productivity and quality of life. In addition, the

increase in non-dominant hand motor function can

also affect the dominant hand motor function to be

better (Stöckel & Weigelt, 2012).

https://orcid.org/0000-0003-3720-3584

https://orcid.org/0000-0001-7774-9675

https://orcid.org/0000-0002-3857-9770

https://orcid.org/0000-0002-2763-3073

https://orcid.org/0000-0002-7211-8097

https://orcid.org/0000-0002-1894-1189

https://orcid.org/0000-0002-3671-9127

Bilateral movements are the movements of the

two arms that are used together to contract the

muscles, then produce a force, and then move the

weight given (Fountaine, 2018). Meanwhile, the other

movements are alternating movements. Alternating

Movements is an activity that uses limbs alternately,

one example of which is hand movements. This

activity is useful for training non-dominant hand and

hand motor skills (Arceneaux et al., 1997). Activities

using non-dominant hands can balance hand motor

skills. One way is by using non-dominant hands to do

things that require proper coordination.

146

Sartika, E., Pasaribu, N., Setiawan, R., Gunawan, R., Siswanto, D., Lin, C. and Setiawan, F.

Virtual Reality Stimulants of Motor Ability through the Virtual Reality-based Game.

DOI: 10.5220/0010747100003113

In Proceedings of the 1st International Conference on Emerging Issues in Technology, Engineering and Science (ICE-TES 2021), pages 146-152

ISBN: 978-989-758-601-9

Rowing is a physical activity that uses the hand as

the control. The rowing simulation places the user as

the rower of a boat using one paddle in each hand.

Rowing activity requires both hands to move

simultaneously (Bilateral Movements). While

climbing is a physical activity that uses hands and

moves using alternating movements as the control.

Climbing is a sport that requires the body to move to

the top of the rock climbing. One of the muscles that

play a role when climbing is the arm muscles, because

the arm muscles help to pull the body upwards. The

ability to produce locomotive movements in a very

short time is the result of the maximum cooperation

between strength and speed. The combination of

strength and speed affects the formation of power

which can be seen from the results of its movement.

Virtual Reality is a technology that allows users

to enter and interact in a virtual environment. In

addition, Virtual Reality allows developers to

manipulate virtual environments so that they can be

tailored to the needs of consumers and developers

(Stevens & Phillips Stoykov, 2004). Virtual Reality

in its development is widely used as a video game.

But along with its development, Virtual Reality is

also used as a means of doing physical training

(Okechukwu & Udoka, 2011).

One of them is hand

motor training, this is because Virtual Reality can be

combined with additional tools such as controllers /

joysticks that allow users to perform various

variations of movement. In addition, the sensors /

buttons on the controller / joystick can maximize user

accessibility so that users can make movements or

interact with visual objects in the Virtual Reality

environment. (Stevens & Phillips Stoykov, 2004).

Based on these reasons, a simulation using Virtual

Reality will be realized using the bilateral movements

and alternating movements method so that data can

be collected to prove that the use of Virtual Reality

by using these two methods can improve the

dominant and non-dominant hand motor skills in

humans.

The purpose of this research is to determine the

influence of bilateral movement methods and

alternating movements in simulations using Virtual

Reality on improved motor capabilities in non-

dominant hands. Simulation creation using Unity

software. Simulation is created in the form of Virtual

Reality, design, and implementation of simulations in

three dimensions. The simulation designed is a

simulation of a Rowing Game (bilateral movement)

and a Climbing Game (alternating movement).

2 METHODS

The method used in this research consists of library

review to find out the definition and type of game that

is right to be applied. Furthermore, the game design

steps are made to make it happen. Analysis of

realization results is discussed in results and

discussion.

2.1 Bilateral Movement Method

Bilateral movements are the movements of both arms

that are used together to contract muscles, then

produce force, and then move the weight exerted

(Fountaine, 2018). Bilateral Movements provide an

easier understanding of movement for people who are

undergoing recovery. When both hands are moved

together, the tendency towards synchronization

between arms will be stronger, which is the need to

focus on moving both hands much less. In this way,

bilateral movements provide greater possibilities to

produce an interpretation of movement that will be

easier to understand by the motor compared to when

driven separately (Stevens & Phillips Stoykov, 2004).

Bilateral hand training, compared to unilateral

training or other forms of mobility training, shows

more significant development for patients with

chronic and acute hemiparesis. However, this

bilateral hand training activity did not show any more

significant and effective development for hemiplegia

sufferers(Stevens & Phillips Stoykov, 2004).

Rowing Movements are movements performed

continuously, requiring aerobic or anaerobic power.

The drive phase cycle in rowing starts when the

rowers push with their legs then then pull their lower

arms and backs sequentially. These movements also

require muscle strength and endurance(Conde et al.,

2005). The cycle of movement can be seen in the

Figure 1.

Figure 1: Rowing Movements.

Rowing movement is one of the movements that

uses the bilateral movement method which is

considered the most relevant to be applied in this

Virtual Reality Stimulants of Motor Ability through the Virtual Reality-based Game

147

research. This is due to a movement pattern that

requires both hands or arms to be moved

simultaneously and which is later used to improve the

motor skills of the non-dominant or impaired hand.

2.1.1 Design Game Rowing

In this research, bilateral movement simulation is

implemented in Rowing Game. The Rowing Game

Design Block Diagram can be seen in Figure 2. The

design process starts from tuning the virtual reality

gear and then designing the environment which

consists of creating terrain and detailing tree and rock

objects. After that, it is continued with the design of

the boat object in which there is a camera and player

controller. Next, a hitbox is designed which will be

attached to the boat. The objective design is carried

out after the environment and boat objects have been

created. Objective consists of objects coins and finish

area. The final part is designing the User Interface

which consists of a timer, starting countdown, coin

counter, and Game over Panel. The design process

diagram can be seen in Figure 2.

Figure 2: Rowing Game Design Block Diagram.

2.2 Alternating Movement Method

The ability to be able to use both hands is referred to

as bilateral coordination. Bilateral coordination

includes 2 types of movements, namely simultaneous

movements, and alternating movements. Good

bilateral coordination of the hands is demonstrated by

the balance in both rough motor movements of the

hands.

The alternating movements used in this

simulation are climbing movements. In addition to its

alternating and repetitive movements, this movement

allows researchers to compare the movement between

non-dominant hands and the dominant hands of each

research subject to be known whether alternating

movements affect the motor ability of non-dominant

hands.

Alternating movements are also used as a method

to detect coordination disturbances, this coordination

disorder is indicated by an imbalance of the results of

movement of both hands when performed alternately

(Fimbel et al., 2005). Alternating movements can also

be applied to climbing or climbing movements.

Climbing is a branch of sports that requires the body

to move towards the top of the climbing stone. One of

the muscles that plays a role at the time of climbing is

the arm muscles, because the arm muscles help to pull

the body towards the top. The ability to produce

explosive movements in a very short period is the

result of maximum cooperation between strength and

speed. The combination of strength and speed affects

the formation of power that can be seen from the

results of its movement. The success of climbing

results is determined by the consistency of the results

of arm muscle movements when climbing. The

climbing movement can be seen in Figure 3.

Figure 3: Rock Climbing Activity.

2.2.1 Design Game Climbing

In this research, the simulation of alternating

movement is implemented in the Climbing Game.

The Climbing Game Design Block Diagram can be

seen in Figure 4. In this research, Unity was used to

create simulations with Virtual Reality that

demonstrated an alternating motion or alternating

movements. Using Virtual Reality in the Unity

project requires an Oculus Rift controller, so it is

necessary to install the driver first. In this climbing

simulation project, several Game Objects are needed

such as environment, climbing stones (climbpoint),

player, and time display. Positioning is required in the

process of placing the Game Object that was

previously created. Scripting is then performed to

manipulate the Game Object to act as desired. There

are 3 main scripts in the design of climbing

simulations, namely the Climbing Motion script

(Pull), Gravity (Gravity), and Timer (Timer).

Figure 4: Climbing Game Process Design Diagram.

ICE-TES 2021 - International Conference on Emerging Issues in Technology, Engineering, and Science

148

3 RESULTS AND DISCUSSION

3.1 Bilateral Movements Results

The following is a display of the unity program for

Bilateral Movement (Figure 5). In this rowing

simulation, the designed environment is a

mountainous environment in which there are rocks,

hills, mountains, trees, and a river. This rowing

simulation environment can be seen in Figure 5. The

boat object functions as a player which is the main

object that will interact directly with the user. A

special camera is mounted on the boat object for

virtual reality simulation which will be connected

directly to the Oculus Rift or Google Virtual Reality

which is used by the user to view the Virtual world in

real-time.

(

)

(b)

Figure 5: Display of the Unity Program for Bilateral

Movement (a) Environment Display, (b) Boat Object

Display.

From the simulations that have been created,

testing was conducted with test data taken from 3

research subjects. Data retrieval is done for 1 day. The

research subjects filled out the survey first before

conducting the experiment. Each subject is given 15

minutes to learn to use the provided virtual reality

gear. Each subject experimented 3 times, with a 10-

second time lag between experiments.

The initial conditions of the boat object when

tested are as follows. The position on the x-axis is -

107.06, the position on the y-axis is -0.824, the

position on the z axis is 28.5. The first experiment is

conducted 3 times and each experiment will be

observed and retrieved data. The data taken is the

completion time, the number of rowing subjects, the

trajectory traveled, and the number of coins collected.

In the first attempt, the first user was able to

complete the simulation in 22.17 seconds with 33

paddling and managed to collect 3 out of 3 coins.

Figure 6 is the trajectory the subject took in

experiment 1. Table 1 is the data of experimental

observation 1 for the distance of each paddle touch

point with the water surface against the boat.

Figure 6: Simulation Design Process.

The experiment was conducted on 3 research

subjects. Based on the test results obtained, it can be

concluded that there is an improvement in the

performance of non-dominant hands using bilateral

movement methods. This can be proven by the

results of observation data on 3 research subjects who

showed a smaller error value in each experiment, the

error value is the result of a reduction of the amount

of distance of each paddle touch point with the

surface of the water against the boat on the left and

right hand.

The test results also prove that the research

subjects's understanding of virtual reality gear is

directly proportional to the research subjects's

performance when conducting rowing simulations

using virtual reality. In Table 1, the first subject

conducts an experiment and is observed, and the data

is taken in the form of completion time, trajectory

traversed, and the number of coins that have been

collected. The first subject can complete the

simulation in 33 paddles and successfully collect all

the coins.

Virtual Reality Stimulants of Motor Ability through the Virtual Reality-based Game

149

Table 1: The First Research Subjects Data Experiment 1.

3.2 Alternating Movement Results

The following is a display of the unity program for

Alternating Movement (Figure 7). In this research,

the climbing path is arranged equally between the left

hand and the right hand so that the movement

between the left hand and the right hand can be

compared. The number of climbing stones used are

22 stones (11 stones for the left side and 11 stones for

the right side). The X-axis distance can be adjusted

and adjusted so that the paths do not overlap each

other, in this research the width between the lines is

spaced 0.7 (X-axis). The same is done for the Y axis,

namely the distance between the first stone and the

next stone. After the cliff position and rock climbing

have been positioned, the result will be as shown in

Figure 7.

(a)

(

)

Figure 7: Display of the Unity Program for Alternating

Movement, (a) Display of Environment, (b) Display of

Subject’s Hands

Before conducting the simulation, research

subjects were asked to fill out a questionnaire that had

been made. Based on the results of the questionnaire,

the research subjects were divided into 3 categories,

namely:

- One man who used VR.

- Two men who have never used VR.

- Two women who have never used VR.

The five research subjects had the same age range,

namely 21-25 years. The five of them also had never

experienced rock climbing and were right-handed.

After filling out the questionnaire, subjects were

given 10 minutes to get used to using the VR

Controller. After that, the subject is allowed to do a

simulation so that data can be collected. In the data

collection process, the data taken are:

- The results of the dominant and non-dominant

hand climbing movements of the research

subject.

- Travel time of research subjects in completing

the simulation.

- The distance traveled by the research subject in

completing the simulation.

The simulation is said to be complete if:

- Research subjects can climb to the last rock.

- Research subjects fail to climb or fall in the

simulation.

Data collection was carried out 2 times a day for

5 days. Each time the data was collected, the subject

was given time to rest for 10 minutes to ensure that

the research subject did not experience fatigue for the

next data collection due to the previous data

collection. Subject research was tried on 5 research

Left Point Right Point

Difference Between

Point

2,899347 -2,905545 -0,006198

2,699359 -2,641025 0,058334

2,673499 -2,565061 0,108438

2,575044 -2,555524 0,01952

2,618853 -2,612459 0,006394

2,654607 -2,708993 -0,054386

2,636998 -2,700497 -0,063499

2,702779 -2,700497 0,002282

2,715405 -2,637317 0,078088

2,684289 -2,66491 0,019379

2,757622 -2,630151 0,127471

2,621608 -2,630597 -0,008989

2,661496 -2,63454 0,026956

2,661496 -2,626003 0,035493

2,652396 -2,583199 0,069197

2,641745 -2,658282 -0,016537

2,672914 -2,582476 0,090438

2,652409 -2,634614 0,017795

2,620956 -2,629205 -0,008249

2,683 -2,629205 0,053795

2,67047 -2,672936 -0,002466

2,775788 -2,566797 0,208991

2,635197 -2,552659 0,082538

2,644223 -2,59359 0,050633

2,640778 -2,627459 0,013319

2,677565 -2,611967 0,065598

2,632084 -2,621306 0,010778

2,741297 -2,729553 0,011744

2,769871 -2,683123 0,086748

2,681472 -2,641546 0,039926

2,666943 -2,55028 0,116663

2,547802 -2,966956 -0,419154

Sum of the distance

from the left point to

the center of the boat

Sum of the distance

from the right point

to the center of the

boat

Total

88,250784 87,389818 0,860966

Number of paddle

subject

Difference between the number of left and

right points

0,860966

stones

ICE-TES 2021 - International Conference on Emerging Issues in Technology, Engineering, and Science

150

subjects. The result of dominant and non-dominant

hand climbing movement is scaled on a cartesian field

that has been made to be known the extent of

deviation that occurs in the hand movements of the

research subjects. To find the area of deviation is used

Reimann integral method written as in Equation (1).

𝐿=𝐿



+𝐿



++ ⋯ +𝐿



𝐿=𝑓(𝑥



)𝛥𝑥



+ 𝑓(𝑥



)𝛥𝑥



+⋯ +𝑓(𝑥



)𝛥𝑥



(1)

𝑓(𝑥



) is the value when point 𝑛 , and 𝛥𝑥



is the

distance of each change between sample point 1 to the

next sample point. In this data the value

𝑓(𝑥



) is the

position magnitude value of 𝑥 the sample point.

The first subject is the first female subject who has

never used VR. Table 2 is the data on the area of hand

movement deviation for the first subject, and Table 3

is the observation data for the first subject.

Table 2: Hand Movement Deviation in the First Subject.

Table 3: Observation Data on The First Subject

Based on observational data in Table 2 and Table

3, the first subject showed that the movement of the

right hand is better than the movement of the left

hand, this can be seen from the area of deviation

formed from the right hand is smaller than the left

hand, which is an average difference of 49.8. The first

user also showed an improvement in the ability of the

left-hand judging by the decrease in deviation area

formed from experiment 1 to experiment 10. The

research subjects showed an increase in the distance

that could be traveled in each data collection. This

shows the effect of using VR which is getting better

if it is done regularly.

Table 4: Observation data from Research Subjects.

RightLeftRightLeftRightLeftRightLeftRightLeft

1 1457771520331201138 28

2 2430493328206425528242

3 69 87 57 172 84 477 54 156 23 37

4 55 60 37 146 39 194 39 194 42 87

5 1326 8 74 839011380 26

6 21884519152

7 293 140 22 6

8011

910

Avg 35 52 45,6 115,4 45,6 115,4 45,6 115,4 45,6 115,4

Area

Data 5Data 1 Data 2 Data 3 Data 4

RightLeftRightLeftRightLeftRightLeftRightLeft

1 100 112 43 114 56 45 17 61 25 101

2 52 32 147 91 0 103 0 36 1 43

3 152 69 295 165 43 161 17 76 52 47

4 7 19 185 17 5 62 53 63 7 7

5 5 241779913963091 0 54

6 243 12 0 84 48 145 14 33 9 53

7 239 49 13 157 4 49 54 50 69 82

8 27 7 56 11 96 45 61 126

936551068154

10 104 99 63 57

11 14 6 186 328

12 36 67

13 194 380

14 63 12

Avg 114 45,3 110,9 91,8 34,5 75,6 32,3 56,9 59,6 107,9

Area

Data 6 Data 7 Data 8 Data 9 Data 10

Data Distance Limit Time Time difference to Distance

1 2,3 22 4,78

2 2,3 18 3,91

3 2,6 23 4,42

4 4,2 44 5,24

5 3,5 30 4,29

6 3,7 34 4,59

7 3,7 32 4,32

8 5,1 34 3,33

9 4,1 38 4,63

10 6,9 45 3,26

Right Left Difference Right Left Difference

1 3552 1770,62446,6

2 45,6 115,4 69,8 54,2 72,4 18,2

3 45,6 115,4 69,8 42,8 57,6 14,8

4 45,6 115,4 69,8 81,1 94,6 13,5

5 45,6 115,4 69,8 64,3 69,3 5

6 114 45,3 68,7 82,5 107 24,5

7 110,9 91,8 19,1 70,3 58,8 11,5

8 34,5 75, 6 41,1 43,9 45,1 1,2

9 32,3 56, 9 24,6 93,2 93,9 0,7

10 59,6 107,9 48,3 60,3 71,7 11,4

Average 56,87 89,11 49,8 66,32 69,44 14,74

Data

First Subject (women)*

econd Subject (women)

Right Left Difference Right Left Difference Right Left Difference

1 99,5 158,7 59,2 87 68,7 18,3 123,1 104 19,1

2 72,7 61,3 11,4 16,3 95,4 79,1 77 94 17

3 54,4 64,3 9,9 64 161,2 97,2 87,5 128,7 41,2

4 88,9 154,6 65,7 52,4 110,3 57,9 48,2 71,1 22,9

5 66,9 109,9 43 54,7 58,3 3,6 49,4 49,1 0,3

6 66,3 62,1 4,2 65,8 68,5 2,7 36,7 66,4 29,7

7 64 61,9 2,1 84,5 170,9 86,4 37,4 42,3 4,9

8 59,8 44,3 15,5 54,5 74,8 20,3 62,9 65,3 2,4

9 77,6 49,1 28,5 84,1 67,8 16,3 47,8 51,1 3,3

10 74,2 123,2 49 71,4 168,1 96,7 50 64,7 14,7

Average 72,43 88,94 28,85 63,47 104,4 47,85 62 73,67 15,55

Fifth Subject (men)

Data

Third Subject (men)* Fourth Subject (men) *

Virtual Reality Stimulants of Motor Ability through the Virtual Reality-based Game

151

Table 4 shows that of the 5 research subjects, it

can be concluded that the dominant hand has better

movement than the non-dominant hand. This is

evidenced by the deviation area formed by the

dominant hand is smaller than the non-dominant

hand. The fifth subject has already used VR, showing

a stable difference between the area reached by the

left and right hands. This shows that stimulants using

periodic VR can help the performance of both hands,

even the left-hand ability is more like the right-hand

ability.

4 CONCLUSIONS

The improvement of non-dominant hand

performance using bilateral movement method. This

can be proven by the results of observation data on 3

research subjects (the number of research subject is

limited due to the covid-19 pandemic condition) who

showed a smaller error value in each experiment, the

error value is the result of a reduction of the amount

of distance of each paddle touch point with the

surface of the water against the boat on the left and

right hand. The test results also prove that the

subject's understanding of virtual reality is directly

proportional to the subject's performance when

conducting rowing simulations using virtual reality.

In the use of alternating movements, subjects with

slower climbing speeds tend to have balanced

movement. This is indicated by a small difference in

deviation between dominant and non-dominant hand

movements. The influence of VR usage is getting

better if done periodically. Men tend to learn more

about VR than women. This can be seen with a rapid

increase in the distance traveled when conducting

simulations, with an average increase in men of 7.11

and women of 4.38. Subjects with slower climbing

speeds tend to have balanced movement. This is

indicated by a small difference in deviation between

dominant and non-dominant hand movements.

From this research, it can be concluded that both

games using VR can be used to stimulate the

performance of both hands by using bilateral and

alternating movements. There is an increase in the

ability of the non-dominant hand getting closer to the

ability of the dominant hand in both games.

REFERENCES

Arceneaux, J. M., Kirkendall, D. J., Hill, S. K., Dean, R. S.,

& Anderson, J. L. (1997). Validity and reliability of

rapidly alternating movement tests. International

Journal of Neuroscience, 89(3–4), 281–286.

doi:10.3109/00207459708988480

Conde, J., Rubio, T., Ferreira, G., Luz Coelho, R., De

Oliveira, F., & Osiecki, R. (2005). Strength and Power

Determinant of Rowing Performance. Journal of

Exercise Physiology, 8(1), 11–25.

Fimbel, E. J., Domingo, P. P., Lamoureux, D., & Beuter, A.

(2005). Automatic detection of movement disorders

using recordings of rapid alternating movements.

Journal of Neuroscience Methods, 146(2), 183–190.

doi:10.1016/j.jneumeth.2005.02.007

Fountaine, C. J. (2018). Unilateral and Bilateral Exercise

Movements: Considerations for Program Design.

ACSM’s Health and Fitness Journal, 22(3), 11–16.

doi:10.1249/FIT.0000000000000390

Okechukwu, M., & Udoka, F. (2011). Understanding

Virtual Reality Technology: Advances and

Applications. Advances in Computer Science and

Engineering. doi:10.5772/15529

Stevens, J. A., & Phillips Stoykov, M. E. (2004).

Simulation of Bilateral Movement Training Through

Mirror Reflection: A Case Report Demonstrating an

Occupational Therapy Technique for Hemiparesis.

Topics in Stroke Rehabilitation, 11(1), 59–66.

doi:10.1310/GCFE-QA7A-2D24-KHRU

Stöckel, T., & Weigelt, M. (2012). Brain lateralisation and

motor learning: selective effects of dominant and non-

dominant hand practice on the early acquisition of

throwing skills. Laterality, 17(1), 18–37.

doi:10.1080/1357650X.2010.524222

ICE-TES 2021 - International Conference on Emerging Issues in Technology, Engineering, and Science

152