-->PONE-D-25-56146-->-->Virtual reality experience in physical education and sports lessons: An investigation into its effect on the balance and coordination skills of middle school students-->-->PLOS One

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Additional Editor Comments:

Thank you for submitting your manuscript.

The topic is timely and of clear interest, and both reviewers recognize the potential value of your work. At the same time, their comments highlight several areas where the manuscript requires substantial clarification and improvement. In particular, the study design, methodological details, and statistical analyses need to be presented more clearly and rigorously, and the narrative structure, especially in the introduction and discussion, would benefit from greater focus and coherence.

I encourage you to revise the manuscript thoroughly, addressing all reviewer comments in detail and ensuring that the revised version provides a clearer, more robust, and more transparent account of your study. We look forward to considering a substantially improved version.

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Reviewers' comments:

Reviewer's Responses to Questions

-->Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. -->

Reviewer #1: Yes

Reviewer #2: Partly

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-->2. Has the statistical analysis been performed appropriately and rigorously? -->

Reviewer #1: No

Reviewer #2: No

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-->3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.-->

Reviewer #1: Yes

Reviewer #2: Yes

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-->4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.-->

Reviewer #1: Yes

Reviewer #2: Yes

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-->5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)-->

Reviewer #1: Overall, I think adding to the literature on VR and activities is a great idea. Knowing what VR can do from a balance and motor aspect will help many populations and possibly even work towards a run at reducing obesity.

This article topic is great but there is significant improvements needed in many areas.

Sections

Abstract

In the abstract there is a couple things that need clarification:

When describing the KTK / children’s body coordination test it is not clear if it is one total test or a series of tests. (it does talk about it some later but still should be semi clear to reader in abstract)

Also here it talks about the backward balance test. I think that is a part of the KTK from reading later in the article but in abstract it is confusing since the y balance test is mentioned but not a backward balance test. Please correct this in the writing.

INTRO

Have you looked into or compared active video gaming? Line 57 talks about regular games compared to VR but no mention of active gaming. That shouldn’t be left out as it is part of video games and does show balance and Physical activity improvements.

Line 69: clarify that “it” means VR and that VR improves balance and coordination.

Line 72: this sentence and reference seems out of place like it was just thrown in to the paragraph. There is an interesting fact in regards to that maybe expand upon its importance.

METHODS

Line 85: this sentence is not needed as it is really common knowledge that pre post test is a common research method.

Line 89: please clarify year 7. Is that 6th grade or 7th grade. Also later in the document you call it 8th year. Please be consistent on the numbers and definitions

Exclusion criteria is having a history of vertigo not an exclusion criteria. And if not why not?

Data collection tools

The use of the KTK is great. But I am not clear as to the scoring. Is each part its own score and then is there a total score for the KTK? If there is a total score, please explain that to the reader. Also with this is the parts of the test to be capitalized or not. Inconsistencies are occurring in the document. Please correct throughout the entire text.

SHAPE 1

This figure is not at all clear. Please clarify what y axis is and what is this trying to tell me. Is it a frequency chart? What does the lines mean and what do the numbers mean?

Line 106 should that be .85 to 1.0 versus .85 to -.01 not consistent with the .99 to 1.0 for the inter rater range.

Application plan

What was the rationale behind only 10 minutes of game play? Is there a reference that says 10 min only or is that more in line with what time was allotted in the classroom session?

Games

Any references of past studies using Snowboard or tennis in the literature?

Data analysis

The most correct way to report and analysis this data should be with a 2 (condition) x 2 (time) mixed model ANOVA. And then running T test for post analysis

With the data charts and writing. Please correct the redundancy of having all the stats in the charts and the writing.

TABLE 1. you have the pre and posttest KTK but I want to see clarification is that is a total score or sum of all the other 4 scores or some other individual test result.

TABLE 2. is it balance or denge test in the chart?

Line 19: should those words be capitalized? If so correct throughout the document.

Line 216: I am unsure what you mean by warranting a revaluation of the calculation. Do you mean you need to redo the stats or are you thinking you need to reevaluate the use of a particular calculation.

Line 225 please reference table 5 here. You do a reference to each other table but not here. Please be consistent. The reference at the end of the paragraph is confusing.

Line 237. Referring to year 8 here is it 7 or 8.

Discussion

Overall, the discussion seems to just be a listing of other references it doesn’t tie any of your data or findings to current literature. Could you please bring together your results and findings to compare to the specific references you use in your discussion.

Your last paragraph starts to bring together the info learned from your study, but I would suggest tying it in also in the previous paragraphs of the discussion.

Reviewer #2: Dear authors,

The topic appears to be a current and relevant one (the use of virtual reality (VR) in physical education for the development of motor skills in children), the subject falling within important interdisciplinary fields (physical education, educational technology, motor development). We determined that an experimental design with control group and pre-test/post-test is used, with a limited intervention duration (8 weeks), with two standardized instruments (Körperkoordinationstest für Kinder, a valid instrument for coordination and Y Balance Test, a valid test for dynamic balance). We also determined that the authors report statistical effects for t-test, p-value and Cohen’s d (effect size) and include limitations of the study, which is methodologically correct.

However, I ask authors to pay attention to the following comments and observations:

1) The abstract is too descriptive and too long for journal standards, contains premature interpretations (“practically significant improvements in all criteria”), includes excessive details about statistical results, but does not clearly summarize the design and hypothesis, and does not clearly mention the characteristics of the participants. It is stated that the results clearly demonstrate the effectiveness of VR, but the pre-test shows initial differences between groups, which weakens this claim.

2) The introduction indicates incomplete aspects, weak for the structure, i.e. many general statements about technology in education, but without explicit hypotheses, and the justification of the scientific gap is poorly formulated (the statement: “insufficiently researched, particularly in Turkish sources” and a geographical gap is not sufficient for scientific justification). The literature is cited descriptively, not critically, and some references are poorly connected to the objective (e.g. studies on cognitive or general VR).

3) Methods is the section with the most important methodological problems. We determined that the sample is small, the randomization is ambiguous (it states “random sampling” but the description indicates convenience sampling), demographic characteristics (sex, age, physical activity level, BMI) are missing, the groups are not balanced at baseline, significant differences in the pre-test for backward balance, single-leg hop, total KTK. I believe that all of these aspects present a major internal validity problem and also affect replicability.

From the point of view of the intervention, it is extremely short (10 minutes per week for 8 weeks!!!!), the protocol is insufficiently described (missing: activity intensity, exact number of repetitions, effort monitoring) and it is not clear whether all people played the same levels and whether previous VR experience was controlled.

The instruments are not fully reported, the description of the Y Balance test contains an error in the ICC (“0.85–0.01” - logically impossible interval), and the normalization formula is written incorrectly.

I determined that verbal consent is mentioned, but for minors, written parental consent should be provided, from the point of view of research ethics!!!

Problems for replicability, because they are not completely described: participant characteristics, randomization procedure, control of external variables, exact protocol of the intervention, intensity monitoring.

I ask the authors to clarify, provide details and check the entire Methods section once again. Thank you

4) The statistical analysis indicates problems, in the sense that the independent t-test for comparing post-tests in the context of initial differences between groups is not clear (maybe the authors could determine ANCOVA or mixed ANOVA), there is no analysis of statistical power (power analysis), there are no corrections for multiple testing, and some interpretations of the effect size are exaggerated.

The relevance of the statistical analyses is partially adequate, because the t-test is acceptable for pre/post comparison in the same group, but for the experimental design it is suboptimal. Mixed ANOVA or ANCOVA with pretest as covariate would have been correct. The problem becomes major because there are significant initial differences.

5) Results are described redundantly (text + table), some interpretations are incorrect (the effectiveness of the intervention is stated despite the existence of baseline imbalance), and some results are contradictory (experimental backward balance is not significant in paired t-test). og authors to clarify, provide details and double-check the entire Results section. Thanks

6) Discussion is predominantly confirmatory, the initial differences between groups are not critically discussed, alternative explanations (maturation, learning effect) are missing and there are no detailed comparisons with contradictory results from the literature. The discussion is more enumerative than analytical, statistical limitations are not discussed and explanations for the effects are missing.

7) Limitations are mentioned, but they are not complete. Missing: selection bias, baseline imbalance, acceptance of a small sample and statistical problems.

8) Exaggerations in Discussion and Conclusions. Example: "VR game significantly improved the students' balance and coordination"!! The initial differences between the groups may partly explain the results, so the conclusion is stronger than the data allow. The conclusions are partly exaggerated because the design and statistical analysis do not support firm claims of causality.

9) I ask the authors to analyze the relevance of all references and the age of some of them (about 25% are older than 10 years, especially since there are many recent studies and research on this topic). I recommend careful analysis of:

https://doi.org/10.3390/app15179826

https://doi.org/10.1186/s12887-025-05897-x

https://doi.org/10.3390/children12101405

https://doi.org/10.3390/children11070863

References 7,8, 24, 30 are potentially irrelevant, because they are weakly connected to the topic. They are not wrong, but they do not directly contribute to the main argument. I ask the authors to check this aspect once again. Thank you.

10) Tables do not have complete legends (they are minimalist) and abbreviations are not fully defined.

11) Figures are more illustrative than scientific, they have no analytical role.

I think the article is promising, especially the central idea of using VR in physical education, but the authors need to present a clearer, more detailed, better argued version with a more solid statistical analysis.

Otherwise, a good article.

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Reviewer #1: No

Reviewer #2: Yes:  Dan Iulian ALEXE

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Virtual reality experience in physical education and sports lessons: An investigation into its effect on the balance and coordination skills of middle school students

PONE-D-25-56146R1

Dear Dr. YANAR TUNÇEL,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Francesca D'Elia, Ph.D.

Academic Editor

PLOS One

Additional Editor Comments (optional):

Thank you for submitting the revised version of your manuscript. I have carefully reviewed your responses and the updated manuscript. You have addressed all reviewer comments comprehensively, and the revisions have substantially strengthened the clarity, methodological transparency, and overall quality of the work. As the changes fully resolve the concerns raised in the previous round, no further reviewer input is required.

Your manuscript is now suitable for publication in PLOS One.

Reviewers' comments: