Cybersickness and sense of presence as predictors of VR task performance in individuals with and without Post-COVID-19 condition

Abstract Virtual reality (VR) is increasingly applied in neurological assessment, yet little is known about whether user experience factors, such as cybersickness and sense of presence, relate differently to VR task performance depending on the presence of neurological symptoms. This study tested 58 patients with Post-COVID-19 condition (PCC) symptoms and 54 control individuals (non-PCC group) on a VR-based spatial memory task. The Simulator Sickness Questionnaire (SSQ) and the Igroup Presence Questionnaire (IPQ) were used to assess cybersickness and sense of presence, respectively. Multiple linear regressions, adjusted for age and sex, showed that the PCC group reported significantly higher SSQ scores across all subscales. In contrast, both groups showed similar IPQ responses and task performance (i.e., number of correct responses, number of attempts, and execution time). Moderated regression models, adjusted for the same covariates, showed that cybersickness did not predict task execution time in either group. However, in the PCC group, higher sense of presence ratings predicted faster task completion, an effect not observed in the non-PCC group. Considering covariate effects, age consistently predicted slower performance. In addition, female sex emerged as a significant covariate specifically for sense of presence, with women reporting higher scores than men. Overall, the results indicate that PCC is associated with increased VR-induced cybersickness, while a heightened sense of presence may facilitate motor and cognitive processing during task performance, particularly in individuals with neurological conditions. Further experimental studies are needed to investigate how variations in presence levels influence performance in VR-based cognitive tasks.