Advancing Cognitive–Motor Assessment: Reliability and Validity of Virtual Reality-Based Testing in Elite Athletes

Emerging virtual reality (VR) technologies provide objective and immersive methods for assessing cognitive–motor function, particularly in elite sport. This study evaluated the reliability and validity of VR-based cognitive–motor assessments in a large sample of elite male athletes (n = 829). Ten cognitive–motor tests, delivered via Oculus Quest 2 headsets, were used, covering four domains: Balance and Gait (BG), Decision-Making (DM), Manual Dexterity (MD), and Memory (ME). A Confirmatory Factor Analysis (CFA) was conducted to establish a four-factor model and generate data-driven weights for domain-specific composite scores. The results demonstrated that the composite scores for BG, MD, ME, and a Global Cognitive–Motor (CM) score were all normally distributed. However, the DM score significantly deviated from normality, exhibiting a pronounced ceiling effect. Test–retest reliability was high across all cognitive–motor domains. In summary, VR assessments offer ecologically valid and precise measurements of cognitive–motor abilities by capitalising on high-fidelity motion tracking and standardised test delivery. In particular, the Global CM Score offers a robust metric for parametric analyses. While future work should address the DM ceiling effect and validate these tools in diverse populations, this approach holds significant potential for enhancing the precision and sensitivity of psychological and clinical assessment.