The development and evaluation of virtual reality-based training on performance and rehabilitation outcomes

Sports injuries are types of injuries that usually occur during sports, training, or exercise. Sports injuries often result from poor training methods, inappropriate equipment, lack of fitness, insufficient warm-up, and trauma (Salerno, 2009). Knee injuries are considered one of the most common injuries in athletes and include a large part of the cost of medical care for sports injuries (Loes et al., 2000; Sancheti et al., 2010). The ACL is the most common knee ligament injury in rugby, soccer, ski, volleyball, gymnastics, and basketball players due to quick deceleration movements such as landing, pivoting, cutting, and changing direction in these sports. Despite increased knowledge of ACL injury mechanisms, rehabilitation programmes and surgical techniques, the rates of return-to-sport (RTS) and the subsequent ACL re-injury after ACL reconstruction (ACLR) are not optimal (Buckthorpe, 2019). Therefore, rehabilitation plays a significant role in helping athletes return to sports activities, and inappropriate rehabilitation can even devastate a satisfactory ACLR (Wright et al., 2015). This dissertation consists of two studies, including a systematic review in Chapter 2 that explores the research conducted on the application of immersive technologies for improving the outcome of the rehabilitation phases after ACL reconstruction and examines the correlation between virtual reality, rehabilitation, exercise therapy, and sport-related ACL injuries in patients. The second study in Chapter 3 validates the Microsoft Azure Kinect camera for body tracking of dynamic movements against the gold standard Qualisys system. The findings indicated that VR-based systems could be a considerable alternative to real-world training to improve certain aspects of athletic performance because immersive technologies effectively offer a tool to control virtual environmental features. Finally, immersive technologies and VR-based systems are still in their infancy and will need considerable imp