The effect of empathy intervention and VR exergames on social anxiety in left-behind children.

Introduction: This study investigated the comparative effectiveness of empathy intervention and virtual-reality exergames in reducing social anxiety among rural left-behind children (RLBC) in China. Methods: Sixty RLBC from Huangdu Primary School in Shaodong City, Hunan Province were randomly assigned to three groups-the Empathy Intervention Group (EG), the VR Exergames Group (VG), and the Control Group (CG)-with 20 participants each. The Children's Social Anxiety Scale (CSAS) was administered at baseline (T0), post-intervention (T1, Week 12), and 4-week follow-up (T2). Results: Results showed no baseline differences between groups (P > 0.05). At T1, both EG and VG demonstrated significant reductions in overall CSAS and subscale scores, with VG outperforming EG. By T2, VG maintained significant gains (P < 0.05), while EG exhibited delayed but sustained improvement (P < 0.05), though no significant change occurred between T1 and T2 (P > 0.05). The control group remained stable throughout (P > 0.05). Discussion: These findings suggest VR exergames yield stronger immediate effects, while empathy interventions show gradual efficacy, highlighting distinct therapeutic trajectories for RLBC's social anxiety management.