The VR-BBT demonstrated strong reliability and validity despite differences in performance counts compared to BBT. The affected hand showed greater movement distance but lower speed, indicating inefficient motor control. These parameters were significantly associated with FMA-UE, suggesting their potential as objective markers of upper limb motor impairment. These findings suggest that the VR-BBT could serve as a complementary tool for motor function assessment, with potential applications in tele-rehabilitation and virtual reality-based rehabilitation. Trial registration KCT0009584 (Clinical Research Information Service, Republic of Korea).