A PILOT TRIAL OF TELEHEALTH ACTIVE VIDEO GAMING USING IMMERSIVE VIRTUAL REALITY ON CARDIOMETABOLIC HEALTH AMONG YOUTH WITH CEREBRAL PALSY

赖，博士-R03 项目摘要/摘要 由于运动参与率低得令人担忧，患有脑瘫的青少年(YwCP)处于相当高的水平 随着年龄的增长，心血管疾病(CVD)、相关疾病和心血管疾病死亡率的风险。 经常参加有氧运动是一种有效的非药物预防方法 心血管疾病和代谢综合征，但有效的方式，如步行、跑步和骑自行车 通常不适合行动不便的女青年会这一大群人。不断增长的可用性 互联网接入和远程医疗的接受度(由于冠状病毒大流行)创造了前所未有的 有机会让大量服务不足的青年会参与锻炼行为。当与最近的 消费者可获得的虚拟现实(VR)视频游戏技术的进步，远程医疗计划具有 有潜力创造无障碍和完全身临其境的单人和多人实时视频游戏体验，请访问 这个家。这种令人愉快的锻炼方式可能会增加青年会保持规律的可能性 在一段时间内参与，这是引起心脏代谢健康变化所必需的。这 应用程序提出了一个试点项目，建立在我们最近的可行性工作的基础上。干预将利用一种 理论驱动的协议，用于通过远程健康远程交付和客观监控VR运动。 这些程序将纯粹由远程医疗驱动，包括远程筛查、同意、数据收集和 干预程序。参与者将从儿童医院、成人康复诊所和 社区组织网络。34名青年会将被随机分成两组：1)12周 虚拟现实游戏加行为远程体育训练(VRT)或为期12周的等待名单控制(WC) 在接受VRT之前要经历习惯性活动。VRT参与者将被要求至少完成 每周150分钟的中等强度运动。使用探索性统计程序，这项初步研究将 比较超敏C反应蛋白与血胰岛素、糖化血红蛋白、甘油三酯、 VRT组和单纯WC组之间的胆固醇和血压。在0、6和12周时，心脏代谢 结果将在家里通过远程评估进行衡量。此外，这项研究将定性地探索 通过与来自两个国家的参与者进行半结构化访谈而不充分参与的行为机制 干预后或辍学时的群体。使用扎根理论方法，参与者的反馈将是 被构建为一个实质性的理论，可以最大限度地提高青年会在电竞游戏中的长期参与度。 研究结果将被用来为远程医疗疗效试验的发展提供信息，该试验可以容易地复制 跨越各种站点和设置。

Byron Lai, PhD – R03 Project Summary/Abstract Due to alarmingly low rates of exercise participation, youth with cerebral palsy (YwCP) are at substantially high risk for cardiovascular disease (CVD), related conditions, and CVD mortality as they age into adulthood. Regular participation in aerobic exercise is an effective non-pharmaceutical method for preventing cardiovascular disease and metabolic syndrome, but effective modalities such as walking, running, and cycling are often not suitable for the large demographic of YwCP who have reduced mobility. The growing availability of internet access and acceptance of telehealth (due to the coronavirus pandemic) create an unprecedented opportunity to engage large, underserved groups of YwCP in exercise behavior. When combined with recent advances in consumer-available virtual reality (VR) video game technology, telehealth programs have the potential to create accessible and fully immersive single- and multiplayer active video gaming experiences at the home. This enjoyable modality of exercise may enhance the likelihood that YwCP maintain regular participation over periods of time that are necessary to elicit changes in cardiometabolic health. This application proposes a pilot project that builds upon our recent feasibility work. The intervention will utilize a theory driven protocol for remotely delivering and objectively monitoring VR exergaming through telehealth. The procedures will be purely telehealth driven and include remote screening, consent, data collection, and intervention procedures. Participants will be recruited from a children’s hospital, adult rehabilitation clinic, and network of community organizations. Thirty-four YwCP will be randomized to one of two groups: 1) 12 weeks of VR exergaming plus behavioral tele-physical education coaching (VRT) or a 2) 12-week waitlist control (WC) that undergoes habitual activity before receiving VRT. VRT participants will be prescribed to complete at least 150 min per week of moderate-intensity exercise. Using exploratory statistical procedures, this pilot study will compare changes in high sensitivity C-reactive protein and blood insulin, hemoglobin A1c, triglycerides, cholesterol and pressure between the VRT and WC only groups. At 0, 6, and 12 weeks, cardiometabolic outcomes will be measured at the home via tele-assessment. Additionally, the study will qualitatively explore behavioral mechanisms that underly participation via semi-structured interviews with participants from both groups at post-intervention or dropout. Using a Grounded Theory approach, participant feedback will be constructed into a substantive theory that can maximize long-term engagement of YwCP in tele-exergaming. Study findings will be used to inform the development of a telehealth efficacy trial that can be easily replicated across various sites and settings.