JMIR Publications

ABSTRACT

Background:

Access to physical activity among youth with spina bifida (SB) is much lower than it is for children without disability. Enjoyable home-based exercise programs are greatly needed.

Objective:

To examine the usability of a virtual reality (VR) active video gaming system (i.e., bundle of consumer-available equipment) in two youth with SB to meet U.S. physical activity guidelines.

Methods:

Two wheelchair users with SB (12 years, f / 13 years, m) underwent 1 month of home-exercise training using a VR system. The system included the Oculus Quest, a head-strap to reduce pressure on the front of the face, a polar H10 Bluetooth heart rate monitor, a no-cost mobile phone application (VR Health), and 13 games. The intervention protocol was conducted entirely in the home due to the Covid-19 pandemic. The VR system was shipped to participants, and they were instructed to do their best to complete 60-minutes of moderate-intensity VR exercise per day. Exercise duration, intensity, and calories expended were objectively monitored and recorded during exercise using the heart rate monitor and the VR Health app. Participants were instructed to archive their exercise data after each session into a cloud-based server, managed by research staff. Fatigue and depression were measured via self-report questionnaires at pre- and post-intervention. Participants underwent a semi-structured interview with research staff at post-intervention. Qualitative feedback was used to explain and expand the quantitative exercise data.

Results:

Across the 1-month intervention period, the total average minutes of exercise performed each week for participant 1 and 2 were 281 and 262 minutes, respectively. The total average minutes of moderate-intensity exercise per week for participant 1 and 2 were 184 and 215 minutes, respectively. Participants appeared to improve their overall levels of depression from pre- to post-intervention, but these changes were slightly below minimal detectable changes at a case level. Participants reported that the amount of exercise they completed was far higher than what was objectively recorded, due to usability issues with the chest-worn heart rate monitor. Participants noted that they were motivated to exercise due to the enjoyment of the games and VR headset, as well as support from a caregiver.

Conclusions:

This study tested the usability of the latest state-of-the-art technology in consumer-available VR gaming among two youth with SB who use wheelchairs. Participants used the headset to safely achieve exercise guidelines. Study findings identified recommendations and knowledge gaps that can be pursued in future efficacy trials.