JMIR Publications

ABSTRACT

Background:

Motor learning, a primary goal of pediatric rehabilitation, is facilitated when tasks are presented at a ‘just-right’ challenge level: at the edge of the child’s current abilities, yet attainable enough to motivate the child in persistent efforts for success. Immersive virtual reality (VR) may be ideally suited for ‘just-right’ task challenge because it enables precise adjustments of task parameters in motivating environments. Rehabilitation-specific VR tasks often use dynamic difficulty algorithms based on task performance to personalize task difficulty. However, these approaches do not consider relevant cognitive processes that could also impact ‘just-right’ challenge, such as attention and engagement. Objective physiological measurement of these cognitive processes using wearable sensors could support their integration within ‘just-right’ challenge detection and prediction algorithms. As a first step towards this goal, it is important to explore relationships between objectively and subjectively measured psychophysiological state at progressively challenging task difficulty levels.

Objective:

1) Evaluate the performance of wearable sensors in a novel movement-based motor learning immersive VR task; 2) Evaluate changes in physiological data at three task difficulty levels; and 3) Explore the relationship between physiological data, task performance, and self-reported cognitive processes at each task difficulty level.

Methods:

Within-participant experimental design. Twelve children and youth aged 8-16 years (six with cerebral palsy at Gross Motor Function Classification Levels I-II and six typically developing children) will be recruited to take part in a single 90-minute data collection session. Physiological sensors include electrodermal activity (EDA), heart rate, electroencephalography (EEG), and eye-tracking. After collecting physiological data at rest, participants will play a seated unimanual immersive VR task involving bouncing a virtual ball on a virtual racket. They will first play for three minutes at a pre-defined medium level of difficulty to determine their baseline ability level, and then at a personalized choice of three progressive difficulty levels for three minutes each level. Following each 3-minute session, participants will complete a short Likert-scale questionnaire evaluating engagement, attention, cognitive workload, physical effort, self-efficacy, and motivation. Data loss and data quality will be calculated for each sensor. Repeated-measures ANOVAs will evaluate changes in physiological response at each difficulty level. Correlation analyses will determine within individual relationships between task performance, physiological data, and self-reported data at each difficulty level.

Results:

Research Ethics Board approval has been obtained and data collection is underway.

Conclusions:

Wearable sensors may provide insights into physiological effects of immersive VR task interaction at progressive difficulty levels in children and youth with and without physical impairments. Understanding the relationship between physiological and self-reported cognitive processes is a first step in better identifying and predicting ‘just-right’ task challenge during immersive VR motor learning interventions.