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

利用沉浸式虚拟现实进行远程健康主动视频游戏对脑瘫青少年心脏代谢健康的试点试验

• 批准号: 10375206
• 负责人: Byron Lai
• 金额: $ 14.53万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10375206
• 关键词: Adherence; Adult; Aerobic Exercise; Age; Analysis of Covariance; Behavior; Behavioral; Behavioral Mechanisms; Blood; Blood Pressure; C-reactive protein; Cardiovascular Diseases; Caregivers; Case Study; Cerebral Palsy; Childhood; Cholesterol; Clinic; Collection; Community Networks; Computers; Consent; Control Groups; Data Collection; Development; Diabetes Mellitus; Diagnostic Reagent Kits; Doctor of Philosophy; Dose; Dropout; Enrollment; Equipment; Evidence based program; Exercise; Feedback; General Population; Glycosylated hemoglobin A; Guidelines; Health; Health Professional; Home; Hypertension; Immersion; Insulin; Internet; Intervention; Interview; Measurement; Measures; Metabolic syndrome; Methods; Modality; Monitor; Motion; Motor; Outcome; Participant; Pediatric Hospitals; Persons; Physical Education; Pilot Projects; Population; Procedures; Property; Protocols documentation; Psychometrics; Randomized; Randomized Controlled Trials; Rehabilitation therapy; Research; Research Personnel; Resolution; Risk Factors; Running; Sample Size; Site; Spottings; Structure; Supervision; Techniques; Technology; Time; Triglycerides; Underserved Population; Video Games; Videoconferencing; Waiting Lists; Walking; Wheelchairs; Work; Youth; arm; base; cardiometabolic risk; cardiometabolism; cardiovascular disorder risk; cohort; community organizations; cost; cost efficient; design; disability; eHealth; efficacy study; efficacy trial; exercise intensity; exercise intervention; exercise training; exergame; experience; head mounted display; high risk; hypercholesterolemia; improved; mode of exercise; mortality; pandemic coronavirus; physically handicapped; pilot trial; post intervention; pressure; prevent; programs; recruit; remote delivery; remote screening; scale up; sedentary lifestyle; statistics; telehealth; telemonitoring; theories; vigorous intensity; virtual monitoring; virtual reality; virtual reality environment

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.

黎拜伦博士 – R03 项目概要/摘要 由于运动参与率极低，脑瘫青少年 (YwCP) 的参与率相当高 随着年龄的增长，心血管疾病 (CVD)、相关疾病和 CVD 死亡率的风险。 定期参加有氧运动是预防糖尿病的有效非药物方法 心血管疾病和代谢综合征，但步行、跑步和骑自行车等有效方式 通常不适合 YwCP 的大量人口，他们的流动性较低。 互联网接入和远程医疗接受度（由于冠状病毒大流行）创造了前所未有的 与最近的活动相结合，有机会让大量未得到充分服务的 YwCP 群体参与锻炼行为。 随着消费者可用的虚拟现实 (VR) 视频游戏技术的进步，远程医疗计划已 创造可访问且完全身临其境的单人和多人活动视频游戏体验的潜力 这种令人愉快的在家锻炼方式可以提高 YwCP 保持规律的可能性。 在引起心脏代谢健康变化所必需的一段时间内参与。 申请提出了一个以我们最近的可行性工作为基础的试点项目，该干预措施将利用 理论驱动的协议，用于通过远程医疗远程提供和客观监控 VR 运动游戏。 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 参与者将从儿童医院、成人康复诊所和 34 名 YwCP 将被随机分为两组：1) 12 周。 VR 运动游戏加上行为远程体育辅导 (VRT) 或 2) 12 周候补名单控制 (WC) 在接受 VRT 之前进行习惯性活动的参与者将被要求至少完成。 这项试点研究将采用探索性统计程序，每周进行 150 分钟的中等强度运动。 比较高敏C反应蛋白和血液胰岛素、血红蛋白A1c、甘油三酯、 VRT 组和仅 WC 组之间的胆固醇和压力在第 0、6 和 12 周时的心脏代谢。 此外，该研究将通过远程评估在家中测量结果。 通过与双方的半结构化访谈作为参与基础的行为机制 使用扎根理论方法，参与者的反馈将在干预后或退出后进行。 构建了一个实质性理论，可以最大限度地提高 YwCP 长期参与远程运动游戏的程度。 研究结果将用于为可轻松复制的远程医疗功效试验的开发提供信息 跨各种站点和设置。