Lai Byron, Wright Ashley, Hutchinson Bailey, Bright Larsen, Young Raven, Davis Drew, Malik Sultan Ali, Rimmer James H
Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, 1600 7th Avenue South, Birmingham, AL, 35233, United States, 1 2056389790 ext 8-9725.
CMH Kharian Medical College, National University of Medical Sciences, Rawalpindi, Pakistan.
JMIR Form Res. 2025 Apr 25;9:e65801. doi: 10.2196/65801.
Children have busy daily schedules, making school an ideal setting for promoting health-enhancing exercise behavior. However, children with mobility disabilities have limited exercise options to improve their cardiorespiratory fitness and cardiometabolic health.
This study aims to test the feasibility of implementing a virtual reality (VR) exercise program for children with mobility disabilities in a high school setting.
A pre- to posttrial single-group design with a 6-week exercise intervention was conducted at a high school. The study aimed to enroll up to 12 students with a disability. Participants were given the option of exercising at home or school. The exercise prescription was three 25-minute sessions per week at a moderate intensity, using a head-mounted VR display. School exercise sessions were supervised by research staff. Home exercise sessions were performed autonomously. Several implementation metrics of feasibility were recorded, including exercise attendance, volume, adverse events or problems, and benefits related to health-related fitness (walking endurance and hand-grip strength). The study also included a qualitative evaluation of critical implementation factors and potential benefits for participants that were not included in the study measures. Outcomes were descriptively analyzed, and 2-tailed t tests were used as appropriate.
In total, 10 students enrolled in the program and 9 completed the study (mean age 17, SD 0.6 y). In total, 5 (56%) participants exercised at school, and 4 (44%) exercised at home; 1 participant dropped out prior to exercise. The mean attendance for all 9 completers was 61.1% (11/18 sessions). The mean exercise minutes per week was 35.5 (SD 22) minutes. The mean move minutes per session was 17.7 (SD 11) minutes. The mean minutes per session was 18 (SD 1.4) minutes for school exercisers and 17 (SD 18) minutes for home exercisers, indicating variable responses from home exercisers. The mean rating of perceived exertion per exercise session was 4.3 (SD 2), indicating a moderate intensity that ranged from low to hard intensity. No adverse events or problems were identified. No improvements in walking endurance or hand-grip strength were observed. School exercisers achieved a higher attendance rate (83%) than home exercisers (27%; P<.001) and seemingly had a 2-fold increase in the volume of exercise achieved (school: mean 279, SD 55 min; 95% CI 212-347; home: mean 131, SD 170 min; 95% CI -140 to 401; P=.10). Qualitative themes relating to implementation factors and benefits to participant well-being were identified.
This study identified factors to inform an optimal protocol for implementing a high school-based VR exercise program for children with disabilities. Study findings demonstrated that moderate exercise at school is feasible in VR, but simply providing children with VR exergaming technology at home, without coaching, will not successfully engage them in exercise.
儿童日常日程繁忙，学校是促进有益健康的运动行为的理想场所。然而，行动不便的儿童改善心肺功能和心脏代谢健康的运动选择有限。
本研究旨在测试在高中环境中为行动不便的儿童实施虚拟现实（VR）运动计划的可行性。
在一所高中进行了一项为期6周运动干预的试验前至试验后的单组设计。该研究旨在招募多达12名残疾学生。参与者可以选择在家或在学校锻炼。运动处方是每周进行三次，每次25分钟，强度适中，使用头戴式VR显示器。学校的锻炼课程由研究人员监督。家庭锻炼课程自主进行。记录了可行性的几个实施指标，包括锻炼出勤率、运动量、不良事件或问题以及与健康相关的体能（步行耐力和握力）相关的益处。该研究还包括对关键实施因素和未纳入研究措施的参与者潜在益处的定性评估。对结果进行描述性分析，并在适当情况下使用双尾t检验。
共有10名学生报名参加该计划，9名学生完成了研究（平均年龄17岁，标准差0.6岁）。共有5名（56%）参与者在学校锻炼，4名（44%）在家锻炼；1名参与者在锻炼前退出。所有9名完成者的平均出勤率为61.1%（11/18节课程）。每周平均锻炼分钟数为35.5（标准差22）分钟。每次锻炼的平均移动分钟数为17.7（标准差11）分钟。学校锻炼者每次锻炼的平均分钟数为18（标准差1.4）分钟，家庭锻炼者为17（标准差18）分钟，表明家庭锻炼者的反应各不相同。每次锻炼的平均主观用力程度评分为4.3（标准差2），表明强度适中，范围从低强度到高强度。未发现不良事件或问题。未观察到步行耐力或握力有改善。学校锻炼者的出勤率（83%）高于家庭锻炼者（27%；P<0.001），并且锻炼量似乎增加了两倍（学校：平均279，标准差55分钟；95%置信区间212 - 347；家庭：平均131，标准差170分钟；95%置信区间 - 140至401；P = 0.10）。确定了与实施因素和参与者幸福感益处相关的定性主题。
本研究确定了一些因素，可为为残疾儿童实施基于高中的VR运动计划的最佳方案提供参考。研究结果表明，在学校进行适度的VR锻炼是可行的，但仅在家中为儿童提供VR运动游戏技术而没有指导，将无法成功促使他们参与锻炼。
