Immersive virtual reality arm exercise, physical activity, and cardiometabolic health in cerebral palsy: A phase 1 trial

Abstract

Aim: To examine the feasibility of a seated virtual reality exercise telehealth intervention on physical activity and cardiometabolic health in young people with cerebral palsy (CP). Method: This was a randomized two-arm parallel group study: an immediate start group versus a waitlist control that continued usual activities of daily living. The home-based intervention targeted 150 minutes per week of moderate-intensity exergaming for 12 weeks, using Meta Quest virtual reality headsets and games, adapted for seated exercise. Data were collected remotely in weeks 0, 7, and 13. Results: Thirty-two young people with CP enrolled (mean age 16 years 8 months [SD 3 years 8 months], 19 females, 13 males), with a 9.4% dropout rate. Immediate start completers (n = 13) averaged 144 minutes per week (SD 73 minutes per week) of total exercise but fell short of the moderate-exercise target (150 minutes per week) at week 3 by 25%, week 6 by 31%, and week 12 by 48%. Immediate start surveys demonstrated that moderate-to-vigorous physical activity increased by 166% and 108% at weeks 7 and 13 respectively. Immediate start insulin levels improved by 45.2% and triglycerides by 20.2% from week 0 to 7. Waitlist control insulin and high-sensitivity C-reactive protein worsened from week 0 to 13 by 42.8% and 40% respectively. Interpretation: Seated virtual reality exercise is a feasible and safe intervention that significantly increases physical activity participation. It shows potential for favorably influencing certain cardiometabolic markers, although further research is needed to establish sustained benefits.