Feasibility of a virtual reality-based exercise intervention and low-cost motion tracking method for estimation of motor proficiency in youth with autism spectrum disorder

Darren R Hocking, Adel Ardalan, Hisham M Abu-Rayya, Hassan Farhat, Anna Andoni, Rhoshel Lenroot, Stan Kachnowski, Darren R Hocking, Adel Ardalan, Hisham M Abu-Rayya, Hassan Farhat, Anna Andoni, Rhoshel Lenroot, Stan Kachnowski

Abstract

Background: Motor impairment is widely acknowledged as a core feature in children with autism spectrum disorder (ASD), which can affect adaptive behavior and increase severity of symptoms. Low-cost motion capture and virtual reality (VR) game technologies hold a great deal of promise for providing personalized approaches to motor intervention in ASD. The present study explored the feasibility, acceptability and potential efficacy of a custom-designed VR game-based intervention (GaitWayXR™) for improving gross motor skills in youth with ASD.

Methods: Ten children and adolescents (10-17 years) completed six, 20-min VR-based motor training sessions over 2 weeks while whole-body movement was tracked with a low-cost motion capture system. We developed a methodology for using motion tracking data to quantify whole-body movement in terms of efficiency, synchrony and symmetry. We then studied the relationships of the above quantities with standardized measures of motor skill and cognitive flexibility.

Results: Our results supported our presumption that the VR intervention is safe, with no adverse events and very few minor to moderate side-effects, while a large proportion of parents said they would use the VR game at home, the most prohibitive reasons for adopting the system for home therapy were cost and space. Although there was little evidence of any benefits of the GaitWayXR™ intervention in improving gross motor skills, we showed several positive correlations between the standardized measures of gross motor skills in ASD and our measures of efficiency, symmetry and synchrony from low-cost motion capture.

Conclusions: These findings, though preliminary and limited by small sample size, suggest that low-cost motion capture of children with ASD is feasible with movement exercises in a VR-based game environment. Based on these preliminary findings, we recommend conducting larger-scale studies with methods for improving adherence to VR gaming interventions over longer periods.

Keywords: Artificial neural network; Kinect; Motion capture; Motor skills; Technology-based intervention; Video game; Virtual reality.

Conflict of interest statement

HF is currently an employee of Playing Forward LLC but was an employee at La Trobe University during the execution of the study. All other authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Schematic of in-lab VR-based videogame intervention setup
Fig. 2
Fig. 2
Screenshot of prescribed movements (jumping jacks) performed during the CandyDance game demonstrated by an animated character in the in-lab VR-based play session
Fig. 3
Fig. 3
Quantities used to calculate various measures on jumping jack movements
Fig. 4
Fig. 4
Frequency of side effects of simulation based on severity (none, slight, moderate, severe) and type of symptom using the Simulation Sickness Questionnaire (SSQ)

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