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

doi:10.1186/s12984-021-00978-1

Abstract

BackgroundMotor 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.MethodsTen 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.ResultsOur 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.ConclusionsThese 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.

Highlights

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
Data segmentation cleaning To study the participants’ motor profiles in detail, we focused on one particular movement, i.e. jumping jacks
Feasibility, tolerability and usability There were no serious adverse events recorded, mild to moderate side effects arising from virtual reality (VR) were reported

Summary

Introduction

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. Not included within the core ASD domains of restricted interests, repetitive behaviors and impaired social communication skills, motor impairments are pervasive in individuals with ASD. These impairments affect a variety of domains, including balance [3], movement planning [4], gait [5], and fine and gross motor coordination [6]. Motor difficulties in individuals with ASD appear to be present from birth [7] and persist across the lifespan [8, 9] These motor challenges have been consistently found to be a precursor to later ASD symptoms and diagnosis [10, 11]. An important goal is to determine if we can improve motor skills in youth with ASD and develop sensitive outcome measures to track motor performance over time

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Discussion

Conclusion