Feasibility of Vigorous Extended Reality Tele-Exergaming on Cardiometabolic Health in Youth with Mobility Disabilities: Protocol for a Case Series (Preprint)

<sec> <title>BACKGROUND</title> Young people with mobility disabilities have limited evidence-based options to maintain their cardiometabolic health and cardiorespiratory fitness. Active video gaming using extended reality (XR) head-mounted displays is becoming increasingly common for promoting serious exergaming. However, there is a need to identify dosing that can lead to meaningful effects on cardiometabolic health and cardiorespiratory fitness. </sec> <sec> <title>OBJECTIVE</title> The primary purpose is to explore the effects of a remote, 6-week, vigorous-intensity, XR exergaming program, on body composition and cardiometabolic health, among four young people with cerebral palsy who are overweight or obese. The secondary aim is to assess the effects of the program on cardiorespiratory fitness. The tertiary aim is to describe the safety and acceptability of the intervention. </sec> <sec> <title>METHODS</title> This study is a phase 1 feasibility study with a pre-to-post trial design with a case series of 4 participants. Overweight or obese young people with cerebral palsy (ages 13-24 yrs) will be purposively selected to participate based on two mobility categories (ambulatory, n=2; non-ambulatory, n=2). The intervention prescription will include 240 min/week of vigorous intensity exercise at home, with tele-monitoring of exercise data that will be supplemented by weekly coaching calls. Participants will exercise using a head-mounted display, to control an immersive exergame. Caregivers will agree to manage a play schedule and assess their child’s safety during play. Body composition will be measured using a Dual-Energy X-ray Absorptiometry at pre- and post-intervention (week 0 and 7, respectively). Blood-related health (fasting insulin, lipids, hSCRP, hbA1c) will be measured via a blood-spot test, as well as blood pressure measured via a sphygmomanometer. Cardiorespiratory fitness (peak oxygen consumption) will be measured using a portable metabolic cart (COSMED K5) during a graded exercise test on an arm-ergometer at pre- and post-intervention. Quantitative process metrics and qualitative feedback will be used to assess feasibility. Changes in outcomes over time will be descriptively analyzed. </sec> <sec> <title>RESULTS</title> Recruitment began in October 2025. All data are anticipated to be collected by December 2025. Full results are anticipated to be analyzed and submitted for publication by March 2026. </sec> <sec> <title>CONCLUSIONS</title> This trial tests an accessible and intensive program, which leverages high-intensity exercise gaming with telehealth procedures for children with cerebral palsy. Study findings will inform a larger trial to improve the cardiometabolic health and fitness among young people with mobility disabilities. </sec> <sec> <title>CLINICALTRIAL</title> NCT07155213 </sec>