@Article{info:doi/10.2196/55730,
author="Houzangbe, Samory
and Lemay, Martin
and Levac, Danielle E",
title="Toward Physiological Detection of a ``Just-Right'' Challenge Level for Motor Learning in Immersive Virtual Reality: Protocol for a Cross-Sectional Study",
journal="JMIR Res Protoc",
year="2024",
month="Sep",
day="23",
volume="13",
pages="e55730",
keywords="virtual reality; pediatric rehabilitation; physiological data; engagement; just-right challenge",
abstract="Background: Motor learning, a primary goal of pediatric rehabilitation, is facilitated when tasks are presented at a ``just-right'' challenge level---at the edge of the child's current abilities, yet attainable enough to motivate the child in persistent efforts for success. Immersive virtual reality (VR) may be ideally suited for ``just-right'' task challenges because it enables precise adjustments of task parameters in motivating environments. Rehabilitation-specific VR tasks often use dynamic difficulty algorithms based on task performance to personalize task difficulty. However, these approaches do not consider relevant cognitive processes that could also impact ``just-right'' challenges, such as attention and engagement. Objective physiological measurement of these cognitive processes using wearable sensors could support their integration within ``just-right'' challenge detection and prediction algorithms. As a first step, it is important to explore relationships between objectively and subjectively measured psychophysiological states at progressively challenging task difficulty levels. Objective: This study aims to (1) evaluate the performance of wearable sensors in a novel movement-based motor learning immersive VR task; (2) evaluate changes in physiological data at 3 task difficulty levels; and (3) explore the relationship between physiological data, task performance, and self-reported cognitive processes at each task difficulty level. Methods: This study uses the within-participant experimental design. Typically developing children and youth aged 8-16 years will be recruited to take part in a single 90-minute data collection session. Physiological sensors include electrodermal activity, heart rate, electroencephalography, and eye-tracking. After collecting physiological data at rest, participants will play a seated unimanual immersive VR task involving bouncing a virtual ball on a virtual racket. They will first play for 3 minutes at a predefined medium level of difficulty to determine their baseline ability level and then at a personalized choice of 3 progressive difficulty levels of 3 minutes each. Following each 3-minute session, participants will complete a short Likert-scale questionnaire evaluating engagement, attention, cognitive workload, physical effort, self-efficacy, and motivation. Data loss and data quality will be calculated for each sensor. Repeated-measures ANOVAs will evaluate changes in physiological response at each difficulty level. Correlation analyses will determine individual relationships between task performance, physiological data, and self-reported data at each difficulty level. Results: Research ethics board approval has been obtained, and data collection is underway. Data collection was conducted on December 12, 2023, and April 12, 2024, with a total of 15 typically developing children. Data analysis has been completed, and results are expected to be published in the fall of 2024. Conclusions: Wearable sensors may provide insights into the physiological effects of immersive VR task interaction at progressive difficulty levels in children and youth. Understanding the relationship between physiological and self-reported cognitive processes is a first step in better identifying and predicting ``just-right'' task challenges during immersive VR motor learning interventions. International Registered Report Identifier (IRRID): DERR1-10.2196/55730 ",
issn="1929-0748",
doi="10.2196/55730",
url="https://www.researchprotocols.org/2024/1/e55730",
url="https://doi.org/10.2196/55730"
}