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ORIGINAL RESEARCH article

Front. Rehabil. Sci.
Sec. Rehabilitation in Neurological Conditions
Volume 5 - 2024 | doi: 10.3389/fresc.2024.1405304

Responses of several measures to different intensity levels of upper limb exergames in children with neurological diagnoses: a pilot study

Provisionally accepted
Gaizka Goikoetxea-Sotelo Gaizka Goikoetxea-Sotelo 1,2,3*Hubertus J. Van Hedel Hubertus J. Van Hedel 1,2
  • 1 Swiss Children's Rehab, University Children's Hospital Zurich, University of Zurich, Affoltern am Albis, Switzerland
  • 2 Children’s Research Center, University Children’s Hospital Zurich, University of Zurich, Zurich, Switzerland
  • 3 Department of Health Sciences and Technology, ETH Zürich, Zurich, Zürich, Switzerland

The final, formatted version of the article will be published soon.

    Background: Therapy intensity is among the most critical factors influencing neurorehabilitative outcomes. Because of its simplicity, time spent in therapy is the most commonly used measure of therapy intensity. However, time spent in therapy is only a vague estimate of how hard a patient works during therapy. Several measures have been proposed to better capture the amount of work a patient puts forth during therapy. Still, it has never been analyzed how these measures respond to changes in therapist-selected exercise intensity in children with neurological conditions. Objectives: To investigate the response and the reliability of heart rate variability (HRV), skin conductance (SC), activity counts per minute (AC/min), movement repetitions per minute (MOV/min), and perceived exertion to different therapist-tailored intensity levels of upper limb technology-assisted therapy in children with neurological conditions. Methods: In this pilot cross-sectional study, participants engaged in three personalized, randomized exergame intensity levels ("very easy", "challenging", "very difficult") for eight minutes each. We assessed all measures at each intensity level. The experiment was conducted twice on two consecutive days. We quantified reliability using intra-class correlation coefficients (ICC). Results: We included 12 children and adolescents aged 11.92 (± 3.03) years. HRV, MOV/min, and perceived exertion could differentiate among the three intensity levels.HRV, MOV/min, perceived exertion, and AC/min showed moderate to excellent (0.62 ≤ ICC ≤ 0.98) test-retest reliability. Conclusion: HRV, MOV/min, and perceived exertion show potential for becoming valid and reliable intensity measures for an upper limb robotic rehabilitative setting.However, studies with larger sample sizes and more standardized approaches are needed to understand these measures' responses better.

    Keywords: Intensity measures, Neurorehabilitation, movement repetitions, Heart rate variability, activity counts, Skin conductance, Borg scale

    Received: 22 Mar 2024; Accepted: 08 Oct 2024.

    Copyright: © 2024 Goikoetxea-Sotelo and Van Hedel. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Gaizka Goikoetxea-Sotelo, Swiss Children's Rehab, University Children's Hospital Zurich, University of Zurich, Affoltern am Albis, Switzerland

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.