Leveraging Extended Reality Exergaming and Telehealth to Improve Physical Activity and Health in Children With Disabilities

Changes in C-reactive Protein (hsCRP)

hsCRP (mg/L) is a critical marker of inflammation that contributes to pro-inflammatory and pro-thrombotic elements of CVD risk. A single hsCRP measure is a strong predictor of myocardial infarction or coronary heart disease mortality, and several other diseases of the circulatory system in people without a history of such conditions.

Time frame: week 0, week 6, week 12, week 24, week 36

Changes in Hemoglobin A1C

HbA1C (mmol/mol) measures mean hemoglobin glycation over the previous three months.

Time frame: week 0, week 6, week 12, week 24, week 36

Changes in Fasting Insulin

High fasting insulin indicates the presence of insulin resistance. Exercise interventions can expect a small beneficial change in fasting insulin levels after 1-month of training.

Time frame: week 0, week 6, week 12, week 24, week 36

Changes in Fasting Triglycerides

A triglyceride level \>150 mg/dL, is largely supported as an indicator of CVD risk. Exercise interventions can expect a small beneficial change in triglyceride levels following 1-month of training, even among people with normal triglyceride levels.

Time frame: week 0, week 6, week 12, week 24, week 36

Changes in High-density Lipoprotein

High-density lipoprotein (HDL; mg/dL) cholesterol is a predictor of future CVD among young and middle-aged people. Exercise interventions can expect a small effect after 1-month of training.

Time frame: week 0, week 6, week 12, week 24, week 36

Changes in Low-density Lipoprotein

Low-density lipoprotein (LDL; mg/dL) cholesterol is a predictor of future CVD among young and middle-aged people. Exercise interventions can expect a small effect after 1-month of training.

Time frame: week 0, week 6, week 12, week 24, week 36

Changes in Total Cholesterol

Total cholesterol (mg/dL) is a predictor of future CVD among young and middle-aged people. Exercise interventions can expect a small effect after 1-month of training.

Time frame: week 0, week 6, week 12, week 24, week 36

Changes in Resting Systolic Blood Pressure

Elevated blood pressure (mmHg) during childhood and adolescents is associated with intermediate markers and hard outcomes of CVD in adulthood. Moderate-intensity exercise is negatively associated with blood pressure. Small changes in blood pressure can occur from as early as 1-month of endurance training.

Time frame: week 0, week 6, week 12, week 24, week 36

Changes in Resting Diastolic Blood Pressure

Elevated blood pressure (mmHg) during childhood and adolescents is associated with intermediate markers and hard outcomes of CVD in adulthood. Moderate-intensity exercise is negatively associated with blood pressure. Small changes in blood pressure can occur from as early as 1-month of endurance training.

Time frame: week 0, week 6, week 12, week 24, week 36

2-Minute Step Test

2 minute test is used to assess aerobic capacity by counting the number of steps an individual takes, hitting a target point, in 2 minutes. Individuals can hold on to supports for duration of the test. 2-minute step test will be for only ambulatory individuals. Higher number of steps in 2-minutes equates to higher aerobic capacity.

Time frame: Week 0, Week 6, Week 12, Week 24, Week 36

Timed Up and Go (TUG)

TUG is a 3-meter walking test to assess an individuals functional balance and mobility. Individuals will start in a seated position, stand, walk 3-meters turning around a cone, walk back and sit down. Time will be measured in seconds, with lower time equating to higher functional balance and mobility.

Time frame: Week 0, Week 6, Week 12, Week 24, Week 36

Hand-grip Strength Test (hand-held dynamometer)

Measure of isometric muscular strength of the hand and forearm. Using a hand-held dynamometer, individuals will hold onto device with arm supported at a 90 degree angle and squeeze as hard as they can for 3 seconds. Individuals will do 3 test on each hand, as able, with the average of the 3 attempt being their score. Hand-grip strength will be measured in kg, with higher values equating to more strength.

Time frame: Week 0, Week 6, Week 12, Week 24, Week 36

NIH PROMIS Global Health Pediatric (7 item) survey

7-item survey assessing a child's self-reported health, including physical, mental, and social health. Each question is given a score of 1-5. The sum of all 7 questions will be used to determine the individuals total score which will be referenced to a z-score conversion table, with higher scores equating to better overall health.

Time frame: Week 0, Week 6, Week 12, Week 24, Week 36

Changes in Body Weight

Body weight measured in lbs using a off-the-shelf bathroom scale.

Time frame: Week 0,Week 6, Week 12, Week 24, Week 36