The portable Interactive Physical and Cognitive Exercise System (iPACES, v 2.8), tablet, smart watch and an under-desk stationary elliptical will be sent to the home of a participant and used in-home for three months in this experiment. We aim to examine the effects of cognitive and physical stimulation, in adolescents on the autism spectrum. This three-week intervention of exergaming will add to the finding of previous studies that used a 20 minute bout of exergaming. Participants will receive the iPACES set-up and necessary testing materials via mail to remain consistent with the social distancing guidelines due to COVID-19. To begin the experiment, participants will be given a series of questionnaires and cognitive tasks, such as Stroop, Color Trails, and Digit Span via a video call on a remote video conference platform (e.g. Zoom) remaining consistent with the tele-health guidelines. Participants will then be asked to use the game and peddler combination 3-5 times weekly for 30-45 minutes. While this proposed study does not attempt to maximize participation in exercise, it aims to support the belief that exergaming produces a positive effect on cognitive functioning and the reduction of autism-related behaviors of repetition and physical self-stimulation. It will also indirectly investigate the possibility of the use of exergaming as a viable treatment for autism and the feasibility of a remote protocol.
With the prevalence of dementia and neurocognitive decline on the rise, older adult populations have begun seeking out non-pharmacological methods to prevent or ameliorate their symptoms. Specifically, prior research has shown greater cognitive benefits from simultaneous exercise and cognitive stimulation than exercise alone, particularly for patients with mild cognitive impairment (MCI). In response to the COVID-19 pandemic, we conducted a pilot study to test the feasibility of a remote, home-based, exercise intervention for older adults. For three months, six older adults engaged in integrative physical and cognitive exercise via a neuro-exergame called the interactive Physical and Cognitive Exercise System (iPACES v2.0), which involves pedaling an under-desk elliptical while playing an interactive video game. Participants completed the Montreal Cognitive Assessment (MoCA) before and after the intervention, and exit interviews were conducted via Zoom at the conclusion of the study. While participants found the neuro-exergame to be entertaining, several setup and technical difficulties arose that made their overall experience more difficult. Our findings suggest that a more effective intervention would involve more user-friendly features that allow for greater ease of use by older adults with MCI.
Autism Spectrum Disorder (ASD) is a neurodevelopmental disability that is characterized by emotional, social, and behavioral challenges (Centers for Disease Control and Prevention [CDC], 2020). One common characteristic of Autism Spectrum Disorder is impairment in executive function (EF) (Craig, Margari, Legrottaglie, Palumbi, Giambattista, & Margari, 2016). EF describes the governing of cognitive processes through control and regulation and is often associated with activity in the prefrontal cortex (Craig et al., 2016). One intervention that is being considered as an Evidence Based Practice (EBP) to help with characteristics of ASD, like executive dysfunction, is exercise (Dillion, Adams, Goudy, Bittner, & McNamara, 2017). Some studies have even looked at the synergistic effects of exercise and virtual gaming on cognition in youth diagnosed with ASD (Anderson-Hanley, Tureck, & Schneiderman, 2011). Anderson-Hanleyet. al (2011) found that use of an interactive physical physical and cognitive exercise system (iPACES) had a positive effect on improving some of the symptoms of ASD such as enhancing executive function and decreasing repetitive behaviors. In this study, we aimed to analyze the effectiveness of iPACES on a single youth with ASD over a three-month intervention. Problems due to the COVID-19 pandemic shifted our aim to look at the effects of multiple 20 min bouts of exergaming in a single case study. One youth was enrolled and successfully completed a series of experimental procedures, including the exercise induced feeling inventory (EIFI), the paper Stroop Task pre-intervention and an electronic Stroop Task pre- and post-intervention. This youthalso attempted newly developed versions of the iPACES game and provided feedback. The canal version of the game seemed to be a more interesting version according to the youth's report. Interestingly, the participant found that the bout using the canal version of game required more physical effort and felt more revitalizing according to the EIFI. Comparison of the Stroop A to Stroop C change scores for electronic Stroop Task as part of the iPACES v3 application and for the paper Stroop task revealed that the assessments were comparable. A review of the graphical display of the time series data for the electronic Stroop indicated that there was no increase in performance on this executive function task after exercise withiPACES.Because the electronic Stroop used was a new version that is still in development, it may not have been sufficiently challenging to the participant's cognitive ability (few errors were registered), lacking sensitive to any effects on executive functioning. Therefore, further development of the electronic Stroop may be required. Further research should also be conducted to see the effectiveness of exergaming over a longer period of time as there may be greater effects.