Effect of Hand Grip and Center of Mass Location on Muscle Activity While Manipulating a Surgical Table Segment.

OCCUPATIONAL APPLICATIONSHand grip location relative to the center of mass of an object can impact the activity of trunk and upper limb muscles. Aligning the hand grip location with the center of mass in the anterior/posterior direction minimizes muscle activity. Whether a proximal or distal grip requires more effort appears to be muscle dependent. Our work illustrates how design features influencing hand grip and center of mass location, such as handles and hand-operated mechanisms, can impact the user. Reducing physical effort via design is important to improve usability and help mitigate the high incidence of musculoskeletal injury resulting from manual materials handling tasks.

Background Manual materials handling tasks are associated with a high risk of injury. The physical effort required to lift and manipulate objects can be influenced by design.Purpose Examine the effect of hand grip location and center of mass on physical effort during a surgical table section attachment task.Methods Twelve participants lifted, carried, and placed a table section onto a surgical table. Hand grip and center of mass location of the table section were both modified in three anteroposterior axis directions (proximal, aligned, and distal), as was the mass (6.8, 9.1, and 11.4 kg). Physical effort was quantified as the normalized peak activity from six unilateral trunk and upper limb muscles recorded via surface electromyography.Results As hypothesized, when an effect was present, aligning the hand grip with the center of mass resulted in the lowest level of muscle activity for all muscles. Whether a proximal or distal relationship between hand grip and the center of mass was more arduous differed by muscle: the deltoid, biceps, and extensor digitorum had greater activity with a center of mass located distal to the hand grip, while erector spinae and trapezius muscles had greater activity with a hand grip distal to the center of mass. Flexor digitorum activity was high in both misaligned conditions of hand grip. Mass, as has been previously documented, had a significant and direct effect on all muscle groups.Conclusions This work has implications for design features such as handles, buttons, or release mechanisms that can dictate where the user grips. By quantifying the impact of anteroposterior axis hand grip and center of mass location on the physical demands of manipulating an object, ergonomists and designers can consider the consequences of incorporating features that could misalign the hand grip location and center of mass.

Evaluating the benefit of contact-force feedback in robotic surgery using the Saroa surgical system: A preclinical study.

INTRODUCTION: Robotic surgery without contact-force feedback could be less safe, as forces exerted by the robot system may exceed tissue tolerance. This study aimed to evaluate the benefit of contact-force feedback. METHODS: Nine junior and 11 senior surgeons performed two tasks using Saroa, a robotic surgical system with a force feedback function. In Task A, the participants estimated the order of stiffness of substances when feedback was on and off. In Task B, the effect of feedback on compression with a designated force (3 N) was assessed. RESULTS: In Task A, the proportion of participants who correctly estimated the order of stiffness of the substances was similar when feedback was on and off. However, the median maximum force applied to the substances was significantly smaller when feedback was on than when it was off (5.0 vs. 6.9 N, p = .011), which was more obvious among the junior surgeons (5.0 vs. 7.7 N, p = .015) than among the senior surgeons (4.7 vs. 5.9 N, p = .288). In Task B, deviations from the designated force (3 N) for three substances were smaller when feedback was on (0, -0.1, and 0.7, respectively) than when it was off (-0.3, -0.5, and 1.3, respectively). Regarding the dispersion of the force to the substances, the interquartile range tended to be smaller with feedback; this trend was more obvious in the junior surgeons. CONCLUSION: With contact-force feedback, tissue stiffness could be estimated with a small force, particularly by the junior surgeons; specified force could be accurately applied to the tissue.

Long-duration spaceflight adversely affects astronaut piloting performance.

A group of highly experienced pilots performed full-motion, simulated T-38 landings before and after extended missions aboard the International Space Station (ISS). On the day of return from the ISS pilots' performance was degraded on the initial landing attempt, with difficulty maintaining altitude during banking turns and navigational errors, which affected touchdown parameters such as touchdown speed, height over runway threshold and touchdown distance from the runway threshold. A positive result was that all pilots successfully completed a second landing attempt on the same day, suggesting a rapid recovery of performance once exposed to the task at hand. These results are consistent with a previous study that demonstrated significant deficits in post-flight driving performance, and both the pilot and driver subjects' performance recovered to pre-flight levels within four days of return from the ISS. We propose that the primary factors underlying the post-flight performance deficits were the inability to respond appropriately to gravitational and visual tilts and a reduction in multitasking ability.

Effects of video game immersion and task interference on cognitive performance: a study on immediate and delayed recall and recognition accuracy.

This study investigates the cognitive impacts of video game immersion and task interference on immediate and delayed recall as well as recognition tasks. We enrolled 160 subjects aged 18 to 29, who were regular players of "shoot-em-up" video games for at least 3 years. Participants were assigned to one of three experimental groups or a control group. The experimental conditions varied in the timing and type of tasks: the first group performed a video game session between recall tasks, the second group multitasked with video games and recall tasks simultaneously, and the third group engaged in task switching from video games to recall tasks. Using the Rey Auditory Verbal Learning Test, we measured the effects of these conditions on cognitive performance, focusing on error types and recall accuracy. Results indicated that multitasking and task switching significantly affected the subjects' performance, with notable decrements in recall and recognition accuracy in conditions of high task interference. The study highlights the cognitive costs associated with multitasking in immersive digital games and provides insights into how task similarity and interference might increase error rates and affect memory performance.

Exploring the influence of music on cognitive performance in female assembly line workers at a medical device manufacturing unit.

The significance of enhancing working conditions for the physical health and performance of workers, particularly female workers, underscores the need for research in this domain and the examination of interventions such as music. Previous studies have yielded diverse outcomes regarding the influence of music on individuals' performance; hence, further research in this area appears imperative. The aim of this study is to explore the impact of music on the cognitive and task performance of female assembly operation operators. This study is an interventional (quasi-experimental) study that involved 81 participants from the female workforce of the medical equipment assembly unit in Isfahan, Iran. The evaluation encompassed task performance, working memory using N-Back test, sustained attention using continues performance test (CPT), degree of sleepiness, and mental fatigue using Flicker Fusion test, along with physiological parameters such as heart rate and blood oxygen level. Participants underwent testing both in the presence of classical music and in a condition without music playback. The provision of background music enhanced the workers' sustained attention and working memory. It led to improved task performance and a reduction in drowsiness. Concerning physiological parameters, it resulted in a slight decrease in heart rate at the end of the work shift and a marginal increase in participants' blood oxygen levels. Background music enhanced working memory (p-value = 0.001), sustained attention (p-value = 0.001), and improved the task performance of workers(p-value = 0.005). Additionally, likely due to increased relaxation, it led to a decrease in heart rate (p-value = 0.001) and an increase in blood oxygen levels (p-value = 0.016). Music also played a role in reducing participants' sleepiness (p-value = 0.001).

EEG microstate transition cost correlates with task demands.

The ability to solve complex tasks relies on the adaptive changes occurring in the spatio-temporal organization of brain activity under different conditions. Altered flexibility in these dynamics can lead to impaired cognitive performance, manifesting for instance as difficulties in attention regulation, distraction inhibition, and behavioral adaptation. Such impairments result in decreased efficiency and increased effort in accomplishing goal-directed tasks. Therefore, developing quantitative measures that can directly assess the effort involved in these transitions using neural data is of paramount importance. In this study, we propose a framework to associate cognitive effort during the performance of tasks with electroencephalography (EEG) activation patterns. The methodology relies on the identification of discrete dynamical states (EEG microstates) and optimal transport theory. To validate the effectiveness of this framework, we apply it to a dataset collected during a spatial version of the Stroop task, a cognitive test in which participants respond to one aspect of a stimulus while ignoring another, often conflicting, aspect. The Stroop task is a cognitive test where participants must respond to one aspect of a stimulus while ignoring another, often conflicting, aspect. Our findings reveal an increased cost linked to cognitive effort, thus confirming the framework's effectiveness in capturing and quantifying cognitive transitions. By utilizing a fully data-driven method, this research opens up fresh perspectives for physiologically describing cognitive effort within the brain.

Effects of blinded and nonblinded sequential human redundancy on inspection effort and inspection outcome in low prevalence visual search.

Human redundancy is often used in safety-critical domains to help protect against errors. For example, mammograms are read by two radiologists, or the dose of a drug is calculated by two physicians who perform the task redundantly one after the other. However, the expected reliability gain may be compromised by social loafing (SL), i.e., a reduction of individual effort caused by the team setting. In two laboratory studies, we therefore investigated whether different forms of human redundancy cause SL and impact task outcome. In each experiment, about 20 participants inspected images alone for rare targets, while 40 participants worked in teams of two, either performing the first or second inspection. We measured effort using inspection time and inspection area, and measured task outcome using the number of detected targets and false alarms. While there was no transfer of target marks in experiment 1 (blinded redundancy), the second inspectors in experiment 2 saw marks set during the first inspection (nonblinded redundancy). In experiment 1, data revealed no indications of SL but increased time, area covered, detections and false alarms for team-based relative to solo performance. In experiment 2, teams clearly adapted their inspection intensity. The second inspectors searched the images significantly shorter than the first inspectors. While detected targets did not differ between the two redundant groups, the second inspectors were found to produce significantly fewer false alarms than the first inspectors. However, the advantage of detected targets and area coverage still favored the teams. Thus, the principle of redundancy was effective in both forms of sequential redundancy, even if it led to different behaviors and perceptions at the individual level.

Double task switching: An investigation into the effects of similarity and task-rule congruency on cognitive flexibility.

Similarity between tasks is an understudied factor in research on cognitive flexibility. This behavioural experiment had 31 participants perform a task switch paradigm in which participants were required to switch between 4 tasks of varying similarity. The experiment was constructed in a way that simultaneously allows for investigating the impact of mental fatigue and task-rule congruency on the participants. The results indicate that similarity between tasks substantially impacts performance with different effects on RT and accuracy. While learning effects may have negated the impact of mental fatigue across the 5 experimental blocks, a significant decrease in performance was observed within blocks. Furthermore, the exploratory analysis proposes a novel interaction between task-rule incongruent trials and the task of the previous trial. These results support the notion that neither the interference view of cognitive flexibility nor the reconfiguration view are fully adequate at explaining task switch costs if similarity is added as a factor. The presented study presents strong evidence that fundamental findings in the domain of cognitive flexibility may not map linearly to more ecological settings where tasks are often more dissimilar.

Gaze transition entropy as a measure of attention allocation in a dynamic workspace involving automation.

Real-world work environments require operators to perform multiple tasks with continual support from an automated system. Eye movement is often used as a surrogate measure of operator attention, yet conventional summary measures such as percent dwell time do not capture dynamic transitions of attention in complex visual workspace. This study analyzed eye movement data collected in a controlled a MATB-II task environment using gaze transition entropy analysis. In the study, human subjects performed a compensatory tracking task, a system monitoring task, and a communication task concurrently. The results indicate that both gaze transition entropy and stationary gaze entropy, measures of randomness in eye movements, decrease when the compensatory tracking task required more continuous monitoring. The findings imply that gaze transition entropy reflects attention allocation of operators performing dynamic operational tasks consistently.

Cognitive-motor interference in people with essential tremor.

Adapting to different environments throughout daily activities requires flexibility in allocating attention. Compromised dual-tasking can hinder mobility, increase fall risk, and decrease functional independence in patients with essential tremor, who exhibit both mobility and cognitive impairments. We evaluated motor and cognitive dual-task effects and task prioritization in 15 people with Essential Tremor (ET) and 15 age-matched people without ET during a standard and more challenging water-carry TUG. Task-specific interference was evaluated by calculating motor and cognitive dual-task effects, whereas task prioritization was assessed by contrasting the cognitive dual-task effect with the motor dual-task effect. The simultaneous performance of two tasks did not differentially impact motor or cognitive performance in either group, and both groups prioritized cognitive task performance in standard and water-carry TUG assessments. This study enhances our understanding of motor-cognitive interactions in individuals with essential tremor. These insights could lead to patient-centered approaches to therapy to improve functional performance in dynamic daily environments.

A reliable and valid assessment of upper limb movement quality after stroke: the observational Drinking Task Assessment.

OBJECTIVE: To develop and evaluate the reliability and validity of a new observational Drinking Task Assessment (DTA) designed to assess quality of movement in task performance after stroke. DESIGN: Reliability and validity. METHODS: The DTA measures movement time and movement quality (smoothness, trunk, shoulder, elbow, and grasp movements) on a 4-level ordinal scale. Thirty participants with chronic stroke were assessed independently by 2 therapists. Intra-class correlation (ICC), standard error of measurement (SEM) and minimal real difference (MRD), weighted kappa, percentage of agreement, and Svensson method were used for reliability assessment. Motion capture-based kinematics and established clinical scales were used to evaluate validity. RESULTS: The absolute SEM and MRD for movement time were 0.4 and 1 s (11%), respectively. The ICC (≥ 0.93) and weighted kappa (0.71-1.0) showed good to excellent agreement for intra- and inter-rater reliability. DTA showed strong correlations with Fugl-Meyer Assessment (0.74), Action Research Arm Test (0.93), and kinematic measures of smoothness (0.93), trunk displacement (0.91), elbow extension (0.73), and shoulder movements (0.56), indicating good construct validity. CONCLUSIONS: The new DTA proved to be a reliable and valid tool for assessment of movement quality during task performance after stroke.

Using mobile EEG to study auditory work strain during simulated surgical procedures.

Surgical personnel face various stressors in the workplace, including environmental sounds. Mobile electroencephalography (EEG) offers a promising approach for objectively measuring how individuals perceive sounds. Because surgical performance does not necessarily decrease with higher levels of distraction, EEG could help guide noise reduction strategies that are independent of performance measures. In this study, we utilized mobile EEG to explore how a realistic soundscape is perceived during simulated laparoscopic surgery. To examine the varying demands placed on personnel in different situations, we manipulated the cognitive demand during the surgical task, using a memory task. To assess responses to the soundscape, we calculated event-related potentials for distinct sound events and temporal response functions for the ongoing soundscape. Although participants reported varying degrees of demand under different conditions, no significant effects were observed on surgical task performance or EEG parameters. However, changes in surgical task performance and EEG parameters over time were noted, while subjective results remained consistent over time. These findings highlight the importance of using multiple measures to fully understand the complex relationship between sound processing and cognitive demand. Furthermore, in the context of combined EEG and audio recordings in real-life scenarios, a sparse representation of the soundscape has the advantage that it can be recorded in a data-protected way compared to more detailed representations. However, it is unclear whether information get lost with sparse representations. Our results indicate that sparse and detailed representations are equally effective in eliciting neural responses. Overall, this study marks a significant step towards objectively investigating sound processing in applied settings.

Fusion of Multi-Task Neurophysiological Data to Enhance the Detection of Attention- Deficit/Hyperactivity Disorder.

OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental disorder with a prevalence ranging from 6.1 to 9.4%. The main symptoms of ADHD are inattention, hyperactivity, impulsivity, and even destructive behaviors that may have a long-term negative influence on learning performance or social relationships. Early diagnosis and treatment provide the best chance of reducing and managing symptoms. Currently, ADHD diagnosis relies on behavioral observations and ratings by clinicians and parents. Medical diagnosis of ADHD was reported to be delayed because of a global shortage of well-trained clinicians, the heterogeneous nature of ADHD, and combined comorbidities. Therefore, alternative ways to increase the efficiency of early diagnosis are needed. Previous studies used behavioral and neurophysiological data to assess patients with ADHD, yielding an accuracy range from 56.6% to 92%. Several factors were shown to affect the detection rate, including methods and tasks used and the number of electroencephalogram (EEG) channels. Given that children with ADHD have difficulty sustaining attention, in this study, we tested whether data from multiple tasks with different difficulties and prolonged experiment times can probe the levels of brain resources engaged during task performance and increase ADHD detection. Specifically, we proposed a Deep Neural Network-based (DNN) fusion model of multiple tasks to enhance the detection of ADHD. METHODS & RESULTS: Forty-nine children with ADHD and thirty-two typically developing children were recruited. Analytic results show that the fusion of multi-task neurophysiological data can increase the separation rate to 89%, whereas a single data type can only achieve a best accuracy of 81%. Moreover, the use of multiple tasks helps distinguish between children with ADHD and typically developing children. Our results suggest that different neurophysiological models from multiple tasks can provide essential information to assist in ADHD screening. In conclusion, the proposed model offers a more efficient, and accurate alternative for early clinical diagnosis and management of ADHD. The application of artificial intelligence and multimodal neurophysiological data in clinical settings sets a precedent for digital health, paving the way for future advancements in the field.

Exploring the Impact of an Interactive Electronic Pegboard on Manual Dexterity and Cognitive Skills of Patients With Stroke: Preliminary Analysis.

BACKGROUND: As individuals age, the incidence and mortality rates of cerebrovascular accidents significantly rise, leading to fine motor impairments and cognitive deficits that impact daily life. In modern occupational therapy, assessing manual dexterity and cognitive functions typically involves observation of patients interacting with physical objects. However, this pen-and-paper method is not only time-consuming, relying heavily on therapist involvement, but also often inaccurate. Digital assessment methods, therefore, have the potential to increase the accuracy of diagnosis, as well as decrease the workload of health care professionals. OBJECTIVE: This study examined the feasibility of an interactive electronic pegboard for the assessment and rehabilitation of patients with stroke. METHODS: We explored the pegboard's clinical applicability by examining the relationship among stages, timing, and difficulty settings, as well as their alignment with patient capabilities. In total, 10 participants used a prototype of the pegboard for functional and task assessments; questionnaire interviews were conducted simultaneously to collect user feedback. RESULTS: Patients with stroke consistently required more time to complete tasks than expected, significantly deviating from the initial time frames. Additionally, the participants exhibited a slight reduction in performance levels in both manual dexterity and cognitive abilities. Insights from questionnaire responses revealed that the majority of participants found the prototype interface easy and enjoyable to use, with good functionality. CONCLUSIONS: This preliminary investigation supports the efficacy of interactive electronic pegboards for the rehabilitation of the hand functions of patients with stroke, as well as training their attentional and cognitive abilities. This digital technology could potentially alleviate the burden of health care workers, positioning it as a valuable and intelligent precision health care tool.

Dependence of Cerebral Oxygenation and Task Performance on Coloured Light Exposure and Chronotype: Blue and Red Do Not Have the Same Effects on the Prefrontal Cortex.

BACKGROUND: In our previous studies, we investigated the right-left asymmetry (RLA) of cerebral tissue oxygenation (StO2) at rest in humans and the influence of the individual chronotype (i.e. individual chronobiological disposition) on StO2. The aim of the current study was to investigate (i) whether the RLA exists during a cognitive task and coloured light exposure (CLE), and (ii) how changes in StO2 induced by CLE and cognitive performance during a 2-back task are related to the subject's chronotype. METHODS: 36 healthy subjects (22 female, 14 male, age 26.3 ± 5.7 years) were studied twice on two different days. They were exposed to a sequence of blue followed by red light or vice versa in a randomised crossover study design. During CLE, subjects were asked to perform a 2-back task. We measured StO2 of the right and left prefrontal cortex (PFC) as well as the right and left visual cortex with functional near-infrared spectroscopy (fNIRS). At the behavioural level, we recorded the number of correct and incorrect answers given by the subjects. The chronotype was determined with the Horne and Östberg morningness-eveningness questionnaire. RESULTS: (i) We found that the blue and red light caused a RLA in the PFC. For red light exposure, the 2-back performance was negatively correlated with StO2 in the right PFC (r = -0.283, p = 0.016), and for blue light, exposure in the left PFC (r = -0.326, p = 0.005). (ii) 83% of subjects who performed the 2-back task at their optimal time of day according to their chronotype showed increased and higher changes in StO2 (ΔStO2 > 1%) compared to subjects who did not exercise at their optimal time of day. (iii) No correlation was found between chronotype and 2-back task performance (red: p = 0.38; blue: p = 0.42). CONCLUSIONS: We found for the first time that blue and red light exposure target different regions of the PFC during performance of a 2-back task, which can be explained by the approach and withdrawal model. These results illustrate that studying the subregions (i.e. right, left, and even centre) of the cortex provides a better understanding of the CLE effects in the human brain. Our study also shows that individual chronotype plays an important role in the individual changes in StO2 induced by CLE.

Note on the Dual-Task Paradigm and its Use to Measure Listening Effort.

People regularly communicate in complex environments, requiring them to flexibly shift their attention across multiple sources of sensory information. Increasing recruitment of the executive functions that support successful speech comprehension in these multitasking settings is thought to contribute to the sense of effort that listeners often experience. One common research method employed to quantify listening effort is the dual-task paradigm in which individuals recognize speech and concurrently perform a secondary (often visual) task. Effort is operationalized as performance decrements on the secondary task as speech processing demands increase. However, recent reviews have noted critical inconsistencies in the results of dual-task experiments, likely in part due to how and when the two tasks place demands on a common set of mental resources and how flexibly individuals can allocate their attention to them. We propose that in order to move forward to address this gap, we need to first look backward: better integrating theoretical models of resource capacity and allocation as well as of task-switching that have been historically developed in domains outside of hearing research (viz., cognitive psychology and neuroscience). With this context in mind, we describe how dual-task experiments could be designed and interpreted such that they provide better and more robust insights into the mechanisms that contribute to effortful listening.

The effects of sport-specific training on individuals action strategies while avoiding a virtual player approaching on a 45° angle while completing a secondary task.

Sports provide varying scenarios where athletes must interact with and avoid opposing players in dynamic environments. As such, sport-specific training can improve one's ability to integrate visual information which may result in improved collision avoidance behaviours. However, improved visuomotor capabilities are highly task dependent (i.e., athletes must be tested in sport-specific settings). The current study examined whether sport-specific training influenced individuals' collision avoidance behaviours during a sport-specific task in virtual reality. Untrained young adults (N = 21, 22.9±1.9 yrs, 11 males) and specifically trained athletes (N = 18, 20±1.5 yrs, 7 males) were immersed in a virtual environment and were instructed to walk along a 7.5m path towards a goal located along the midline. Two virtual players positioned 2.83m to the left and right of the midline approached participants on a 45° angle at one of three speeds: 0.8x, 1.0x, or 1.2x each participant's average walking speed. Participants were instructed to walk to a goal without colliding with the virtual players while performing a secondary task; reporting whether a shape changed above either of the virtual players' heads. Results revealed that athletes had a higher percentage of correct responses on the secondary task compared to untrained young adults. However, there was no group differences in the average time to first avoidance or average minimum clearance, but athletes were more variable in their avoidance behaviours. Findings from this study demonstrate that athletes may be more adaptive in their behaviours and may perform better on attentionally demanding tasks in dynamic environments.

Shifts in task absorption during decision-making episodes.

In today's rapidly evolving technological landscape, this study investigates the impact of new technology on organizational work dynamics. By integrating the Job Demands-Resources theory and the Episodic Process Model, we examine the cognitive mechanisms that influence task performance during decision-making episodes. Our research focuses on episodic job demands and resources, emphasizing the mediating role of task absorption in the relationship between these factors and task performance. Our findings reveal that episodic job resources positively affect task absorption and performance, while job demands moderate the relationship between job resources and task absorption. Employing the Beer Distribution Game alongside neuroscience-based eye-tracking techniques, we analyze visual attention dynamics during decision-making episodes, providing novel insights into the interplay between task absorption and task performance. Theoretically, our study highlights the significance of task absorption in understanding how episodic job resources impact decision-making performance. Practically, our results advocate for the implementation of decision-making-focused skills development through physiological measures such as neurofeedback training programs. This research underscores the importance of individual time management in enhancing task performance, contributing to a nuanced understanding of job resources, job demands, and task absorption in the context of technological transformation.

Is Video Gaming a Cure for Cybersickness? Gamers Experience Less Cybersickness Than Non-Gamers in a VR Self-Motion Task.

Cybersickness remains a major drawback of Virtual Reality (VR) headsets, as a breadth of stationary experiences with visual self-motion can result in visually-induced motion sickness. However, not everybody experiences the same intensity or type of adverse symptoms. Here we propose that prior experience with virtual environments can predict ones degree of cybersickness. Video gaming can enhance visuospatial abilities, which in-turn relate negatively to cybersickness - meaning that consistently engaging in virtual environments can result in protective habituation effects. In a controlled stationary VR experiment, we found that 'VR-naive' video gamers experienced significantly less cybersickness in a virtual tunnel-travel task and outperformed 'VR-naive' non-video gamers on a visual attention task. These findings strongly motivate the use of non-VR games for training VR cybersickness resilience, with future research needed to further understand the mechanism(s) by which gamers become cybersickness resilient - potentially expanding access to VR for even the most susceptible participants.

Toward Physiological Detection of a "Just-Right" Challenge Level for Motor Learning in Immersive Virtual Reality: Protocol for a Cross-Sectional Study.

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.