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Alharbi M, Du H, Harris D, Wood G, Dodd H, Buckingham G. Evaluating the impact of virtual reality game training on upper limb motor performance in children and adolescents with developmental coordination disorder: a scoping review using the ICF framework. J Neuroeng Rehabil 2024; 21:95. [PMID: 38840217 PMCID: PMC11151681 DOI: 10.1186/s12984-024-01393-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/30/2024] [Indexed: 06/07/2024] Open
Abstract
OBJECTIVE This scoping review aims to explore published literature testing Virtual Reality (VR) interventions for improving upper limb motor performance in children and adolescents with Developmental Coordination Disorder (DCD). Our primary focus was on the types of VR systems used and the measurement tools employed within the International Classification of Functioning, Disability and Health Children and Youth Version (ICF-CY) domains in these studies. METHODS A comprehensive search of six electronic databases up to 11th January 2024 was conducted using predefined terms. Inclusion and exclusion criteria were applied to determine study eligibility, with two authors independently assessing titles, abstracts, and full-text articles. RESULTS Out of 788 potential studies, 14 met the eligibility criteria. Studies predominantly utilized non-immersive VR (nVR) systems, for example, commercial platforms such as Nintendo Wii. Most interventions targeted general motor coordination or balance, with only four studies specifically focusing on upper limb motor performance. The Movement Assessment Battery for Children-2 was the predominant assessment tool. However, the use of game scores and trial durations raised concerns about the accuracy of assessments. The majority of studies reported no significant improvement in upper limb motor performance following VR interventions, though some noted improvements in specific tasks or overall outcomes. CONCLUSION The findings suggest that, while nVR interventions are being explored for paediatric motor rehabilitation, their impact on enhancing upper limb motor performance in children with DCD is unclear. The variability in intervention designs, outcome measures, and the predominant focus on general motor skills rather than specific upper limb improvements highlight the need for more targeted research in this area. IMPACT This review underscores the importance of developing precise and clinically relevant measurement tools in a broader range of VR technologies to optimize the use of VR in therapy for children with DCD. Future research should aim for more rigorous study designs and emerging immersive technologies to maximize therapeutic benefits.
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Affiliation(s)
- Mohammed Alharbi
- Department of Public Health and Sport and Sciences, University of Exeter, Exeter, UK.
- Department of Physical Therapy, Faculty of Applied Medical Sciences, University of Hail, Hail, Kingdom of Saudi Arabia.
| | - Haoyang Du
- Department of Public Health and Sport and Sciences, University of Exeter, Exeter, UK
| | - David Harris
- Department of Public Health and Sport and Sciences, University of Exeter, Exeter, UK
| | - Greg Wood
- Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
| | - Helen Dodd
- Department of Public Health and Sport and Sciences, University of Exeter, Exeter, UK
| | - Gavin Buckingham
- Department of Public Health and Sport and Sciences, University of Exeter, Exeter, UK
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Burin-Chu S, Baillet H, Leconte P, Lejeune L, Thouvarecq R, Benguigui N. Effectiveness of virtual reality interventions of the upper limb in children and young adults with cerebral palsy: A systematic review with meta-analysis. Clin Rehabil 2024; 38:15-33. [PMID: 37499213 DOI: 10.1177/02692155231187858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
OBJECTIVE To examine the characteristics and the effectiveness of virtual reality systems on upper limb impairments in children and young adults with cerebral palsy. DATA SOURCES An electronic search was conducted on PubMed, PEDro, Web of Science, Central, and EMBASE. METHODS The protocol of this review was prospectively registered in the PROSPERO database (CRD42022302271). Randomized controlled trials that tested the effects of virtual reality-based interventions on the upper limb of participants with cerebral palsy were included. The methodological quality of the studies was measured by the PEDro scale. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation. The data of the studies were analyzed in meta-analysis and presented in forest plots and narrative synthesis. RESULTS Twenty-two studies involving 746 participants were included. Ten different virtual reality systems were used in the interventions, of which six were designed specifically for rehabilitation and four commercial video games. We found an effect in favor of virtual reality when it was used in combination with conventional therapy for upper limb activity (SMD = 0.65; 95% CI (0.19 to 1.11)). However, the certainty of the evidence of the comparisons ranged from very low to low. CONCLUSION Virtual reality seems to be an effective tool for upper limb activity in children and young adults with cerebral palsy. Nevertheless, future studies should present a better methodological quality, a larger sample size, and well-defined rehabilitation programs to reduce the inconsistency of the evidence in this domain.
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Affiliation(s)
| | - Héloïse Baillet
- Normandie Univ, UNICAEN, ENSICAEN, CNRS, GREYC, Caen, France
| | | | - Laure Lejeune
- Normandie Univ, UNICAEN, ENSICAEN, CNRS, GREYC, Caen, France
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Loudoun FM, Boyle B, Larsson-Lund M. Making choices in digital play spaces: Children's experiences. Scand J Occup Ther 2023; 30:1460-1471. [PMID: 37917097 DOI: 10.1080/11038128.2023.2271050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 10/11/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Digital spaces are rapidly emerging as a space for children to engage in autotelic play. AIM To explore and describe children's experiences of choice-making in their play in digital spaces from the perspective of children themselves. METHODS Focus groups were conducted with a total of eight children aged six years of age within their school, in a large city in Ireland. A Mosaic Approach with drawing, cutting, and colouring in was used to elicit the children's voices to ensure their active engagement throughout the data collection. Data was analyzed using focus group analysis. RESULTS Data analysis revealed three main themes; children enjoy the ability to make choices in their play, that they are often constrained in their ability to make choices, and that they negotiate ways in which they can select options for play in digital spaces. CONCLUSIONS Findings indicate that children are agentic individuals who are capable of making decisions in their play in digital spaces. This knowledge provides implications for Occupational Therapists to enhance play as an occupation in digital spaces.
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Affiliation(s)
- Fiona M Loudoun
- Department of Occupational Science and Occupational Therapy, University College Cork, Cork, Ireland
- Department of Occupational Therapy, Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
| | - Bryan Boyle
- Department of Occupational Science and Occupational Therapy, University College Cork, Cork, Ireland
- Department of Occupational Therapy, Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
| | - Maria Larsson-Lund
- Department of Occupational Therapy, Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
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Barman M, Jena AK. Usefulness of interactive video-based instruction on learning performance in relation to cognitive development of children with moderate intellectual disability. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023:17446295231202021. [PMID: 37729593 DOI: 10.1177/17446295231202021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
The usefulness of information and communication technology has been witnessed around the globe with the occurrence of rapid changes in the field of education i.e. through the formal or informal way. For this, the researchers have assessed Interactive video-based instruction (IVBI) on (N = 95; males = 47 & females = 48 age range between 12 and 15 years) moderate intellectual disability children in Guwahati, Assam, India from three day-care rehabilitation centres. The main objective was to examine the effect of IVBI intervention (IIVBI & CIVBI) on academic performance in association with the cognitive development of children with moderate intellectual disability in a comfortable setting within working hours. The findings conclude that children in the CIVBI group performed more actively as compared to IIVBI and comparison group, and it was due to the involvement of video-based instruction that helped understand the topic more precisely and acts effectively for CIVBI children in an experimental setting.
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Affiliation(s)
- Munmi Barman
- Department of Education, Assam University Silchar, Assam, India
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Phelan I, Carrion-Plaza A, Furness PJ, Dimitri P. Home-based immersive virtual reality physical rehabilitation in paediatric patients for upper limb motor impairment: a feasibility study. VIRTUAL REALITY 2023; 27:1-16. [PMID: 36686613 PMCID: PMC9840166 DOI: 10.1007/s10055-023-00747-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
Upper limb motor impairment (ULMI) rehabilitation is a long-term, demanding and challenging process to recover motor functionality. Children and adolescents may be limited in daily life activities due to reduced functions such as decreased joint movement or muscle weakness. Home-based therapy with Immersive Virtual Reality can offer greater accessibility, delivery and early rehabilitation to significantly optimise functional outcomes and quality of life. This feasibility study aimed to explore the perceptions and impacts of an immersive and interactive VR scenario suitable for ULMI rehabilitation for children at home. It was analysed using mixed methods (quantitative and qualitative) and from a multidirectional perspective (patients, clinicians and family members). Amongst the main results, it was found that IVR for ULMI home rehabilitation (1) is easy to learn and acceptable; (2) improves motor function; (3) reduces the difficulty in the reproduction of therapeutic movements; (4) is motivating and enjoyable and (5) improves quality of life. This study is the first study on the use of IVR applied to home rehabilitation of ULMI in children. These results suggested that similar outcomes may be possible with self-directed IVR home rehabilitation compared to face to face conventional rehabilitation, which can be costly to both the patient and the healthcare system, decreasing the length of stay at the hospital and treatment duration. It has also presented an innovative solution to the Covid-19 emergency where children could not receive their clinic therapy. Further research is recommended to understand better the mechanisms involved in physiotherapeutic recovery and how IVR rehabilitation helps to improve conventional treatments. Trial Registration Protocol ID NCT05272436. Release Date: 9th March 2022.
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Affiliation(s)
- Ivan Phelan
- Centre for Culture, Media and Society, College of Social Sciences and Arts, Sheffield Hallam University, Sheffield, S1 1WB UK
| | - Alicia Carrion-Plaza
- Centre for Culture, Media and Society, College of Social Sciences and Arts, Sheffield Hallam University, Sheffield, S1 1WB UK
| | - Penny J Furness
- Department of Psychology, Sociology and Politics, College of Social Sciences and Arts, Sheffield Hallam University, Sheffield, S1 1WB UK
| | - Paul Dimitri
- Sheffield Children’s NHS Foundation Trust, Sheffield Children’s, Sheffield, S10 2TH UK
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Rafiei Milajerdi H, Ordooiazar F, Dewey D. [Formula: see text]Is active video gaming associated with improvements in social behaviors in children with neurodevelopmental disorders: a systematic review. Child Neuropsychol 2023; 29:1-27. [PMID: 35236234 DOI: 10.1080/09297049.2022.2046721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Active video gaming (AVG) is a way that children with neurodevelopmental disorders can participate in social play and could be associated with improvements in social behaviors. However, limited research has investigated if AVG is associated with improvements in social behaviors in children and adolescents with neurodevelopmental disorders. A systematic literature search was conducted in Medline, Embase, Psycinfo, Cinahl, and Eric, Web of Science, and Scopus. Three main concepts were searched: exergaming, neurodevelopmental disorders, and social behaviors. Keywords and subject headings were used for each concept. 3080 articles were identified in the initial search in 2019; in January 2021, 167 additional articles were identified. Of these, 8 studies with 242 children with autism spectrum disorder, cerebral palsy, or developmental coordination disorder were included in this review. Six studies reported that participation in AVG was associated with improved social functioning, social interaction, emotional well-being, and social/emotional skills in children with ASD, CP, and DCD. In contrast, two studies that included children diagnosed with ASD did not find any association between AVG participation and social behaviors. The findings of this systematic review suggest that participation in an AVG intervention may be associated with improved social behaviors in children and adolescents with ASD, CP, and DCD. However, due to the limited number of studies included, this finding must be interpreted with caution. Future research is needed that examines the treatment fidelity of AVG in improving social behavior skills in children with neurodevelopmental disorders and the generalizability of these skills to real-life social situations.
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Affiliation(s)
| | | | - Deborah Dewey
- Departments of Paediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Kaya Ciddi P, Yilmaz Ö. Exercise intensity of active video gaming in cerebral palsy: hip- versus wrist-worn accelerometer data. Dev Neurorehabil 2022; 25:479-484. [PMID: 35815544 DOI: 10.1080/17518423.2022.2099028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The aim of this study was to compare exercise intensity of active video games (AVGs) between hip- and wrist-worn accelerometer data in cerebral palsy (CP). METHODS Twenty children and adolescents (9.35 ± 3.71 years) with CP performed two exercise sessions, completing a standardized series of AVGs. Exercise intensity was collected, while one accelerometer was fitted to wrist and hip in separate, counterbalanced sessions. RESULTS Accelerometer counts per minute and cut-points determined were significantly different between the wrist- and hip-worn outputs (p < .001). Metabolic equivalents (METs) of performing AVGs exceeded the three METs moderate intensity threshold in wrist-worn (3.12 ± 0.86) accelerometer and hip-worn data tend to underestimate intensity (1.16 ± 0.08). CONCLUSIONS Previous studies showed METs required to perform AVGs were related to moderate intensity (3-6 METs) in CP with mild deficits. Wrist-worn accelerometer, exceeding 3 METs, seem to have higher accuracy in measuring exercise intensity of AVGs than hip-worn.
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Affiliation(s)
- Pınar Kaya Ciddi
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Istanbul Medipol University, Istanbul, Turkey
| | - Öznur Yilmaz
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Hacettepe University, Ankara, Turkey
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Shakya S, Parsekar SS, Ramachandran S, Madapura S. S, Balakrishna Shetty H, Anaby D, Gopalakrishna S, Venkatesan VS, Rao BK. Physiotherapy interventions for head and trunk control in children with developmental disabilities: A scoping review protocol. F1000Res 2022; 11:1074. [PMID: 36875989 PMCID: PMC9975404.2 DOI: 10.12688/f1000research.123955.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
Background: Head and trunk control is prerequisite skill that maximizes engagement and participation in one's environment by integrating vision, oromotor skill, arm control and respiration. Various physiotherapy and technology-based interventions have been utilized to facilitate head and trunk control in children with developmental disabilities. This scoping review is planned to map and summarize existing studies from the scientific literature on physiotherapy and technology-based interventions for head and trunk control in children with developmental disabilities. Methods: The scoping review will utilize the Joanna Briggs Institute scoping review methodology. The review will cover studies including children and adolescents aged between six months and 17 years 11 months 29 days, with developmental disabilities where in child finds difficulty in lifting its head and aligning head and trunk. We will include randomized controlled trial (RCT), non-RCT, quasi-experimental trial, and systematic reviews that have employed physiotherapy and technology-based interventions. Database-specific search strategy will be used to search records in Medline (PubMed and Web of Science), Embase, Scopus, CINAHL, PEDro, and Cochrane Library. Additionally, various grey literatures and clinical-trial registries will be searched. Two reviewers, independently, will screen and extract the data. Tables and visual representations will be utilized to present the extracted data. Registration details: The protocol has been registered in Open Science Framework, DOI: 10.17605/OSF.IO/B3RSU (22 nd August 2022).
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Affiliation(s)
- Shristi Shakya
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shradha S. Parsekar
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Selvam Ramachandran
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shamantha Madapura S.
- Department of Biomedical Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Harikishan Balakrishna Shetty
- Department of Biomedical Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Sivakumar Gopalakrishna
- Department of Physiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - V. S. Venkatesan
- Department of Biomedical Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Bhamini Krishna Rao
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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9
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Barman M, Jena AK. Effect of interactive video-based instruction on learning performance in relation to social skills of children with intellectual disability. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 69:683-696. [PMID: 37547560 PMCID: PMC10402858 DOI: 10.1080/20473869.2021.2004535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 08/08/2023]
Abstract
Interactive video-based instruction (IVBI) session was organized in day-care rehabilitation settings to provide training in acquiring new skills related to social skills development for targeted moderate intellectual disability (MID) population. The main objective is to inter-relate the effect of individual and collaborative interactive video-based instruction on social skills development for experimental group children with those in the comparison group. A quasi-experimental design was conducted on (n = 99, comprising 56 males and 43 females) students with MID from selected three rehabilitation centres of Guwahati, Assam, India. The mean and standard deviation of individual interactive video-based instruction (IIVBI) and collaborative interactive video-based instruction (CIVBI) was better than the conventional group. The ANCOVA result shows a significant effect of IIVBI and CIVBI in the improvement of social skills over conventional approach on students after controlling the effect of the pre-test. The interactive session in both the experimental group allowed the students to create their own space for learning social skills via different activities using IVBI. The researchers concludes that regular practice of various activities through video sessions can help children with intellectual disability to overcome minor obstacles by themselves without any additional service.
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Affiliation(s)
- Munmi Barman
- Department of Education, Assam University Silchar, Assam, India
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10
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Fahr A, Kläy A, Keller JW, van Hedel HJA. An Interactive Computer Game for Improving Selective Voluntary Motor Control in Children With Upper Motor Neuron Lesions: Development and Preliminary Feasibility Study. JMIR Serious Games 2021; 9:e26028. [PMID: 34319236 PMCID: PMC8367178 DOI: 10.2196/26028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/30/2021] [Accepted: 05/08/2021] [Indexed: 11/24/2022] Open
Abstract
Background Computer game–based interventions are emerging in pediatric neurorehabilitation, as they can provide two key elements for motor learning—motivating environments that enable long-term compliance, which is particularly relevant for children, and augmented feedback for improving movement performance. Objective The overall aim of this study is to develop an interactive computer play for children with upper motor neuron lesions to train selective voluntary motor control and give particular attention to motivation and feedback. We also aim to determine features that make games engaging, investigate which sensory feedback modality is noticed the fastest during play, develop an interactive game, and evaluate its feasibility. Methods We identified engaging game features by interviewing 19 children and adolescents undergoing rehabilitation. By using a test version of the game, we determined the response times of 10 patients who had to react to visual, auditory, or combined feedback signals. On the basis of the results of these two subprojects, we developed and designed a game environment. Feasibility was studied in terms of the practicability and acceptability of the intervention among 5 children with upper motor neuron lesions. Results The game features deemed the most important by pediatric patients were strategic gameplay (13/29, 45% of answers) and choice (6/29, 21%). While playing the game, an acoustic alarm signal (reaction time: median 2.8 seconds) was detected significantly faster (P=.01) than conditions with other feedback modalities (avatar velocity reduction: median 7.8 seconds; color desaturation: median 5.7 seconds). Most children enjoyed playing the game, despite some technical issues. Conclusions The careful identification of game features that increase motivation and feedback modalities that inform children quickly led to the development of an interactive computer play for training selective voluntary motor control in children and adolescents with upper motor neuron lesions.
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Affiliation(s)
- Annina Fahr
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern a.A., Switzerland.,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.,Institute for Biomechanics, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Andrina Kläy
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern a.A., Switzerland.,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Jeffrey W Keller
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern a.A., Switzerland.,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Hubertus J A van Hedel
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern a.A., Switzerland.,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
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Lai B, Powell M, Clement AG, Davis D, Swanson-Kimani E, Hayes L. Examining the Feasibility of Early Mobilization With Virtual Reality Gaming Using Head-Mounted Display and Adaptive Software With Adolescents in the Pediatric Intensive Care Unit: Case Report. JMIR Rehabil Assist Technol 2021; 8:e28210. [PMID: 34042602 PMCID: PMC8193485 DOI: 10.2196/28210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/22/2021] [Accepted: 04/28/2021] [Indexed: 01/19/2023] Open
Abstract
Background Early rehabilitative mobilization for adolescents is safe and feasible. However, there is a lack of published rehabilitation strategies and treatments that can maximize engagement and outcomes among adolescents in the pediatric intensive care unit (PICU). Virtual reality (VR) gaming using a head-mounted display (HMD) and adaptive software can allow active and nonactive gameplay at the bedside for people with limited arm mobility, making it a potentially inclusive and enjoyable treatment modality for adolescents in the PICU. Objective The purpose of this brief case study is to report on the preliminary feasibility of incorporating adaptive VR gaming using an HMD with 2 adolescents who received early mobility treatment within the PICU. Methods This study was a mini-ethnographic investigation of 2 adolescents (a 15-year-old male and a 13-year old male) in the PICU who underwent VR gaming sessions as part of their early mobilization care, using an Oculus Rift HMD and adaptive software (WalkinVR) that promoted full gameplay in bed. The Rift was plugged into a gaming laptop that was set up on a table within the patient’s room before each session. The intervention was delivered by an adapted exercise professional and supervised by a physical therapist. Patients had access to a variety of active games (eg, boxing, rhythmic movement to music, and exploratory adventure) and nonactive games (eg, racing and narrative adventure). Gaming sessions were scheduled between usual care, when tolerable and requested by the participant. The interventionist and therapists took audio-recorded and written notes after completing each gaming session. These data were analyzed and presented in a narrative format from the perspective of the research team. Results Case 1 participated in 4 gaming sessions, with an average of 18 minutes (SD 11) per session. Case 2 participated in 2 sessions, with an average of 35 minutes (SD 7) per session. Both cases were capable of performing active gaming at a moderate level of exercise intensity, as indicated by their heart rate. However, their health and symptoms fluctuated on a daily basis, which prompted the gameplay of adventure or nonactive games. Gameplay appeared to improve participants’ affect and alertness and motivate them to be more engaged in early mobilization therapy. Gameplay without the WalkinVR software caused several usability issues. There were no serious adverse events, but both cases experienced symptoms based on their condition. Conclusions The findings of this study suggest that VR gaming with HMDs and adaptive software is likely a feasible supplement to usual care for adolescents within the PICU, and these findings warrant further investigation. Recommendations for future studies aimed at incorporating VR gaming during early mobilization are presented herein.
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Affiliation(s)
- Byron Lai
- Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Maegen Powell
- Department of Physical and Occupational Therapy, Children's of Alabama, Birmingham, AL, United States
| | - Anne Grace Clement
- Department of Physical and Occupational Therapy, Children's of Alabama, Birmingham, AL, United States
| | - Drew Davis
- Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Erin Swanson-Kimani
- Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Leslie Hayes
- Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
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Lai B, Davis D, Narasaki-Jara M, Hopson B, Powell D, Gowey M, Rocque BG, Rimmer JH. Feasibility of a Commercially Available Virtual Reality System to Achieve Exercise Guidelines in Youth With Spina Bifida: Mixed Methods Case Study. JMIR Serious Games 2020; 8:e20667. [PMID: 32880577 PMCID: PMC7499165 DOI: 10.2196/20667] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/20/2020] [Accepted: 08/11/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Access to physical activity among youth with spina bifida (SB) is much lower than it is for children without disability. Enjoyable home-based exercise programs are greatly needed. OBJECTIVE Our objective is to examine the feasibility of a virtual reality (VR) active video gaming system (ie, bundle of consumer-available equipment) to meet US physical activity guidelines in two youth with SB. METHODS Two youth with SB-a 12-year-old female and a 13-year-old male; both full-time wheelchair users-participated in a brief, 4-week exercise program using a popular VR head-mounted display: Oculus Quest (Facebook Technologies). The system included a Polar H10 (Polar Canada) Bluetooth heart rate monitor, a no-cost mobile phone app (VR Health Exercise Tracker [Virtual Reality Institute of Health and Exercise]), and 13 games. The intervention protocol was conducted entirely in the homes of the participants due to the coronavirus disease 2019 (COVID-19) pandemic. The VR system was shipped to participants and they were instructed to do their best to complete 60 minutes of moderate-intensity VR exercise per day. Exercise duration, intensity, and calories expended were objectively monitored and recorded during exercise using the heart rate monitor and a mobile app. Fatigue and depression were measured via self-report questionnaires at pre- and postintervention. Participants underwent a semistructured interview with research staff at postintervention. RESULTS Across the intervention period, the total average minutes of all exercise performed each week for participants 1 and 2 were 281 (SD 93) and 262 (SD 55) minutes, respectively. The total average minutes of moderate-intensity exercise performed per week for participants 1 and 2 were 184 (SD 103) (184/281, 65.4%) and 215 (SD 90) (215/262, 82.1%) minutes, respectively. One participant had a reduction in their depression score, using the Quality of Life in Neurological Disorders (Neuro-QoL) test, from baseline to postintervention, but no other changes were observed for fatigue and depression scores. Participants reported that the amount of exercise they completed was far higher than what was objectively recorded, due to usability issues with the chest-worn heart rate monitor. Participants noted that they were motivated to exercise due to the enjoyment of the games and VR headset as well as support from a caregiver. CONCLUSIONS This study demonstrated that two youth with SB who used wheelchairs could use a VR system to independently and safely achieve exercise guidelines at home. Study findings identified a promising protocol for promoting exercise in this population and this warrants further examination in future studies with larger samples.
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Affiliation(s)
- Byron Lai
- Division of Pediatric Rehabilitation Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Drew Davis
- Division of Pediatric Rehabilitation Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Mai Narasaki-Jara
- Department of Kinesiology, California Polytechnic State University Pomona, Pomona, CA, United States
| | - Betsy Hopson
- Division of Pediatric Neurosurgery, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Danielle Powell
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Marissa Gowey
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Brandon G Rocque
- Division of Pediatric Neurosurgery, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - James H Rimmer
- Dean's Office, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
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13
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MacIntosh A, Desailly E, Vignais N, Vigneron V, Biddiss E. A biofeedback-enhanced therapeutic exercise video game intervention for young people with cerebral palsy: A randomized single-case experimental design feasibility study. PLoS One 2020; 15:e0234767. [PMID: 32569284 PMCID: PMC7307764 DOI: 10.1371/journal.pone.0234767] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 06/01/2020] [Indexed: 11/18/2022] Open
Abstract
Importance/Background Movement-controlled video games have potential to promote home-based practice of therapy activities. The success of therapy gaming interventions depends on the quality of the technology used and the presence of effective support structures. Aim This study assesses the feasibility of a novel intervention that combines a co-created gaming technology integrating evidence-based biofeedback and solution-focused coaching (SFC) strategies to support therapy engagement and efficacy at home. Methods Following feasibility and single-case reporting standards (CONSORT and SCRIBE), this was a non-blind, randomized, multiple-baseline, AB, design. Nineteen (19) young people with cerebral palsy (8–18 years old) completed the 4-week home-based intervention in France and Canada. Participant motivations, personalized practice goals, and relevance of the intervention to daily activities were discussed in a Solution Focused Coaching-style conversation pre-, post-intervention and during weekly check-ins. Participants controlled a video game by completing therapeutic gestures (wrist extension, pinching) detected via electromyography and inertial sensors on the forearm (Myo Armband and custom software). Process feasibility success criteria for recruitment response, completion and adherence rates, and frequency of technical issues were established a priori. Scientific feasibility, effect size estimates and variance were determined for Body Function outcome measures: active wrist extension, grip strength and Box and Blocks Test; and for Activities and Participation measures: Assisting Hand Assessment (AHA), Canadian Occupational Performance Measure (COPM) and Self-Reported Experiences of Activity Settings (SEAS). Results Recruitment response (31%) and assessment completion (84%) rates were good and 74% of participants reached self-identified practice goals. As 17% of technical issues required external support to resolve, the intervention was graded as feasible with modifications. No adverse events were reported. Moderate effects were observed in Body Function measures (active wrist extension: SMD = 1.82, 95%CI = 0.85–2.78; Grip Strength: SMD = 0.63, 95%CI = 0.65–1.91; Box and Blocks: Hedge’s g = 0.58, 95%CI = -0.11–1.27) and small-moderate effects in Activities and Participation measures (AHA: Hedge’s g = 0.29, 95%CI = -0.39–0.97, COPM: r = 0.60, 95%CI = 0.13–0.82, SEAS: r = 0.24, 95%CI = -0.25–0.61). Conclusion A definitive RCT to investigate the effectiveness of this novel intervention is warranted. Combining SFC-style coaching with high-quality biofeedback may positively engage youth in home rehabilitation to complement traditional therapy. Trial registration ClinicalTrials.gov, U.S. National Library of Medicine: NCT03677193.
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Affiliation(s)
- Alexander MacIntosh
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada.,Complexité, Innovation, Activités Motrices et Sportives, Sciences du Sport, de la Motricité et du Mouvement Humain, Université Paris-Saclay, Orsay, France
| | - Eric Desailly
- Recherche et innovation, Fondation Ellen Poidatz, Saint Fargeau-Ponthierry, France
| | - Nicolas Vignais
- Complexité, Innovation, Activités Motrices et Sportives, Sciences du Sport, de la Motricité et du Mouvement Humain, Université Paris-Saclay, Orsay, France.,Complexité, Innovation, Activités Motrices et Sportives, Université d'Orléans, Orléans, France
| | - Vincent Vigneron
- Informatique, Bio-informatique et Systèmes Complexes, l'Université d'Evry Val-d'Essonne, Evry, France
| | - Elaine Biddiss
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
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14
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Baglio G, Zanette M, Di Cesare M, Di Tella S, Clerici M, Baglio F, Blasi V. Rehabilitation and Disability Spectrum From Adverse Childhood Experience: The Impact of the Movement Cognition and Narration of Emotions Treatment (MCNT) Version 2.0. Front Psychiatry 2020; 11:609819. [PMID: 33569016 PMCID: PMC7868411 DOI: 10.3389/fpsyt.2020.609819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/14/2020] [Indexed: 11/20/2022] Open
Abstract
Adverse Childhood Experiences (ACE) are associated with an increased risk of cerebral, behavioral, and cognitive outcomes, and vulnerability to develop a Borderline Intellectual Functioning (BIF). BIF is characterized by an intelligence quotient (IQ) in the range 70-85, poor executive functioning, difficulties in emotion processing, and motor competencies. All these difficulties can lead to mental and/or neurodevelopmental disorders that require long-term care. Accordingly, we developed an intensive and multidomain rehabilitation program for children with ACE and BIF, termed the Movement Cognition and Narration of emotions Treatment (MCNT1.0). The efficacy of MCNT1.0 on cognitive and social functioning was demonstrated with a previously reported randomized controlled trial (RCT). To extend the impact of the treatment also to the motor domain a new version, called MCNT2.0, was implemented. The present study aims to verify the feasibility of MCNT2.0 and its effects on the motor domain. A quasi-experimental approach was used in which a group of 18 children with ACE and BIF were consecutively recruited and participated in the MCNT 2.0 program. Participants were compared with the MCNT1.0 group as an active comparator, using the dataset of the RCT. The two groups received a full evaluation comprising: the Wechsler Intelligent Scale for Children-IV (WISC-IV), the Movement-ABC (M-ABC), the Test of Gross Motor Development (TGMD), the Social Skills from Vineland Adaptive Behavioral Scale-II (VABS-II) and the Child Behavior Check List 6-18 (CBCL). An ANCOVA was carried out on changes in the scale scores from baseline with age and baseline score as covariates. Results showed a mean adherence to treatment of 0.85 (sd = 0.07), with no differences between groups in IQ, and Social Skills changes, while greater improvements for motor abilities were shown in the MCNT 2.0 group: M-ABC (p = 0.002), and TGMD (p = 0.002). Finally, greater improvement in the CBCL scale was observed in the MCNT 1.0 group (p = 0.002). Results indicate that due to its positive effects on cognitive, social participation and motor domains, MCNT2.0 may represent a protective factor against maladaptive outcomes of children with ACE and BIF.
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Affiliation(s)
- Gisella Baglio
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Don Carlo Gnocchi Foundation Onlus, Milan, Italy
| | - Michela Zanette
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Don Carlo Gnocchi Foundation Onlus, Milan, Italy
| | - Monica Di Cesare
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Don Carlo Gnocchi Foundation Onlus, Milan, Italy
| | - Sonia Di Tella
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Don Carlo Gnocchi Foundation Onlus, Milan, Italy
| | - Mario Clerici
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Don Carlo Gnocchi Foundation Onlus, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Francesca Baglio
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Don Carlo Gnocchi Foundation Onlus, Milan, Italy
| | - Valeria Blasi
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Don Carlo Gnocchi Foundation Onlus, Milan, Italy
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15
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Banerjee-Guénette P, Bigford S, Glegg SMN. Facilitating the Implementation of Virtual Reality-Based Therapies in Pediatric Rehabilitation. Phys Occup Ther Pediatr 2020; 40:201-216. [PMID: 31416381 DOI: 10.1080/01942638.2019.1650867] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aims: Evaluate the impact of a multifaceted knowledge translation (KT) strategy for the implementation of virtual reality (VR) intervention by rehabilitation clinicians in a pediatric hospital setting.Methods: Eleven therapists were recruited and completed a questionnaire on perceptions on VR usage. A multifaceted KT strategy was implemented over five months. VR usage was tracked and clinician perceptions were reassessed. Baseline characteristics were summarized using descriptive statistics and a Wilcoxon signed rank sum test evaluated changes pre- and post-KT.Results: Perceived ease of use, behavioral control, self-efficacy, and barriers to use improved significantly post-KT; however, intention to use did not. Usage was higher pre-KT than the last two months of KT. Pre-KT, barriers included system setup and use, knowledge of games, and lack of resources, whereas post-KT, they were the lack of appropriate patients and patient-specific experience. KT supports and patient engagement were reasons for continued use.Conclusions: This study highlights the importance of supporting clinicians when implementing VR in clinical rehabilitation. Clinicians benefit from experiential and individualized learning opportunities, peer-led coaching, and hands-on training. Whether these strategies translate to increased usage and how usage is influenced by environmental factors (i.e. lack of appropriate clients) warrants additional research.
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Affiliation(s)
| | - Sarah Bigford
- Development and Rehabilitation, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Stephanie M N Glegg
- Sunny Hill Health Centre for Children, Vancouver, BC, Canada.,Occupational Science and Occupational Therapy, The University of British Columbia, Vancouver, BC, Canada
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16
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Pin TW. Effectiveness of interactive computer play on balance and postural control for children with cerebral palsy: A systematic review. Gait Posture 2019; 73:126-139. [PMID: 31323621 DOI: 10.1016/j.gaitpost.2019.07.122] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 06/11/2019] [Accepted: 07/01/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Interactive computer play (ICP) becomes popular in rehabilitation for children with cerebral palsy (CP). With the nature of ICP, it could be an effective intervention specifically to improve balance and postural control for children with CP. The present paper aimed to review the effectiveness of ICP on postural control and balance for children with CP. METHODS Electronic databases including Medline, AMED, EBSCOhost, PsycINFO, Embase, the Cochrane Library and the DARE were searched up to September 2018. Studies were included if (1) participants were aged under 18 and had CP, (2) ICP intervention was performed, (3) an explicit objective was postural control and balance of the participants, and (4) results were fully published in English-language peer-reviewed journals. Characteristics of study participants, ICP protocols and study results were extracted. Level of evidence of each studies was graded using the guidelines from the American Academy of Cerebral Palsy and Developmental Medicine. Methodological quality was graded using the Physiotherapy Evidence Database (PEDro) scale. Effect sizes were calculated on available data. RESULTS Twenty studies were included, with nine of level I or II evidence. Most studies had fair methodological rigor. Huge variations in the study designs and protocols of ICP were found among the studies. CONCLUSIONS ICP seemed to be more effective than conventional therapy in improving postural control and balance, with medium to large effect sizes for children with mild to moderate severity of CP. Future studies of high methodological rigour are required to verify the role of on-site guidance of the children during ICP and the effect on children with more severe CP.
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Affiliation(s)
- Tamis W Pin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
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17
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Preliminary Study of the Effect of Training With a Gaming Balance Board on Balance Control in Children With Cerebral Palsy: A Randomized Controlled Trial. Am J Phys Med Rehabil 2019; 99:142-148. [PMID: 31464757 DOI: 10.1097/phm.0000000000001300] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE A new protocol based on the use of a gaming balance board for children with cerebral palsy was tested. DESIGN A total of 56 children with cerebral palsy were enrolled and randomly divided into two groups: experimental and control. The children in experimental group underwent 12 wks of rehabilitation using their foot to play personal computer games with the proposed balance board, whereas those in the control group played personal computer games with a computer mouse in the standing position. Balance control was assessed before and after the intervention using the Zebris FDM System for measuring the center of pressure. The Pediatric Balance Scale and 2-min walk test were used for evaluating functional balance. RESULTS In the analysis of covariance, the proposed new balance board used for the personal computer games decreased the postural sway (sway path, F = 6.95, P = 0.011; sway area, F = 11.79, P = 0.001) and improved the performance of the functional balance tests. CONCLUSIONS This study demonstrated the possibility that this new gaming balance board can be used for balance control in children with cerebral palsy.
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18
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Biddiss E, Chan-Viquez D, Cheung ST, King G. Engaging children with cerebral palsy in interactive computer play-based motor therapies: theoretical perspectives. Disabil Rehabil 2019; 43:133-147. [PMID: 31104517 DOI: 10.1080/09638288.2019.1613681] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To provide a theoretically grounded understanding of engagement in interactive computer play-based motor therapies by children with cerebral palsy in home settings. METHODS A motivational framework for engagement and its relationship with three contemporary theories (self-determination theory, expectancy-value theory, social cognitive theory of self-regulation) was overviewed. A scoping review was conducted to understand how engagement is influenced by features of the technology and intervention design that impact intrinsic and extrinsic motivation, child and parent values and expectancies, and the processes of self-regulation. Multiple reviewers screened and extracted data from 26 articles describing home-based clinical trials of interactive computer play-based motor interventions for children with cerebral palsy. A narrative synthesis framework was used for analysis. RESULTS Features of the technology and the intervention influence feelings of autonomy (e.g., personalization), competence (e.g., calibration), and relatedness (e.g., social play, virtual therapist/coach). There may be multiple and differently valued goals in interactive computer play-based interventions (e.g., game- and therapy-focused) that, if disconnected or unmet, negatively impact engagement. Multiplayer interactions, real-time feedback and progress tracking provide information that influences self-regulation and engagement over time. CONCLUSIONS Optimizing engagement in interactive computer play-based motor interventions requires closer alignment with client-led values/goals; design of technologies and interventions that sustain intrinsic motivation; and feedback that informs/builds self-efficacy. Implications for rehabilitation The decision to prescribe an interactive computer play-based motor intervention should be guided by client-led goals and an informed understanding of the capacity of the interactive computer play-based intervention to meet individual client values/expectancies. Sustaining intrinsic motivation in interactive computer play-based motor therapies is greatly influenced by features of the technology (e.g., calibration, feedback, personalization) and the intervention (e.g., interactions with therapists, social play). Increased effort should be directed towards ensuring that interactive computer play-based interventions and technologies reward and reinforce efforts towards therapy goals.
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Affiliation(s)
- Elaine Biddiss
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Daniela Chan-Viquez
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Stephanie T Cheung
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
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19
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Mentiplay BF, FitzGerald TL, Clark RA, Bower KJ, Denehy L, Spittle AJ. Do video game interventions improve motor outcomes in children with developmental coordination disorder? A systematic review using the ICF framework. BMC Pediatr 2019; 19:22. [PMID: 30651097 PMCID: PMC6335818 DOI: 10.1186/s12887-018-1381-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 12/20/2018] [Indexed: 12/21/2022] Open
Abstract
Background Children with developmental coordination disorder (DCD) experience a range of difficulties that can potentially limit their academic, social and physical ability. Recent research has developed interventions that aim to improve motor outcomes in a variety of paediatric cohorts using video gaming equipment. Therefore, we aimed to systematically review the literature on virtual reality or video game interventions that aim to improve motor outcomes in children with DCD. Methods Seven databases were searched for studies using the following criteria: a) virtual reality or video game based intervention; b) children with DCD; and c) motor outcomes relating to body structure and function, activity or participation. Data were extracted relating to study design, participant characteristics, details of the intervention, outcome measures, results, and feasibility/adherence. Results Fifteen articles were included for review, including eight randomised controlled trials. No studies used virtual reality equipment, with all interventions using video games (Nintendo Wii in 12/15 articles). Mixed effects of video game intervention on outcome were found, with conflicting evidence across studies. Studies that reported on feasibility found most children enjoyed and adhered to the video game interventions. Conclusions This review found limited evidence for the effectiveness of video game interventions for children with DCD to improve motor outcomes due to limitations in the research including low sample sizes and low to moderate methodological quality. Further research is needed to determine the effect of video game or virtual reality interventions on motor outcomes in children with DCD. Protocol registration The protocol for this systematic review can be found on PROSPERO (CRD42017064427). Electronic supplementary material The online version of this article (10.1186/s12887-018-1381-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Benjamin F Mentiplay
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia. .,La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia.
| | - Tara L FitzGerald
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Physiotherapy, University of Melbourne, Melbourne, Australia
| | - Ross A Clark
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia.,Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, Australia
| | - Kelly J Bower
- Department of Physiotherapy, University of Melbourne, Melbourne, Australia
| | - Linda Denehy
- Department of Physiotherapy, University of Melbourne, Melbourne, Australia
| | - Alicia J Spittle
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Physiotherapy, University of Melbourne, Melbourne, Australia.,Neonatal Services, The Royal Women's Hospital, Melbourne, Australia
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20
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Pin TW, Butler PB. The effect of interactive computer play on balance and functional abilities in children with moderate cerebral palsy: a pilot randomized study. Clin Rehabil 2019; 33:704-710. [PMID: 30599772 DOI: 10.1177/0269215518821714] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES: To investigate the feasibility and potential efficacy of a six-week interactive computer play training on balance and gross motor function in children with moderate cerebral palsy. DESIGN: A pilot single-blinded matched randomized controlled study. SETTING: Community. PARTICIPANTS: In total, 18 children with moderate cerebral palsy were recruited, paired according to age and severity of cerebral palsy and randomized into intervention group or control group. INTERVENTION: The intervention group received additional trunk control training using the interactive computer play in sitting four times per week, 20 minutes per session for six weeks. All study children continued their usual physiotherapy programme. MEASUREMENTS: All study children were assessed at baseline, week 3, week 6 (completion of intervention) and week 12 using the Pediatric Reach Test, Gross Motor Function Measure-66-Item Set and 2-Minute Walk Test. RESULTS: All intervention children completed and enjoyed the training with no reported adverse event. All children were assessed at all time points. No significant difference was found between the two groups in all assessments. In both groups of children, significant improvements were found in the Gross Motor Function Measure-66-Item Set between week 3 (intervention group: mean 53.41, SD 5.34; control group: mean 52.86, SD 8.33) and week 6 (intervention group: mean 55.00, SD 6.32; control group: mean 54.20, SD 8.35). CONCLUSION: The intervention protocol of a six-week interactive computer play training was feasible and safe for children with moderate cerebral palsy in special school settings. Future studies with larger sample sizes or using single-subject designs are recommended.
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Affiliation(s)
- Tamis W Pin
- 1 Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Cavalcante Neto JL, de Oliveira CC, Greco AL, Zamunér AR, Moreira RC, Tudella E. Is virtual reality effective in improving the motor performance of children with developmental coordination disorder? A systematic review. Eur J Phys Rehabil Med 2018; 55:291-300. [PMID: 30311491 DOI: 10.23736/s1973-9087.18.05427-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Although virtual reality (VR) is an increasingly popular approach within studies that propose interventions for children with developmental coordination disorder (DCD), evidence on the effectiveness of VR remains debatable. The aim of this study was to synthesize evidence on the effectiveness of VR interventions for motor performance improvement in children with DCD. EVIDENCE ACQUISITION Searches were conducted in the MEDLINE/PubMed, Scopus, Web of Science and ERIC databases to select studies published from 1 January 2006 to 30 November 2017. Two independent reviewers performed the primary study selection based on titles, abstracts and full-text reading; this selection included randomized controlled trials (RCTs) that applied VR interventions to children with DCD and assessed outcomes related to motor performance. The methodological quality of the studies included in the search was assessed through the PEDro scale. PRISMA guidelines and Cochrane recommendations for systematic reviews were followed. The effect size of each intervention was calculated to allow for the interpretation of clinical effects, and the body of evidence was synthesised through the GRADE approach. EVIDENCE SYNTHESIS A total of 2160 publications were retrieved; by the end of the selection process, twelve RCTs had been included. Of these twelve, seven were classified as having high methodological quality. Only three studies satisfied the homogeneity conditions to be assessed through the GRADE system, which showed a low level of evidence in favor of VR for improving the motor performance of children with DCD. CONCLUSIONS Not enough evidence currently exists to support or refute the use of VR over non-VR interventions for improving motor performance in children with DCD. Despite the potential for improving the motor performance of DCD children, the absence of specific protocols prevents formal recommendations of VR for these children. Future studies should consider VR protocols that are more specific regarding the tasks, features and target motor skills to be developed by DCD children. In addition, comparisons of similar groups at baseline, the concealment of allocation and the blinding of assessors are internal validity aspects which deserve researchers' attention.
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Affiliation(s)
- Jorge L Cavalcante Neto
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil -
| | - Cristina C de Oliveira
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Ana L Greco
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Antonio R Zamunér
- Department of Kinesiology, Catholic University of the Maule, Talca, Chile
| | - Roberta C Moreira
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Eloisa Tudella
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
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Abstract
PURPOSE A platform requiring multidimensional trunk movement facilitated postural balance in children with cerebral palsy. METHODS The intervention group (n = 20) received 12 weeks of playing personal computer (PC) games using the platform, and the control group (n = 20) played the same games using a computer mouse. Outcomes were center-of-pressure sway, the Berg Balance Scale (BBS), Fullerton Advanced Balance Scale (FAB), and Timed Up and Go (TUG) test scores. RESULTS There were significant interactions between groups and time. There was a significant between-group difference in center-of-pressure sway excursion, BBS test, and TUG test over time. Participants in the intervention group had better balance performance compared with the control group. CONCLUSION Balance training using a PC gaming platform may improve exercise compliance and enhance recovery of balance in children with cerebral palsy.
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Affiliation(s)
- Hsieh-Chun Hsieh
- Department of Special Education, National Tsing Hua University, Hsinchu City, Taiwan
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Amengual Alcover E, Jaume-I-Capó A, Moyà-Alcover B. PROGame: A process framework for serious game development for motor rehabilitation therapy. PLoS One 2018; 13:e0197383. [PMID: 29768472 PMCID: PMC5955522 DOI: 10.1371/journal.pone.0197383] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 05/01/2018] [Indexed: 11/20/2022] Open
Abstract
Serious game development for rehabilitation therapy is becoming increasingly popular because of the motivational advantages that these types of applications provide. Consequently, the need for a common process framework for this category of software development has become increasingly evident. The goal is to guarantee that products are developed and validated by following a coherent and systematic method that leads to high-quality serious games. This paper introduces a new process framework for the development of serious games for motor rehabilitation therapy. We introduce the new model and demonstrate its application for the development of a serious game for the improvement of the balance and postural control of adults with cerebral palsy. The development of this application has been facilitated by two technological transfer contracts and is being exploited by two different organizations. According to clinical measurements, patients using the application improved from high fall risk to moderate fall risk. We believe that our development strategy can be useful not only for motor rehabilitation therapy, but also for the development of serious games in many other rehabilitation areas.
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Affiliation(s)
- Esperança Amengual Alcover
- Department of Mathematics and Computer Science, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Antoni Jaume-I-Capó
- Department of Mathematics and Computer Science, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Biel Moyà-Alcover
- Department of Mathematics and Computer Science, University of the Balearic Islands, Palma de Mallorca, Spain
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Abstract
OBJECTIVES To investigate whether balance and mobility training at home using Wii Fit is feasible and can provide clinical benefits. DESIGN Single-group, pre-post intervention study. SETTING Participants' home. PARTICIPANTS 20 children with cerebral palsy (6-12 years). INTERVENTION Participants undertook 8 weeks of home-based Wii Fit training in addition to usual care. MAIN MEASURES Feasibility was determined by adherence, performance, acceptability and safety. Clinical outcomes were strength, balance, mobility and participation measured at baseline (preintervention) and 8 weeks (postintervention). RESULTS The training was feasible with 99% of training completed; performance on all games improved; parents understood the training (4/5), it did not interfere in life (3.8/5), was challenging (3.9/5) and would recommend it (3.9/5); and there were no injurious falls. Strength increased in dorsiflexors (Mean Difference (MD) 2.2 N m, 95% CI 1.1 to 3.2, p<0.001), plantarflexors (MD 2.2 N m, 95% CI 1.3 to 3.1, p<0.001) and quadriceps (MD 7.8 N m, 95% CI 5.2 to 10.5, p<0.001). Preferred walking speed increased (MD 0.25 m/s, 95% CI 0.09 to 0.41, p<0.01), fast speed increased (MD 0.24 m/s, 95% CI 0.13 to 0.35, p<0.001) and distance over 6 min increased (MD 28 m, 95% CI 10 to 45, p<0.01). Independence in participation increased (MD 1.4 out of 40, 95% CI 0.0 to 2.8, p=0.04). CONCLUSIONS Balance and mobility training at home using Wii Fit was feasible and safe and has the potential to improve strength and mobility, suggesting that a randomised trial is warranted. TRIAL REGISTRATION NUMBER ACTRN12616001362482.
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Affiliation(s)
- Hsiu-Ching Chiu
- Department of Physical Therapy, I-Shou University, Kaohsiung, Taiwan
| | - Louise Ada
- Discipline of Physiotherapy, The University of Sydney, Sydney, Australia
| | - Shin-Da Lee
- Department of Occupational Therapy, Asia University, Taichung, Taiwan
- Department of Physical Therapy, China Medical University, Taichung, Taiwan
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Virtual Reality and Serious Games in Neurorehabilitation of Children and Adults: Prevention, Plasticity, and Participation. Pediatr Phys Ther 2017; 29 Suppl 3:S23-S36. [PMID: 28654475 PMCID: PMC5488703 DOI: 10.1097/pep.0000000000000387] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Use of virtual reality (VR) and serious games (SGs) interventions within rehabilitation as motivating tools for task specific training for individuals with neurological conditions are fast-developing. Within this perspective paper we use the framework of the IV STEP conference to summarize the literature on VR and SG for children and adults by three topics: Prevention; Outcomes: Body-Function-Structure, Activity and Participation; and Plasticity. Overall the literature in this area offers support for use of VR and SGs to improve body functions and to some extent activity domain outcomes. Critical analysis of clients' goals and selective evaluation of VR and SGs are necessary to appropriately take advantage of these tools within intervention. Further research on prevention, participation, and plasticity is warranted. We offer suggestions for bridging the gap between research and practice integrating VR and SGs into physical therapist education and practice.
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Bulea TC, Lerner ZF, Gravunder AJ, Damiano DL. Exergaming with a pediatric exoskeleton: Facilitating rehabilitation and research in children with cerebral palsy. IEEE Int Conf Rehabil Robot 2017; 2017:1087-1093. [PMID: 28813966 PMCID: PMC10436702 DOI: 10.1109/icorr.2017.8009394] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Effective rehabilitation of children with cerebral palsy (CP) requires intensive task-specific exercise but many in this population lack the motor capabilities to complete the desired training tasks. Providing robotic assistance is a potential solution yet the effects of this assistance are unclear. We combined a novel exoskeleton and exercise video game (exergame) to create a new rehabilitation paradigm for children with CP. We incorporated high density electroencephalography (EEG) to assess cortical activity. Movement to targets in the game was controlled by knee extension while standing. The distance between targets was the same with and without the exoskeleton to isolate the effect of robotic assistance. Our results show that children with CP maintain or increase knee extensor muscle activity during knee extension in the presence of synergistic robotic assistance. Our EEG findings also demonstrate that participants remained engaged in the exercise with robotic assistance. Interestingly we observed a developmental trajectory of sensorimotor mu rhythm in children with CP similar, though delayed, to those reported in typically developing children. While not the goal here, the exoskeleton significantly increased knee extension in 3/6 participants during use. Future work will focus on utilizing the exoskeleton to enhance volitional knee extension capability and in combination with EMG and EEG to study sensorimotor cortex response to progressive exercise in children with CP.
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Preston N, Horton M, Levesley M, Mon-Williams M, O'Connor RJ. Development of a parent-reported questionnaire evaluating upper limb activity limitation in children with cerebral palsy. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2017; 23. [PMID: 28112465 PMCID: PMC5811897 DOI: 10.1002/pri.1684] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 07/15/2016] [Accepted: 07/31/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Upper limb activity measures for children with cerebral palsy have a number of limitations, for example, lack of validity and poor responsiveness. To overcome these limitations, we developed the Children's Arm Rehabilitation Measure (ChARM), a parent-reported questionnaire validated for children with cerebral palsy aged 5-16 years. This paper describes both the development of the ChARM items and response categories and its psychometric testing and further refinement using the Rasch measurement model. METHODS To generate valid items for the ChARM, we collected goals of therapy specifically developed by therapists, children with cerebral palsy, and their parents for improving activity limitation of the upper limb. The activities, which were the focus of these goals, formed the basis for the items. Therapists typically break an activity into natural stages for the purpose of improving activity performance, and these natural orders of achievement formed each item's response options. Items underwent face validity testing with health care professionals, parents of children with cerebral palsy, academics, and lay persons. A Rasch analysis was performed on ChARM questionnaires completed by the parents of 170 children with cerebral palsy from 12 hospital paediatric services. The ChARM was amended, and the procedure repeated on 148 ChARMs (from children's mean age: 10 years and 1 month; range: 4 years and 8 months to 16 years and 11 months; 85 males; Manual Ability Classification System Levels I = 9, II = 26, III = 48, IV = 45, and V = 18). RESULTS The final 19-item unidimensional questionnaire displayed fit to the Rasch model (chi-square p = .18), excellent reliability (person separation index = 0.95, α = 0.95), and no floor or ceiling effects. Items showed no response bias for gender, distribution of impairment, age, or learning disability. DISCUSSION The ChARM is a psychometrically sound measure of upper limb activity validated for children with cerebral palsy aged 5-16 years. The ChARM is freely available for use to clinicians and nonprofit organisations.
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Affiliation(s)
- N Preston
- Academic Department of Rehabilitation Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland
| | - M Horton
- Academic Department of Rehabilitation Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland
| | - M Levesley
- School of Mechanical Engineering, University of Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland
| | - M Mon-Williams
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland
| | - R J O'Connor
- National Demonstration Centre in Rehabilitation, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom of Great Britain and Northern Ireland.,Academic Department of Rehabilitation Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland
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Abstract
The implementation of computer games in physical therapy is motivated by characteristics such as attractiveness, motivation, and engagement, but these do not guarantee the intended therapeutic effect of the interventions. Yet, these characteristics are important variables in physical therapy interventions because they involve reward-related dopaminergic systems in the brain that are known to facilitate learning through long-term potentiation of neural connections. In this perspective we propose a way to apply game design approaches to therapy development by "designing" therapy sessions in such a way as to trigger physical and cognitive behavioral patterns required for treatment and neurological recovery. We also advocate that improving game knowledge among therapists and improving communication between therapists and game designers may lead to a novel avenue in designing applied games with specific therapeutic input, thereby making gamification in therapy a realistic and promising future that may optimize clinical practice.
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Laut J, Porfiri M, Raghavan P. The Present and Future of Robotic Technology in Rehabilitation. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2016; 4:312-319. [PMID: 28603663 PMCID: PMC5461931 DOI: 10.1007/s40141-016-0139-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Robotic technology designed to assist rehabilitation can potentially increase the efficiency of and accessibility to therapy by assisting therapists to provide consistent training for extended periods of time, and collecting data to assess progress. Automatization of therapy may enable many patients to be treated simultaneously and possibly even remotely, in the comfort of their own homes, through telerehabilitation. The data collected can be used to objectively assess performance and document compliance as well as progress. All of these characteristics can make therapists more efficient in treating larger numbers of patients. Most importantly for the patient, it can increase access to therapy which is often in high demand and rationed severely in today's fiscal climate. In recent years, many consumer grade low-cost and off-the-shelf devices have been adopted for use in therapy sessions and methods for increasing motivation and engagement have been integrated with them. This review paper outlines the effort devoted to the development and integration of robotic technology for rehabilitation.
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Affiliation(s)
- Jeffrey Laut
- New York University Tandon School of Engineering
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Lucas BR, Elliott EJ, Coggan S, Pinto RZ, Jirikowic T, McCoy SW, Latimer J. Interventions to improve gross motor performance in children with neurodevelopmental disorders: a meta-analysis. BMC Pediatr 2016; 16:193. [PMID: 27899082 PMCID: PMC5129231 DOI: 10.1186/s12887-016-0731-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 11/15/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gross motor skills are fundamental to childhood development. The effectiveness of current physical therapy options for children with mild to moderate gross motor disorders is unknown. The aim of this study was to systematically review the literature to investigate the effectiveness of conservative interventions to improve gross motor performance in children with a range of neurodevelopmental disorders. METHODS A systematic review with meta-analysis was conducted. MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, PEDro, Cochrane Collaboration, Google Scholar databases and clinical trial registries were searched. Published randomised controlled trials including children 3 to ≤18 years with (i) Developmental Coordination Disorder (DCD) or Cerebral Palsy (CP) (Gross Motor Function Classification System Level 1) or Developmental Delay or Minimal Acquired Brain Injury or Prematurity (<30 weeks gestational age) or Fetal Alcohol Spectrum Disorders; and (ii) receiving non-pharmacological or non-surgical interventions from a health professional and (iii) gross motor outcomes obtained using a standardised assessment tool. Meta-analysis was performed to determine the pooled effect of intervention on gross motor function. Methodological quality and strength of meta-analysis recommendations were evaluated using PEDro and the GRADE approach respectively. RESULTS Of 2513 papers, 9 met inclusion criteria including children with CP (n = 2) or DCD (n = 7) receiving 11 different interventions. Only two of 9 trials showed an effect for treatment. Using the least conservative trial outcomes a large beneficial effect of intervention was shown (SMD:-0.8; 95% CI:-1.1 to -0.5) with "very low quality" GRADE ratings. Using the most conservative trial outcomes there is no treatment effect (SMD:-0.1; 95% CI:-0.3 to 0.2) with "low quality" GRADE ratings. Study limitations included the small number and poor quality of the available trials. CONCLUSION Although we found that some interventions with a task-orientated framework can improve gross motor outcomes in children with DCD or CP, these findings are limited by the very low quality of the available evidence. High quality intervention trials are urgently needed.
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Affiliation(s)
- Barbara R Lucas
- Discipline of Paediatrics and Child Health, The University of Sydney, The Children's Hospital at Westmead, Clinical School, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia.
- The George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, , Missenden Rd, Sydney, NSW, 2050, Australia.
- Poche Centre for Indigenous Health, Sydney School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia.
- Physiotherapy Department, Royal North Shore Hospital, St Leonards, Sydney, NSW, 2065, Australia.
| | - Elizabeth J Elliott
- Discipline of Paediatrics and Child Health, The University of Sydney, The Children's Hospital at Westmead, Clinical School, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia
- The George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, , Missenden Rd, Sydney, NSW, 2050, Australia
- The Sydney Children's Hospital Networks (Westmead), Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia
| | - Sarah Coggan
- The George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, , Missenden Rd, Sydney, NSW, 2050, Australia
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Rafael Z Pinto
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, St Leonards, Sydney, NSW, 2065, Australia
- Departamento de Fisioterapia, Faculdade de Ciências e Tecnologia, UNESP-Univ Estadual Paulista, Presidente Prudente, SP, 19060-900, Brazil
| | - Tracy Jirikowic
- Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle, WA, 98195, USA
| | - Sarah Westcott McCoy
- Division of Physical Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle, WA, 98195, USA
| | - Jane Latimer
- The George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, , Missenden Rd, Sydney, NSW, 2050, Australia
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Levac D. How Can Therapists Enhance Children's Engagement in Home-Based Rehabilitation Interventions? Phys Occup Ther Pediatr 2016; 36:359-62. [PMID: 27589366 DOI: 10.1080/01942638.2016.1207998] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Danielle Levac
- a Department of Physical Therapy, Movement and Rehabilitation Science , Northeastern University , Boston , MA , USA
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A pilot single-blind multicentre randomized controlled trial to evaluate the potential benefits of computer-assisted arm rehabilitation gaming technology on the arm function of children with spastic cerebral palsy. Clin Rehabil 2016; 30:1004-1015. [DOI: 10.1177/0269215515604699] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 08/15/2015] [Indexed: 11/15/2022]
Abstract
Objective: To evaluate the potential benefits of computer-assisted arm rehabilitation gaming technology on arm function of children with spastic cerebral palsy. Design: A single-blind randomized controlled trial design. Power calculations indicated that 58 children would be required to demonstrate a clinically important difference. Setting: Intervention was home-based; recruitment took place in regional spasticity clinics. Participants: A total of 15 children with cerebral palsy aged five to 12 years were recruited; eight to the device group. Interventions: Both study groups received ‘usual follow-up treatment’ following spasticity treatment with botulinum toxin; the intervention group also received a rehabilitation gaming device. Main measures: ABILHAND-kids and Canadian Occupational Performance Measure were performed by blinded assessors at baseline, six and 12 weeks. Results: An analysis of covariance showed no group differences in mean ABILHAND-kids scores between time points. A non-parametric analysis of variance on Canadian Occupational Performance Measure scores showed a statistically significant improvement across time points (χ2 (2,15) = 6.778, p = 0.031), but this improvement did not reach minimal clinically important difference. Mean daily device use was seven minutes. Recruitment did not reach target owing to unanticipated staff shortages in clinical services. Feedback from children and their families indicated that the games were not sufficiently engaging to promote sufficient use that was likely to result in functional benefits. Conclusion: This study suggests that computer-assisted arm rehabilitation gaming does not benefit arm function, but a Type II error cannot be ruled out.
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van den Heuvel RJF, Lexis MAS, Gelderblom GJ, Jansens RML, de Witte LP. Robots and ICT to support play in children with severe physical disabilities: a systematic review. Disabil Rehabil Assist Technol 2015; 11:103-116. [PMID: 26330097 DOI: 10.3109/17483107.2015.1079268] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Play is an essential part of children's lives. Children with physical disabilities experience difficulties in play, especially those with severe physical disabilities. With the progress of innovative technology, the possibilities to support play are increasing. The purpose of this literature study is to gain insight into the aims, control options and commercial availability of information and communication technology (ICT) and robots to support play (especially play for the sake of play) in children with severe physical disabilities. METHODS A systematic literature search in the databases PubMed, CINAHL, IEEE and ERIC was carried out. Titles and abstracts were assessed independently by three reviewers. In addition, studies were selected using Google Scholar, conference proceedings and reference lists. RESULTS Three main groups of technology for play could be distinguished: robots (n = 8), virtual reality systems (n = 15) and computer systems (n = 4). Besides, ICT and robots developed for specific therapy or educational goals using play-like activities, five of the in total 27 technologies in this study described the aim of "play for play's sake". CONCLUSIONS Many ICT systems and robots to support play in children with physical disabilities were found. Numerous technologies use play-like activities to achieve therapeutic or educational goals. Robots especially are used for "play for play's sake". Implications for Rehabilitation This study gives insight into the aims, control options and commercial availability for application of robots and ICT to support play in children with severe physical disabilities. This overview can be used in both the fields of rehabilitation and special education to search for new innovative intervention options and it can stimulate them to use these innovative play materials. Especially robots may have great potential in supporting "play for play's sake".
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Affiliation(s)
- Renée J F van den Heuvel
- a Research Centre for Technology in Care , Zuyd University of Applied Sciences , Heerlen , The Netherlands and.,b Department of Health Services Research , CAPRHI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University , Maastricht , The Netherlands
| | - Monique A S Lexis
- a Research Centre for Technology in Care , Zuyd University of Applied Sciences , Heerlen , The Netherlands and
| | - Gert Jan Gelderblom
- a Research Centre for Technology in Care , Zuyd University of Applied Sciences , Heerlen , The Netherlands and
| | - Rianne M L Jansens
- a Research Centre for Technology in Care , Zuyd University of Applied Sciences , Heerlen , The Netherlands and
| | - Luc P de Witte
- a Research Centre for Technology in Care , Zuyd University of Applied Sciences , Heerlen , The Netherlands and.,b Department of Health Services Research , CAPRHI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University , Maastricht , The Netherlands
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Valdes K, Naughton N, Algar L. Sensorimotor interventions and assessments for the hand and wrist: a scoping review. J Hand Ther 2015; 27:272-85; quiz 286. [PMID: 25193532 DOI: 10.1016/j.jht.2014.07.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 06/28/2014] [Accepted: 07/15/2014] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Scoping review. INTRODUCTION Sensorimotor deficits can impair function and may be present in individuals with common upper extremity conditions. PURPOSE OF THE STUDY To provide clinicians with an understanding of the usefulness of the assessments to evaluate sensorimotor function and the interventions reported in the literature to effect positive change in our patients with sensorimotor deficits affecting the hand and wrist. METHODS A systematic search produced seventeen studies involving sensorimotor retraining and assessment of sensorimotor performance for the upper extremity. RESULTS Sensorimotor interventions and assessments found in the literature vary in regards to their effectiveness in restoring sensorimotor function in subjects with a number of conditions that affect hand and wrist function. CONCLUSIONS There is a potential value of sensorimotor interventions for individuals with specific upper extremity conditions. There is a need for further studies to improve treatment of sensorimotor deficits and understanding of sensorimotor interventions.
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Affiliation(s)
- Kristin Valdes
- Drexel University, Philadelphia, PA, USA; Hand Works Therapy, 744 the Rialto, Venice, FL 34285, USA.
| | | | - Lori Algar
- Northeast Orthopaedic and Hand Surgery, Waterbury, CT, USA
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Bingham PM, Calhoun B. Digital Posturography Games Correlate with Gross Motor Function in Children with Cerebral Palsy. Games Health J 2015; 4:145-8. [PMID: 26181808 DOI: 10.1089/g4h.2014.0096] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This pilot study aimed to assess whether performance on posturography games correlates with the Gross Motor Function Measure (GMFM) in children with cerebral palsy. MATERIALS AND METHODS Simple games using static posturography technology allowed subjects to control screen events via postural sway. Game performance was compared with GMFMs using correlation analysis in a convenience sample of nine girls and six boys with cerebral palsy. Likert scales were used to obtain subjective responses to the balance games. RESULTS GMFM scores correlated with game performance, especially measures emphasizing rhythmic sway. Twelve of the 15 subjects enjoyed the game and asserted an interest in playing again. CONCLUSIONS Digital posturography games engage children with cerebral palsy in balance tasks, provide visual feedback in a balance control task, and have the potential to increase autonomy in balance control training among pediatric patients with cerebral palsy. This approach can support the relationship between child and therapist. The potential for interactive posturography to complement the assessment and treatment of balance in cerebral palsy bears continuing study.
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Affiliation(s)
- Peter M Bingham
- 1 Department of Neurology, Fletcher Allen Health Care/University of Vermont , Burlington, Vermont
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36
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James S, Ziviani J, Ware RS, Boyd RN. Randomized controlled trial of web-based multimodal therapy for unilateral cerebral palsy to improve occupational performance. Dev Med Child Neurol 2015; 57:530-8. [PMID: 25955443 DOI: 10.1111/dmcn.12705] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2014] [Indexed: 10/23/2022]
Abstract
AIM The study aimed to investigate the effectiveness of a web-based therapy programme, 'Move it to improve it' (Mitii(™)), in children with unilateral cerebral palsy (UCP) on occupational performance, upper limb function, and visual perception. METHOD Participants (n=102) were matched in pairs and randomized to intervention (Mitii for 20wks; 26 males, mean age 11y 8mo [2y 4mo], Manual Ability Classification System level I=11, II=39, III=1) or control (standard care; 25 males, mean age 11y 10mo [2y 5mo], Manual Ability Classification System level I=13, II=37). Outcomes were the Assessment of Motor and Process Skills (AMPS), Assisting Hand Assessment, Jebsen-Taylor Test of Hand Function (JTTHF), Melbourne Assessment of Unilateral Upper Limb Function (MUUL), Canadian Occupational Performance Measure (COPM), and Test of Visual Perceptual Skills (TVPS-3). RESULTS Participants completed on average 32.4 hours of Mitii (range 3.7-74.7h). The Mitii group demonstrated significantly greater post-intervention scores than the comparison group on the AMPS, JTTHF dominant upper limb, COPM, and TVPS-3. The differences between groups were not clinically significant. There were no differences between groups on measures of impaired upper limb function. INTERPRETATION Mitii delivers individualized, web-based therapy at home and has potential to increase therapy dose. Mitii can be considered as an option to enhance occupational performance and visual perception for children with UCP.
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Affiliation(s)
- Sarah James
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Royal Children's Hospital, The University of Queensland, Brisbane, Qld, Australia
| | - Jenny Ziviani
- Children's Allied Health Research, Queensland Health, Brisbane, Qld, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia
| | - Robert S Ware
- School of Population Health, The University of Queensland, Brisbane, Qld, Australia.,Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Qld, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Royal Children's Hospital, The University of Queensland, Brisbane, Qld, Australia
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AlSaif AA, Alsenany S. Effects of interactive games on motor performance in children with spastic cerebral palsy. J Phys Ther Sci 2015; 27:2001-3. [PMID: 26180367 PMCID: PMC4500030 DOI: 10.1589/jpts.27.2001] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 03/14/2015] [Indexed: 12/30/2022] Open
Abstract
[Purpose] Motor control and muscle strength impairments are the prime reasons for motor behavior disorders in children with spastic cerebral palsy. These impairments lead to histological changes in muscle growth and the learning of motor skills. Therefore, such children experience reduced muscle force generation and decreased muscle flexibility. We investigated the effect of training with Nintendo Wii Fit games on motor performance in children with spastic cerebral palsy. [Subjects and Methods] Forty children with cerebral palsy spastic diplegia aged 6-10 years diagnosed with level-3 functional capabilities according to the Gross Motor Classification System (GMFCS) were enrolled. Participants were divided randomly into equal groups: group (A) that practiced with the Nintendo Wii Fit game for at least 20 minutes/day for 12 weeks and group (B) that underwent no training (control group). The Movement Assessment Battery for Children-2 (mABC-2) was used to assess motor performance, because it mainly involves motor tasks very similar to those involved in playing Nintendo Wii Fit games, e.g., goal-directed arm movements, balancing, and jumping. [Results] There were significant improvements in the subscales of the motor performance test of those who practiced with the Nintendo Wii, while the control group showed no significant changes. [Conclusion] Using motion interactive games in home rehabilitation is feasible for children with cerebral palsy.
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Affiliation(s)
- Amer A AlSaif
- Department of Physical Therapy, Faculty of Applied Medical Sciences, King Abdulaziz University, Saudi Arabia
| | - Samira Alsenany
- Public Health Department, Faculty of Nursing, King Abdulaziz University, Saudi Arabia
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38
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Karlsson P. Interactive computer play - what happens when the game is over? Dev Med Child Neurol 2015; 57:497. [PMID: 25759149 DOI: 10.1111/dmcn.12712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Petra Karlsson
- Cerebral Palsy Alliance, Sydney, NSW, Australia.,School of Medicine, University of Notre Dame, Sydney, NSW, Australia
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Giordani B, Novak B, Sikorskii A, Bangirana P, Nakasujja N, Winn BM, Boivin MJ. Designing and evaluating Brain Powered Games for cognitive training and rehabilitation in at-risk African children. Glob Ment Health (Camb) 2015; 2:e6. [PMID: 28596854 PMCID: PMC5269631 DOI: 10.1017/gmh.2015.5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 03/18/2015] [Accepted: 03/21/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Valid, reliable, accessible, and cost-effective computer-training approaches can be important components in scaling up educational support across resource-poor settings, such as sub-Saharan Africa. The goal of the current study was to develop a computer-based training platform, the Michigan State University Games for Entertainment and Learning laboratory's Brain Powered Games (BPG) package that would be suitable for use with at-risk children within a rural Ugandan context and then complete an initial field trial of that package. METHODS After game development was completed with the use of local stimuli and sounds to match the context of the games as closely as possible to the rural Ugandan setting, an initial field study was completed with 33 children (mean age = 8.55 ± 2.29 years, range 6-12 years of age) with HIV in rural Uganda. The Test of Variables of Attention (TOVA), CogState computer battery, and the Non-Verbal Index from the Kaufman Assessment Battery for Children, 2nd edition (KABC-II) were chosen as the outcome measures for pre- and post-intervention testing. The children received approximately 45 min of BPG training several days per week for 2 months (24 sessions). RESULTS Although some improvements in test scores were evident prior to BPG training, following training, children demonstrated clinically significant changes (significant repeated-measures outcomes with moderate to large effect sizes) on specific TOVA and CogState measures reflecting processing speed, attention, visual-motor coordination, maze learning, and problem solving. CONCLUSIONS Results provide preliminary support for the acceptability, feasibility, and neurocognitive benefit of BPG and its utility as a model platform for computerized cognitive training in cross-cultural low-resource settings.
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Affiliation(s)
- B. Giordani
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
- Departments of Neurology and Psychology and School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - B. Novak
- Games for Entertainment and Learning (GEL) Laboratory, Department of Media and Information, Michigan State University, East Lansing, Michigan, USA
| | - A. Sikorskii
- Department of Statistics and Probability, Michigan State University, East Lansing, Michigan, USA
| | - P. Bangirana
- Department of Psychiatry, Makerere University, Kampala, Uganda
| | - N. Nakasujja
- Department of Psychiatry, Makerere University, Kampala, Uganda
| | - B. M. Winn
- Games for Entertainment and Learning (GEL) Laboratory, Department of Media and Information, Michigan State University, East Lansing, Michigan, USA
| | - M. J. Boivin
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
- Departments of Psychiatry and of Neurology & Ophthalmology, Michigan State University, East Lansing, Michigan, USA
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Laut J, Cappa F, Nov O, Porfiri M. Increasing patient engagement in rehabilitation exercises using computer-based citizen science. PLoS One 2015; 10:e0117013. [PMID: 25793867 PMCID: PMC4368773 DOI: 10.1371/journal.pone.0117013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 12/16/2014] [Indexed: 01/19/2023] Open
Abstract
Patient motivation is an important factor to consider when developing rehabilitation programs. Here, we explore the effectiveness of active participation in web-based citizen science activities as a means of increasing participant engagement in rehabilitation exercises, through the use of a low-cost haptic joystick interfaced with a laptop computer. Using the joystick, patients navigate a virtual environment representing the site of a citizen science project situated in a polluted canal. Participants are tasked with following a path on a laptop screen representing the canal. The experiment consists of two conditions: in one condition, a citizen science component where participants classify images from the canal is included; and in the other, the citizen science component is absent. Both conditions are tested on a group of young patients undergoing rehabilitation treatments and a group of healthy subjects. A survey administered at the end of both tasks reveals that participants prefer performing the scientific task, and are more likely to choose to repeat it, even at the cost of increasing the time of their rehabilitation exercise. Furthermore, performance indices based on data collected from the joystick indicate significant differences in the trajectories created by patients and healthy subjects, suggesting that the low-cost device can be used in a rehabilitation setting for gauging patient recovery.
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Affiliation(s)
- Jeffrey Laut
- Department of Mechanical and Aerospace Engineering, New York University Polytechnic School of Engineering, Six MetroTech Center, Brooklyn, NY, United States of America
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Via Eudossiana 18, Rome 00185, Italy
| | - Francesco Cappa
- Department of Business and Management, LUISS Guido Carli University, Viale Pola 12, Rome 00198, Italy
| | - Oded Nov
- Department of Technology Management and Innovation, New York University Polytechnic School of Engineering, Five MetroTech Center, Brooklyn, NY, United States of America
| | - Maurizio Porfiri
- Department of Mechanical and Aerospace Engineering, New York University Polytechnic School of Engineering, Six MetroTech Center, Brooklyn, NY, United States of America
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Via Eudossiana 18, Rome 00185, Italy
- * E-mail:
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"Kinect-ing" with clinicians: a knowledge translation resource to support decision making about video game use in rehabilitation. Phys Ther 2015; 95:426-40. [PMID: 25256741 PMCID: PMC4348717 DOI: 10.2522/ptj.20130618] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Microsoft's Kinect for Xbox 360 virtual reality (VR) video games are promising rehabilitation options because they involve motivating, full-body movement practice. However, these games were designed for recreational use, which creates challenges for clinical implementation. Busy clinicians require decision-making support to inform game selection and implementation that address individual therapeutic goals. This article describes the development and preliminary evaluation of a knowledge translation (KT) resource to support clinical decision making about selection and use of Kinect games in physical therapy. The knowledge-to-action framework guided the development of the Kinecting With Clinicians (KWiC) resource. Five physical therapists with VR and video game expertise analyzed the Kinect Adventure games. A consensus-building method was used to arrive at categories to organize clinically relevant attributes guiding game selection and game play. The process and results of an exploratory usability evaluation of the KWiC resource by clinicians through interviews and focus groups at 4 clinical sites is described. Subsequent steps in the evaluation and KT process are proposed, including making the KWiC resource Web-based and evaluating the utility of the online resource in clinical practice.
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Deutsch JE, Guarrera-Bowlby P, Myslinski MJ, Kafri M. Is There Evidence That Active Videogames Increase Energy Expenditure and Exercise Intensity for People Poststroke and with Cerebral Palsy? Games Health J 2014; 4:31-7. [PMID: 26181678 DOI: 10.1089/g4h.2014.0082] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This article asked and answered the question of whether there was evidence to support the use of videogames for promotion of wellness and fitness for people poststroke and those with cerebral palsy (CP). A literature search of PubMed, CINAHL, and PEDro using a population, intervention, and outcome (PIO) approach and the key words "stroke (or CP) AND video games (and synonyms) AND energy expenditure (EE) (and synonyms)" was conducted. It yielded two relevant references for people poststroke and five references for people with CP. The literature extraction and synthesis by the categories of the PIO indicated that most studies used only the population of interest, except two that compared the EE with that of healthy controls. The main finding is that both people poststroke (moderate severity) and people with CP (mild severity) can achieve moderate EE playing Wii(™) (Nintendo, Kyoto, Japan), PlayStation(®) (Sony, Tokyo, Japan), and Kinect(™) (Microsoft, Redmond, WA) games. Adults with CP of mild severity played the videogames at vigorous levels, whereas those with severe CP played them at low levels. There appears to be an interaction between development and severity that influences the exercise intensity measured by EE. The findings suggests that videogames are a gateway for wellness promotion.
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Affiliation(s)
- Judith E Deutsch
- 1 Rivers Lab, Rutgers University , Newark, New Jersey, USA.,2 Department of Rehabilitation and Movement Sciences, Rutgers University , Newark, New Jersey, USA
| | - Phyllis Guarrera-Bowlby
- 1 Rivers Lab, Rutgers University , Newark, New Jersey, USA.,2 Department of Rehabilitation and Movement Sciences, Rutgers University , Newark, New Jersey, USA
| | - Mary Jane Myslinski
- 2 Department of Rehabilitation and Movement Sciences, Rutgers University , Newark, New Jersey, USA
| | - Michal Kafri
- 3 Program in Physical Therapy, University of Haifa , Haifa, Israel
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43
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Empleo de sistemas de realidad virtual como método de propiocepción en parálisis cerebral: guía de práctica clínica. Neurologia 2014; 29:550-9. [PMID: 22341675 DOI: 10.1016/j.nrl.2011.12.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 11/03/2011] [Accepted: 12/17/2011] [Indexed: 11/20/2022] Open
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Monge Pereira E, Molina Rueda F, Alguacil Diego I, Cano De La Cuerda R, De Mauro A, Miangolarra Page J. Use of virtual reality systems as proprioception method in cerebral palsy: clinical practice guideline. NEUROLOGÍA (ENGLISH EDITION) 2014. [DOI: 10.1016/j.nrleng.2011.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Sandlund M, Domellöf E, Grip H, Rönnqvist L, Häger CK. Training of goal directed arm movements with motion interactive video games in children with cerebral palsy - a kinematic evaluation. Dev Neurorehabil 2014; 17:318-26. [PMID: 23863100 DOI: 10.3109/17518423.2013.776124] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The main aim of this study was to evaluate the quality of goal-directed arm movements in 15 children with cerebral palsy (CP) following four weeks of home-based training with motion interactive video games. A further aim was to investigate the applicability and characteristics of kinematic parameters in a virtual context in comparison to a physical context. METHOD Kinematics and kinetics were captured while the children performed arm movements directed towards both virtual and physical targets. RESULTS The children's movement precision improved, their centre of pressure paths decreased, as did the variability in maximal shoulder angles when reaching for virtual objects. Transfer to a situation with physical targets was mainly indicated by increased movement smoothness. CONCLUSION Training with motion interactive games seems to improve arm motor control in children with CP. The results highlight the importance of considering both the context and the task itself when investigating kinematic parameters.
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Affiliation(s)
- Marlene Sandlund
- Department of Community Medicine and Rehabilitation, Umeå University , Umeå , Sweden and
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Jaume-i-Capó A, Martínez-Bueso P, Moyà-Alcover B, Varona J. Improving vision-based motor rehabilitation interactive systems for users with disabilities using mirror feedback. ScientificWorldJournal 2014; 2014:964576. [PMID: 25295310 PMCID: PMC4177771 DOI: 10.1155/2014/964576] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 08/05/2014] [Accepted: 08/22/2014] [Indexed: 11/18/2022] Open
Abstract
Observation is recommended in motor rehabilitation. For this reason, the aim of this study was to experimentally test the feasibility and benefit of including mirror feedback in vision-based rehabilitation systems: we projected the user on the screen. We conducted a user study by using a previously evaluated system that improved the balance and postural control of adults with cerebral palsy. We used a within-subjects design with the two defined feedback conditions (mirror and no-mirror) with two different groups of users (8 with disabilities and 32 without disabilities) using usability measures (time-to-start (T(s)) and time-to-complete (T(c))). A two-tailed paired samples t-test confirmed that in case of disabilities the mirror feedback facilitated the interaction in vision-based systems for rehabilitation. The measured times were significantly worse in the absence of the user's own visual feedback (T(s) = 7.09 (P < 0.001) and T(c) = 4.48 (P < 0.005)). In vision-based interaction systems, the input device is the user's own body; therefore, it makes sense that feedback should be related to the body of the user. In case of disabilities the mirror feedback mechanisms facilitated the interaction in vision-based systems for rehabilitation. Results recommends developers and researchers use this improvement in vision-based motor rehabilitation interactive systems.
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Affiliation(s)
- Antoni Jaume-i-Capó
- Unitat de Gràfics, Visió i Intelligència Artificial, Department de Ciències Matemàtiques i Informàtica, Universitat de les Illes Balears, E07122 Palma, Spain
| | - Pau Martínez-Bueso
- Grup d'Investigació d'Evidència, Estils de Vida i Salut, Department d'Infermeria i Fisioteràpia, Universitat de les Illes Balears, E07122 Palma, Spain
| | - Biel Moyà-Alcover
- Unitat de Gràfics, Visió i Intelligència Artificial, Department de Ciències Matemàtiques i Informàtica, Universitat de les Illes Balears, E07122 Palma, Spain
| | - Javier Varona
- Unitat de Gràfics, Visió i Intelligència Artificial, Department de Ciències Matemàtiques i Informàtica, Universitat de les Illes Balears, E07122 Palma, Spain
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Weiss PLT, Tirosh E, Fehlings D. Role of virtual reality for cerebral palsy management. J Child Neurol 2014; 29:1119-24. [PMID: 24799367 DOI: 10.1177/0883073814533007] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 04/03/2014] [Indexed: 11/16/2022]
Abstract
Virtual reality is the use of interactive simulations to present users with opportunities to perform in virtual environments that appear, sound, and less frequently, feel similar to real-world objects and events. Interactive computer play refers to the use of a game where a child interacts and plays with virtual objects in a computer-generated environment. Because of their distinctive attributes that provide ecologically realistic and motivating opportunities for active learning, these technologies have been used in pediatric rehabilitation over the past 15 years. The ability of virtual reality to create opportunities for active repetitive motor/sensory practice adds to their potential for neuroplasticity and learning in individuals with neurologic disorders. The objectives of this article is to provide an overview of how virtual reality and gaming are used clinically, to present the results of several example studies that demonstrate their use in research, and to briefly remark on future developments.
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Affiliation(s)
- Patrice L Tamar Weiss
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Emanuel Tirosh
- The Hannah Khoushy Child Development Center, Bnai Zion Medical Center, The Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Darcy Fehlings
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Department of Paediatrics, University of Toronto, Toronto, Canada
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Chiu HC, Ada L, Lee HM. Upper limb training using Wii Sports Resort™ for children with hemiplegic cerebral palsy: a randomized, single-blind trial. Clin Rehabil 2014; 28:1015-24. [DOI: 10.1177/0269215514533709] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objective: To investigate whether Wii Sports Resort™ training is effective and if any benefits are maintained. Design: Randomized, single-blind trial. Participants: Sixty-two hemiplegic children with cerebral palsy (6–13 years). Intervention: Experimental group undertook six weeks of home-based Wii Sports Resort™ training plus usual therapy, while the control group received usual therapy. Main measures: Outcomes were coordination, strength, hand function, and carers’ perception of hand function, measured at baseline, six, and 12 weeks by a blinded assessor. Results: There was a trend of mean difference (MD) for the experimental group to have more grip strength by six (MD 4.0 N, 95% confidence interval (CI) −0.8 to 8.8, p = 0.10) and 12 (MD 4.1 N, 95% CI −2.1 to 10.3, p = 0.19) weeks, and to have a higher quantity of hand function according to carers’ perception by six (MD 4.5 N, 95% CI −0.7 to 9.7, p = 0.09) and strengthened by 12 (MD 6.4, 95% CI 0.6 to 12.3, p = 0.03) weeks than the control group. There was no difference between groups in coordination and hand function by six or 12 weeks. Conclusion: Wii™ training did not improve coordination, strength, or hand function. Beyond the intervention, carers perceived that the children used their hands more.
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Affiliation(s)
- Hsiu-Ching Chiu
- Department of Physical Therapy, I-Shou University, Kaohsiung City, Taiwan
| | - Louise Ada
- Discipline of Physiotherapy, The University of Sydney, Sydney, Australia
| | - Hsin-Min Lee
- Department of Physical Therapy, I-Shou University, Kaohsiung City, Taiwan
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Radtka S, Hone R, Brown C, Mastick J, Melnick ME, Dowling GA. Feasibility of Computer-Based Videogame Therapy for Children with Cerebral Palsy. Games Health J 2014; 2:222-228. [PMID: 24761324 DOI: 10.1089/g4h.2012.0071] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Standing and gait balance problems are common in children with cerebral palsy (CP), resulting in falls and injuries. Task-oriented exercises to strengthen and stretch muscles that shift the center of mass and change the base of support are effective in improving balance. Gaming environments can be challenging and fun, encouraging children to engage in exercises at home. The aims of this project were to demonstrate the technical feasibility, ease of use, appeal, and safety of a computer-based videogame program designed to improve balance in children with CP. MATERIALS AND METHODS This study represents a close collaboration between computer design and clinical team members. The first two phases were performed in the laboratory, and the final phase was done in subjects' homes. The prototype balance game was developed using computer-based real-time three-dimensional programming that enabled the team to capture engineering data necessary to tune the system. Videogame modifications, including identifying compensatory movements, were made in an iterative fashion based on feedback from subjects and observations of clinical and software team members. RESULTS Subjects (n=14) scored the game 21.5 out of 30 for ease of use and appeal, 4.0 out of 5 for enjoyment, and 3.5 on comprehension. There were no safety issues, and the games performed without technical flaws in final testing. CONCLUSIONS A computer-based videogame incorporating therapeutic movements to improve gait and balance in children with CP was appealing and feasible for home use. A follow-up study examining its effectiveness in improving balance in children with CP is recommended.
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Affiliation(s)
- Sandra Radtka
- University of California , San Francisco and San Francisco State University Joint Graduate Program in Physical Therapy, San Francisco, California
| | | | | | - Judy Mastick
- Department of Physiological Nursing, University of California , San Francisco, San Francisco, California
| | - Marsha E Melnick
- University of California , San Francisco and San Francisco State University Joint Graduate Program in Physical Therapy, San Francisco, California
| | - Glenna A Dowling
- Department of Physiological Nursing, University of California , San Francisco, San Francisco, California
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Tatla SK, Sauve K, Jarus T, Virji-Babul N, Holsti L. The effects of motivating interventions on rehabilitation outcomes in children and youth with acquired brain injuries: a systematic review. Brain Inj 2014; 28:1022-35. [PMID: 24661000 DOI: 10.3109/02699052.2014.890747] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE To systematically review the evidence of the effects of motivating rehabilitation interventions on outcomes in children with acquired brain injury (ABI). METHODS A literature search of six databases was conducted to identify intervention studies published until July 2013. The American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) systematic review methodology was used as a framework. Two reviewers independently extracted data and assessed level of evidence and quality of studies. RESULTS Of 891 records initially retrieved, 166 were screened by abstract and 31 by full text; 10 studies comprised of five randomized controlled trials, two case series and three single subject research design studies met the inclusion criteria. Studies fell into three intervention categories: (1) token economy based interventions; (2) virtual reality (VR); and (3) memory and attention interventions. CONCLUSIONS A paucity of evidence has examined the effects of rehabilitation interventions with a motivational component. Token economies can significantly enhance memory and response inhibition performance in children with ABI. VR systems are motivating, yet findings are limited by the lack of use and availability of psychometrically evaluated measures of motivation. Findings point to the need for further research to evaluate the effects of motivation-based interventions.
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Affiliation(s)
- Sandy K Tatla
- Sunny Hill Health Centre for Children , Vancouver, BC , Canada
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