What make up good video game interventions?

Scoping review

Defining the active ingredients of interactive computer play interventions for children with neuromotor impairments: A scoping review.

Levac, D., Rivard, L. & Missiuna C. in Research in Developmental Disabilities 33 (2012) 214 – 223

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/22093667

Scoping reviews summarize research activity in an area of health evidence to clarify concepts, disseminate information or identify gaps; typically without evaluating the strength of the studies, and often in emerging areas where there is little RCT-based evidence.

Objective: “New rehabilitation interventions are often evaluated in research and incorporated into practice without a clear understanding of their active ingredients.” The authors focus on the components of video game interventions that may affect motor performance in children with neuromotor impairments.

Process: A literature search based on the kernels ‘interactive computer play’ and ‘intervention’ resulted in 23 articles, and led to a thematic analysis explicitly and implicitly linking intervention components with outcomes.

Results: Themes that emerged…

• Video game properties: opportunities for practice, similarity of tasks to real-world movements , adaptability for individuals, feedback, social play.
• Outcomes for the user: neuroplastic changes, problem-solving & motivation due to competition and game characteristics.
• Therapist role as support person.

Video games are an emerging technology applied to rehabilitation. Identifying the components of video games that may contribute to outcomes is a step on the way.

Evidence for video games as therapy for children with CP

Systematic review
Interactive computer play as ‘motor therapy’ for individuals with cerebral palsy

Fehlings, D., Switzer, L., Findlay, B. & Knights, S. in Seminars in Pediatic Neurology, 20:127 – 138

Link to abstract: ncbi.nlm.nih.gov/pubmed/23948687

Objective: To evaluate the quality of evidence for the use of interactive computer games (including video games or virtual reality games) to help motor control and fitness for children with cerebral palsy.

This review covered "any kind of computer game or virtual reality technology where the individual can interact and play with virtual objects in a computer-generated environment". The articles were separated into three groups based on whether the intervention targeted upper extremity, lower extremity or general fitness outcomes.

Process: Literature searching resulted 17 articles that met all the inclusion critera. The American Academy of Neurology Classification of Evidence (AANCE) was used to classify the strength of the articles. Link to document: //qibawiki.rsna.org/images/3/33/American_Academy_of_Neurology_Classification_of_Evidence-20100504.doc

Results: The evidence for use of interactive video games to improve upper extremity function or overall fitness is not ‘statistically conclusive or clinically significant’ – AANCE level U (unproven). The AANCE rating for lower extremity (gross motor) improvements is level B (probably effective). More randomized controlled trials of longer duration with bigger subject sizes will add to the existing evidence.