Monday, December 8, 2014

Annual Guide for Gamers with Disabilities

Ablegamers Holiday Gift Guide

Follow the link below to the AbleGamers’ holiday gift guide. It recommends the top 5 accessibility products, the top 6 games and games to avoid.

www.ablegamers.com/ablegamers-news/ablegamers-holiday-gift-guide-for-gamers-with-disabilities

Friday, November 14, 2014

Case-Based Reasoning for Active Video Games

Tool development

Helping Therapists Make Evidence-Based Decisions about Commercial Motion Gaming
Putnam, C. & Cheng, J.
Proceedings of the 15th International ACM SIGACCESS Conference on Computers and Accessibility; 10/2013, published in SIGACCESS Newsletter 107, September, 2013

Link to Abstract: www.researchgate.net/publication/260587395_Motion-games_in_brain_injury_rehabilitation_an_in-situ_multi-method_study_of_inpatient_care

Objective: The authors identified an information gap where "therapists did not have access to information (games that best met their therapeutic goals) that would help them make evidence-based decisions about which games to use in therapies."

Method: Interviews and observation revealed that therapists are frustrated with finding relevant information about newer games.

Outcome: Authors created a case-based reasoning tool which includes patient variables, session goals, game attributes, subjective and objective outcome measures. Development of this tool should help therapists better employ active video games in therapies.

Wednesday, October 29, 2014

CP Video Gaming

Video Game Review

Design and Evaluation of a Networked Game to Support Social Connection of Youth with Cerebral Palsy
Hernandez, H. A., Ketcheson, M., Scheider, A., Ye, Z., Fehlings, D., Switzer, L., Wright, V., Bursick, S. K., Richards, C. & Graham, T. C. N.
Proceedings of The 16th International ACM SIGACCESS Conference on Computers and Accessibility, October 20-22, 2014.
Abstract... DOI: http://dx.doi.org/10.1145/2661334.2661370

Liberi game was created for youth with GMFCS III to facilitate group game play through making the game easy to join and able to be played by those of differing physical abilities. Because there were no barriers to joining group play (automatic grouping), differences in skill level were managed by oral communication between players and by causing all avatars to move at the same speed (collective feedback). Automatic voice communication facilitated cooperative (and parallel) play. Liberi created a venue for differently-abled youth to 1) interact and 2) game.

Thursday, October 16, 2014

Video Games Through Therapist’s Eyes

Qualitative Research Report

Integrating Virtual Reality Video Games into Practice: Clinician’s Experiences
Levac, D. E. & Miller, P. A.
Physiotherapy Theory and Practice, 29(7) 504-512, 2013
DOI: 10.3109/09593985.2012.762078

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/23362843

Objective: Physical therapists report on using Wii video games with children with brain injuries.

Process: Six physical therapists were interviewed. Two themes arose "technology meets clinical practice", and "onus is on the therapist".

Outcome: There are benefits and challenges where technology meets clinical practice that call on the therapist to be committed to the technology to implement it successfully. "There is a substantial need for knowledge translation initiatives for clinicians in this area".

Thursday, October 2, 2014

Building a Clinical Videogame Tool

Qualitative Study

"Kinect-ing" with Clinicians: A Knowledge Translation Resource to Support Decision Making about Video Game Use in Rehabilitation
Levac, D., Espy, D., Fox, E., Pradhan, S. & Deutsch, J. E.
Physical Therapy Online, Sept 25, 2014
DOI: 10.2522/ptj.20130618

Link to abstract: ptjournal.apta.org/content/early/2014/09/24/ptj.20130618.abstract

Objective: Virtual reality and active video gaming offer promise yet lack evidence of effectiveness when used in clinical practice. Additionally, clinicians require knowledge translation resources to decide how to use video games in clinical practice. This paper describes development of a clinician’s resource for using Kinect video games in physical therapy.

Method: Sixteen clinicians from four sites completed questionnaires; five physical therapists analyzed the results towards developing a knowledge product.

Findings: "This paper described the process and feedback…for improving and further evaluating the 'Kinecting with Clinicians' resource using the 'Knowledge-to-Action cycle' framework to guide the proposed research methods." Next steps are to put the resource online and evaluate usefulness of online resources in clinical practice.

Thursday, September 25, 2014

Survey of VR Clinical Use

Survey

Using Virtual Reality in Clinical Practice: A Multi-Site Exploratory Study
Glegg, M. N. S., Holsti, L., Stanton, S., Hanna, S., Velikonja, D., Ansley, B., Sartor, D. & Brum, C.
NeuroRehabilitation : 2014 Sep 18 pg
DOI: 10:3233/NRE-141152

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/25238866

Objective: For inpatients with acquired brain injury, how is GestureTek virtual reality used for rehabilitation?

Method: 11 therapists at two rehab centres collected data over 8 months on 39 clients; their VR interventions and the therapists’ treatment goals.

Findings and conclusions: Clinical “treatment characteristics and several outcomes of interest paralleled those in the literature; however, novel outcome areas were identified as research gaps. By study’s end, more than half of clients’ VR programs had been discontinued, for reasons consistent with documented barriers to VR use. These findings can help… inform the design of research that has high clinical relevance, and… provide a point of reference for clinicians incorporating VR into their practices.”

Friday, September 5, 2014

Virtual reality conference



10th International Conference on Disability, Virtual Reality and Associated Technologies Gothenburg, Sweden, September 2–4, 2014

Sponsored by the International Society for Virtual Rehabilitation
The society provides a multidisciplinary forum for engineers, scientists and clinicians who are interested in employing new technologies for physical, psychological, cognitive, and social rehabilitation applications. The purposes of the society… are to promote discussion of key issues & encourage clarity in research paradigms, devise a common reference set of terminology / standards / definitions, create opportunities for collaboration and networking, represent the community with respect to funding, government policies, consumer groups and… provide recognition through awards for exceptional member activities."

Conference Presentations: www.icdvrat.org/2014/schedule2014_outline.htm
Abstracts: www.icdvrat.reading.ac.uk/2014/abstracts.htm

Pilot Study
Of  Note: Kinecting the moves: the kinematic potential of rehabilitation-specific gaming to inform treatment for hemiplegia
Glegg, S. M. N., Hung, C. T., Valdés, B. A., Kim, B. D. G. & Van der Loos, H. F. M.

"Two therapy applications for hemiplegic arm rehabilitation were developed and tested… Analysis of data provided by commercially available motion tracking technology could serve as an additional rehabilitation tool for therapists."

Abstract: www.icdvrat.reading.ac.uk/2014/papers/ICDVRAT2014_SP06_Glegg_Hung_etal.pdf
Full Text: caris.mech.ubc.ca/files/2014/08/Kinecting-the-Moves-The-kinematic-potential-of-rehab-ICDVRAT2014.pdf"

Wednesday, August 27, 2014

Patterns of Home Gameplay

Observational Study

Do people with intellectual disability use Nntendo Wii when placed in their home as part of a physitherapy program? An observational study.
Chung, A. M. J., Harvey, L. A, & Hassett, L. M.
Disability and Rehabilitation Assistive Techology Early online 1 – 6
DOI: 10.3109/17483107.2014.938705

Link to abstract www.ncbi.nlm.nih.gov/pubmed/25052846

Objective: In people with intellectual disability, how much Nintendo is played when prescribed as home physiotherapy?

Method: 20 participants with intellectual disability, average age 19, were receiving home-based physiotherapy. They were assigned Wii play for 12 weeks as an effective part of their therapy intervention. Participants or their carers recorded data biweekly. It is unknown whether or not the participants were encouraged to play by their carers or physiotherapists.

Findings: Weeks one and two recorded a median value of 100minuntes a week of play over a median of three days per week; in weeks 11 and 12, a median value of 35 muinutes of play once per week. Note: Averages were not available in the published data.

Thursday, August 14, 2014

Kids Report on Active Videogames at Home

Qualitative Report

Real life active gaming practices of 7 – 11 year old children
Allsop, S., Rumbold, P.L.S., Debuse, D. & Dodd-Reynolds, C.
Games for Health Journal, 2(6), 2013 pp. 347 - 353
DOI: 10.1089/g4h.2013.0050

Link to abstract

Objective: to determine real life behaviors during children’s active videogame play.

Method: 40 questionnaires were returned from 7-11 year old children and their parents.

Findings: of this sample, most children play Wii Sports for around 80 minutes once or twice a week. More than half the children ate or drank during game play and this extended game play. Most perceive active videogaming as “an alternative form of exercise, and the main reasons for active videogame play included for entertainment, health benefits and the environment.”

Monday, July 21, 2014

Therapist-friendly Kinect games

Qualitative study

Design and Evaluation of Virtual Reality-Based Therapy Games with Dual Focus on Therapeutic Relevance and User Experience for Children with Cerebral Palsy Ni, L. T., Fehlings, D. & Biddiss, E., Games for Health, 3(3), 2014-07-18
DOI 10.1089/g4h.2014.0003



Link to abstract: online.liebertpub.com/doi/abs/10.1089/g4h.2014.0003 journalCode=g4h

Objective: This qualitative study evaluates two therapist-made Xbox Kinect games, designed for fun, engagement and therapeutic value, for therapeutic relevance and user experience.

Process: Six therapists and eight 8 – 12 year old children (GMFCS I – III) scored questionnaires before and after playing custom Kinect games designed by therapists.

Outcomes: Therapists rated the games as of "average usability" and were able to focus and grade game play. They reported tracking problems (the system had difficulty distinguishing children’s movements from the assisting therapist’s). Children learned to beat the game. The games were "engaging to the child and therapeutically relevant".

Tuesday, July 8, 2014

Kinect game for children with CP

Gamification of physical therapy for the treatment of pediatric cerebral palsy: A pilot study examining player preferences. Whittinghill, D. & Brown, J. (2014), American Society for Engineering Education 121st Annual Conference & Exposition, Indianapolis, IN.

Pilot study

Link to content: www.asee.org/public/conferences/32/papers/10954/view

Objective: Few active games are made to meet the clinical needs of children with cerebral palsy. The authors created a Microsoft Xbox Kinect game based on the upper body physical therapy routines typically prescribed for children with cerebral palsy, and tested it for player satisfaction. Burnie is juvenile, whimsical and rich in positive feedback. "Reframing the therapy experience is the essence of Burnie’s gamification."

Method: A convenience sample of 21 6 – 34 year olds with and without cerebral palsy played Burnie for 15 minutes, then completed a post-game questionnaire.

Results: A Likert scale with 1 being least favourable and 10 most favourable returned values of overall enjoyment 6.75, pleasing esthetics 7.65 and pleasing game controls 5.4. A lower value on game controls may be a function of the discomfort experienced as a part of therapy exercise, a desired therapy outcome. Overall, the authors feel this study leads to a better 'behaviorally oriented physical therapy game experience'.

Tuesday, July 1, 2014

Wii for UE for CP hemiplegia

Upper limb training using Wii Sports Resort for Children with Hemiplegic Cerebral Palsy: a Randomized, Single-blind Trial
Chiu, HC., Ada, L. & Lee, HM. Clinical Rehabilitation, 2014, May 21
DOI: 10.1177/0269215514533709

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/24849793

Objective: For children with cerebral palsy, are there sustainable gains from a six-week home trial of Wii vs. traditional therapy?

Method: 62 children 6 – 13 years old (GMFCS levels I – V) played Wii bowling, air sports, frisbee and basketball at home 3 times weekly for 6 weeks. In addition all children received traditional therapy 3 times weekly. Participation, coordination, strength and hand function were measured at baseline, 6 and 12 weeks.

Results: Overall, the children completed 96% of all home-based Wii sessions and increased their Wii scores on all games through the test period. There were no differences in coordination or hand function noted. An increase in grip strength between the experimental and control groups was shown at 12 weeks. This may be related to the forced use of the children’s affected hand and arm. Anecdotes from caregivers report new hand movements and increased functional movements.

Tuesday, June 24, 2014

VR on UE in Children with CP: Meta-analysis

Effect of Virtual Reality on Upper Extremity Function in Children with Cerebral Palsy: A Meta-analysis
Chen, Y-P., Lee, S-Y. & Howard A.M. Pediatric Physical Therapy 2014:00 1 - 12
DOI: 10.1097/PEP.0000000000000046

Link to abstract:
www.ncbi.nlm.nih.gov/pubmed/24819682

Purpose: To systematically examine studies that consider the effect of active video games, virtual reality and robot therapy (VR) on improving upper extremity motor function in children with CP.

Method: A considered search strategy was used to include 14 research articles. A scoring system was used for the 3 RCTs, for 10 case series and one cohort study; a level of evidence was assigned to each based on the Oxford Centre for Evidence Based Medicine rating system.

Results: The RCT studies compared VR to traditional therapy, and the case series compared children before and after VR interventions. 5 studies were based on commercially available systems: Wii (1), Sony EyeToy Play (1), Gesturetek (3); the rest were experimental, custom engineered systems (7) or robot assisted interventions (2). The meta-analysis reports the 3 RCTs showed effectiveness for VR vs. traditional therapy, and ‘at least one positive change in one outcome measure in all the case series’. No relationship was seen between effectiveness and intervention length, duration, or frequency. Engineer-built experimental systems are found to be more effective than commercial systems. Commercially available active video games do not meet children’s needs as they cannot be adjusted individually to the child. Overall, the evidence was poor to fair. This meta-analysis makes no conclusive recommendations.

Thursday, June 12, 2014

The GestureTek Virtual Reality system in Rehabilitation: a Scoping Review

Scoping Review

Glegg, S.M.N., Tatla, S.K. & Holstii, L., Disability and Rehabilitation Assistive Technology 2014, 9(2); 89 – 111

Link to abstract:
www.ncbi.nlm.nih.gov/pubmed/23713408

Objective: This scoping review examines research literature with quantitative data specific to the GestureTek virtual reality system used in physical and cognitive rehabilitation. The purpose of this scoping review is to determine the practicality of a systematic review, to identify areas for further research, “…and to allow therapists to be able to seek out readily pertinent evidence to support their clinical decisions about their use of the technology”.

Method: An explicit search strategy was used, resulting in 44 included studies mostly relating to stroke. For cerebral palsy, five studies were reported with evidence level I, II or III: one single case study reported level III evidence for balance and mobility improvement, and another single case reported level I evidence for improved reach, by American Academy for Cerebral Palsy and Developmental Medicine criteria.

Findings: Few strong quality or high level evidence studies are available: lack of common outcome measures limits the possibility of a systematic review. High level, larger studies are needed. This scoping review provides a database of rated studies related to cerebral palsy habilitation and outcomes of balance, mobility and upper extremity improvement.

Thursday, April 24, 2014

Robot therapy for children’s arm rehabilitation

Effects of robotic therapy on upper-extremity function in children with cerebral palsy: A systematic review

Chen, Y-P & Howard, A. M.

Development Neurorehabilitation, Early Online 1-8, 2014
DOI: 10.3109/17518423.2014.899648

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/24724587

Objective: To systematically review the evidence of robotic therapy for the effects on upper extremity function for children with cerebral palsy.

Process: Robotic therapy is understood here to be “the application of electronic, computerized control systems to mechanical devices designed to perform human functions”. A literature search resulted in nine articles (7 case studies, one single case study and one randomized crossover design) relating to three robotic systems; CosmoBot, InMotion2, and NJIT-RAVR. These were reviewed on 11 qualitative scales, with results ranging from 3/11 to 9/11 and averaging 6/11, using a protocol developed by Kwakkel et al and Cambach et al. The studies’ outcome measures were grouped using the ICF model: range of motion, muscle tone and kinematics outcomes were classified as either body structure and function; or activity outcomes, which were scored on the QUEST, Melbourne or Fugl-Meyer scales; or on parent questionnaires. Effect sizes were calculated using the Cochrane Review Manager.

Results: Studies all reported either increased reach duration, smoothness, reduced tone or improvement in some clinical measure. The majority of case studies in this systematic review limit the recommendations that could come from more robust, group design studies. No recommendations can be made.

Tuesday, April 15, 2014

Wii balance board for rehabilitation

Review

Using the Wii Fit as a tool for balance assessment and neurorehabilitation: the first half decade of “Wii-search”

Goble, D. J., Cone, B. L. & Fling, B. W., Journal of Neuroeng Rehabil. 2014; 11:12

DOI: 10.1186/1743-0003-11-12

Link to full text article: www.jneuroengrehab.com/content/11/1/12

Objective: to review the Wii balance board controller (WBB) as a balance force platform measurement tool and as a neurorehabilitation intervention.

Process: WBB was compared with a scientific grade balance platform.

A literature search for “Wii Fit system or WBB for the assessment or training of balance ability” resulted in 11 papers that “trained balance in healthy adults” and 8 papers “that rehabilitated balance in clinical populations”; these were reviewed.

Outcomes: Custom applications have potential to provide low-cost ways to assess balance. Wii research using custom software is “an extremely promising area of exploration”. Research using Wii metrics for measuring balance is “far less convincing to date”. There is little correlation between Wii outcomes and clinical balance tests.

Wii is a motivating tool that typically generates improvements in balance. More robust research is required for the Wii Fit system as a balance intervention.

Wednesday, April 2, 2014

Balance measurement: Wii vs. BOT-2

Instrument Assessment

Evaluating the Nintendo Wii for Assessing Return to Activity Readiness in Youth with Mild Traumatic Brain Injury

DeMatteo, C., Greenspoon, D., Levac, D., Harper, J. A. & Rubinoff, M., Physical and Occupational Therapy in Pediatrics, Early online 1-16 2014-02-26

doi: 10-3109/01942638.2014.855103>/p>

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/24547689

Intent: “Post-injury assessments that challenge activity tolerance and balance are needed to determine readiness return to activity.” The maximal exertion and a count of loss-of-balance instances while playing Wii is compared to balance measures within Bruininks – Oseretsky Test of Motor Proficiency 2 ed. and the Community Balance and Mobility Scale.

Process: 24- 9 to 18 year olds who had experienced mild traumatic brain injury within the past year played a suite of Wii games one time. Losses of balance requiring a protective response were counted during game play and exertion as measured by heart rate, respiration rate and calorie expenditure.

Results: The technique of counting losses of balance during game play did not prove to be a useful assessment of balance and did not correlate with balance measures in BOT-2 and CBM. Of 6 games played, maximal exertion was generated by “Wii Fit Basic Run”.

Friday, February 14, 2014

A new video game assessment tool?

Instrument Development

Development and Use of an Observation Tool for Active Video Gaming and Movement (OTAGM) to Measure Children’s Movement Skill Components During Active Video Game Play

Rosa, R.L., Ridgers, N.D. & Barnett, L.M. in Perceptual and Motor Skills 117:3 (2013) 935-949

doi: 10.2466/03.25.PMS.117x28z4

Link to abstract amsciepub.com/doi/abs/10.2466/03.25.PMS.117x28z4

Objective: There is a growing interest in usefulness of active video games (AVG) for improving movement skills for children with CP. The Observation Tool of Active Gaming and Movement (OTAGM) is an observational tool for movement skills during AVG play. It aims to “capture and quantify specific skill components of children’s movement skills” during free play of AVG. The OTAGM was developed from the Test of Gross Motor Development-2ed (TGMD-2) with a subset of items that mesh with Nintendo Wii game offerings: strike, throw and roll. Specific components of movement skills are coded as well as task engagement, coded as ON/OFF; and body movement, further categorized as stationary-no movement, stationary-some movement, arm movement, leg movement, whole body movement.

This article reports on development, pilot testing and within-rater reliability of the measurement tool.

Process: 18 typically developing children 5 – 8 y/o played Nintendo one hour a week for six weeks. During play, 55-10 minute observations were coded. One child was videotaped for rating after a ten day interval.

Results: The tool needs to have further clarification between categories. Within-rater reliability was at least 83% across all categories. The usefulness of this tool will grow as it is tested in differently-abled populations and as it is able to report typical changes in the motor skills of children with CP.