Active video games and Developmental Coordination Disorder

RCT

A crossover randomised and controlled trial of the impact of active video games (AVG) on motor coordination and perceptions of physical ability in children at risk of Developmental Coordination Disorder (DCD)

Straker, L., Howie, E., Smith, A., Jensen, L., Piek, J. & Campbell, A.

Human Movement Science, 42 (2015) 146 – 160

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/26037276

Objective: In children with DCD, does exposure to AVG vs video game avoidance result in changes to motor coordination, or changes to parents’ or subjects’ perception of motor coordination.

Method: Twenty-one 9 to 12 year old children at risk of DCD were randomized in an unblinded cross-over study. They completed the Movement Assessment Battery for Children-2 (MABC-2) and 3D motion analysis at the beginning of the study and after each condition; video game avoidance and AVG. AVG was done for a minimum of 20 minutes a day for at least 4 days a week for 16 weeks. Parents completed the Developmental Coordination Disorder Questionnaire (DCDQ) and their children, used a global scale to report changes in their physical skills.

Findings: No significant differences were noted in MABC-2 scores, in 3D motion analysis or in the parents DCDQ ratings. "The children reported their motor skills to be significantly enhanced as a result of the AVG intervention in comparison to the period of no intervention".

Kinect: Clinician's Resource

Resource development
Levac, D., Espy, D., Fox, E., Pradhan, S. & Deutsch, J. E.
"Kinect-ing" with Clinicians: A Knowledge Translation Resource to Support Decision Making About Video Game Use in Rehabilitation
Physical Therapy 2015;95:426-440.

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/25256741

Problem: There is a perceived need for support to use of Kinect clinically.

Objective: “…development and preliminary evaluation of a knowledge translation resource to support clinical decision making about selection and use of Kinect games in physical therapy”.

Process: Interviews or focus groups were conducted with 16 clinician participants over 4 sites.

Outcome: Production of “Kinecting With Clinicians Resource (KWIC). Categories include game selection (player or game driven, stability, mobility, mobility plus); game play (spatial accuracy, temporal accuracy, duration, cognitive operators, augmented feedback, progression, score).

Rapid Review: Commercial Gaming Systems for Neurorehabilitation

Commercial Gaming Systems for Neurorehabilitation: Clinical Effectiveness
Published February 18th, 2015 by CADTH

Link to full text

This rapid review is provided by the Canadian Agency for Drugs and Technologies in Health. CADTH reviews drugs, devices, tests and treatments. Rapid reviews are an increasingly popular product, with a turn-around in as little as 3 days.

Objective: What is the evidence of clinical effectiveness of commercial gaming systems for patients undergoing neurorehabilitation?

PICO

• Patients undergoing rehabilitation therapy (acquired or traumatic brain injury, stroke, cerebral palsy, multiple sclerosis, etc.)
• Intervention Use of commercial gaming systems (e.g., Xbox, Kinect, Wii, Wii Fit, etc.)
• Comparator None, or any other established method of neurorehabilitation
• Outcomes Clinical benefits: improved function outcomes (e.g., upper extremity function, range of motion, strength, coordination, balance, mobility, gait, etc.)
• Study Designs Health technology assessments, systematic reviews, meta-analyses, randomized controlled trials, non-randomized studies.

Process: Searches identified six systematic reviews and seventeen randomized controlled trials that were suitable for inclusion.

Outcomes: Each article is summarized in a table; general conclusions are not drawn.

Video Gaming for Rehab

Scoping review

A scoping review of video gaming in adult rehabilitation

Ravenek, K. E., Wolfe, D. L. & Hitzig, S. L.

Disability and Rehabilitation Assistive Technology Early online 1 – 9 DOI: 10.3109/17483107.2015.1029538

Link to abstract: informahealthcare.com/doi/abs/10.3109/17483107.2015.1029538

Objective: To review published research for video gaming with adult rehabilitation.

Process: Five databases were searched for articles arising from 1990. 30 articles met the criteria; they are published in English, use commercially available game systems for adults in rehabilitation settings, describe an intervention and an outcome that is measured.

Scoping reviews take a wide view of emerging topics to synthesize a summary of research and research gaps. The scoping review methodology is taken from Levac et al. “Scoping Studies: Advancing the Methodology”. The process: identify a research question, find studies, filter, organize, synthesize and communicate the results.

Outcome: Nintendo Wii was most often used for adults in rehabilitation settings at risk for falls or with decreased balance (Intervention), and most commonly measured with the Berg Balance Scale (Outcome measure).

Reference: Levac, D., Colquhoun, H. & O’Brien, K. K. Scoping Studies: Advancing the Methodology, Implementation Science, 2010;5:67-77. Full text: www.implementationscience.com/content/pdf/1748-5908-5-69.pdf

New Center for Digital Games Research

New Resource

The Center for Digital Games Research, at the University of California at Santa Barbara, takes a wide, cross-disciplines approach to the design and play of video games and digital media in general.

Digital games, now so embedded in our culture, have a place “in helping us make healthier decisions and foster healthier lifestyles.” The Center for Digital Games Research considers how people interact with health games and how games can be improved to be more effective.

Included in center’s activities are 21 funded projects, and the publication of a health games database, which catalogues “information about hundreds of games, publications, organizations and events - all focused on the use of digital games for health and health care”.

Center for Digital Games Research www.cdgr.ucsb.edu

Database www.cdgr.ucsb.edu/db

News article www.news.ucsb.edu/2015/014784/games-people-play

Therapists’ thoughts on Gaming and Social Media

Qualitative Study

Therapist’s Perceptions of Social Media and Video Game Technologies in Upper Limb Rehabilitation

Tatla, S. K., Shirzad, N., Lohse, K. R., Virji-Babul, N., Hoens, A. M., Holsti, L., Li, L. C., Miller, K. J., Lam, M. Y. & Van der Loos, H. M.

JMIR Serious Games, 2015 3 (1):e2 DOI: 10.2196/games.3401
PMID: 25759148

Full content*: games.jmir.org/2015/1/e2

Objective: The objective of (this) study was to explore therapists’ perceptions of how young people and adults with hemiplegia use gaming and social media technologies in daily life and in rehabilitation, and to identify barriers to using these technologies in rehabilitation.

Method: A purposive sample of occupational and physical therapists was gathered for two focus group sessions. Participants were guided through a semi-structured interview with open questions. The content was audio recorded and transcribed. Coding allowed themes to emerge; participants were involved in affirming the findings.

Findings: The authors identified three themes relating to social media and gaming technologies: the presence or uptake in the lives of rehabilitation clients; barriers to use in therapy, and possible benefits. Clients varied in their use of social media and gaming technologies, and therapists also made limited use of these. Barriers to use included age appropriateness, the therapists’ concern with client’s privacy, questionable transferability of skills, lack of accessibility, and “reconciling (the) therapist role within the gaming context”. Benefits included the social-emotional, rehabilitation and usability features of social media and videogaming.

Examined through the lens of Diffusion of Innovation Theory, barriers to uptake included “increased complexity, limited relative advantage, perceived lack of compatibility with values of some clients and therapists’ reconciling compatibility with their values”. Facilitators of uptake included “motivation, trialability, social connection as key benefit, and perceived compatibility with values of some clients”.

---

*This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Serious Games, is properly cited. The complete bibliographic information, a link to the original publication on http://games.jmir.org, as well as this copyright and license information must be included.

Remapping the Brain with Videogames

Review

Should we integrate video games into home-based rehabilitation therapies for cerebral palsy? Biddess, E. Future Neurology 2012;7 (5) 515-518

For full text Google: “Should we integrate video games into home-based rehabilitation therapies for cerebral palsy?”

Summary: This article reviews the effectiveness of video games on neuroplasticity. Two articles are cited, each using specialized gaming systems and showed neural changes related to specific neurological goals. You et al.(1) found “cortical reorganization following a 4 week intervention with an 8 year old child with hemiparetic CP who engaged in videogame play for 60 min durations, 5 times a week.” Goloumb et al.(2) showed “improved functional scores and altered cortical activation profiles during a grasp tasks in a study fo three adolescents with hemiplegic CP who participated in videogame play for 30 min per days, 5 days a week over a three month period.”

Other trends noted with video games used in therapeutic environments are that games that allow a latitude of movement variability typically would diminish therapeutic benefits, that games typically offer limited possibilities of movement regimes that fit with therapeutic goals, and that in-game feedback and rewards are not always sufficient to motivate the player to persist to the level of therapeutic benefits.

1. You SH, Jang SH, Kim Y, Kwon Y, Barrow I, Hallett M. Cortical reorganization induced by virtual reality therapy in a child with hemiparetic CP. Dev. Med. Child Neurol.47,628–635 (2005).
2. Golomb MR, McDonald B, Warden S et al. In-home virtual reality videogame telerehabilitation in adolescents with hemiplegic CP. Arch. Phys. Med. Rehabil.91,1–7 (2010).