What makes therapy work?

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


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

Link to abstract: www.sciencedirect.com/science/article/pii/S089142221100343X

Objective:
Active ingredients are why a treatment is expected to be effective. Rehabilitation therapists might identify the dosage, intensity of treatments, or the therapist-client interaction, as active ingredients in usual or traditional treatments. The goal of this article is defining the active ingredients of interactive computer play.

New pediatric rehabilitation interventions like interactive computer play are often incorporated into clinical practice without a clear understanding of their active ingredients. Reviews of the literature, while positive, lack strong conclusions and urge more stringent designs.

Method: Scoping reviews can be applied to identify a field of research and interpret the findings of the studies that are reviewed. The purpose of this scoping review is to identify the potential active ingredients of video game and virtual reality interventions used to improve motor outcomes in children and youth with neuromotor impairments.

Findings:A number of studies were gathered and analyzed for themes revealing potential active ingredients either explicitly or implicitly referred to in the study.
Authors explicitly linked the following as possible active ingredients. They were characterized as belonging to a property of the game, an effect of the intervention on the user, or a role of the therapist.

Properties of the game include: duration, frequency or intensity of practice; task relevance to real-world activities, within-game parameters, feedback, and equal-opportunity play. Effects on the user included: neuroplastic changes, problem-solving and motivation. Support roles included one-to-one support, verbal feedback, and parental involvement and enthusiasm.

While little is currently known about the active ingredients in successful therapeutic interventions using virtual reality or video gaming, there is the opportunity to develop theoretical models that predict these ingredients.