As motion interactive games have become more widespread the interest in using these games in rehabilitation of children with motor disorders has increased among both clinical professionals and the families of these children. The general aim of this thesis was to evaluate the feasibility of using interactive games in rehabilitation of children to promote motivation for practice, physical activity, and motor control. A systematic review of published intervention studies was conducted to obtain an overview of existing research and the current levels of evidence for using interactive games in motor rehabilitation of children. Sixteen studies met the inclusion criteria, out of these three were randomized controlled trials while half were case series or case reports. Thirteen studies presented positive findings, which indicated a promising potential. However, more convincing research is needed. Commercially available motion interactive games have only been used in a few studies on motor control, and in none of these home based practice was provided. Moreover, no earlier studies have evaluated if these games may increase motivation for training and daily physical activity among children with disabilities. To address these issues a feasibility intervention including 15 children in the ages 6-16 years and with mild to moderate cerebral palsy was conducted. Each child was provided with a Sony PlayStation2â and the EyeToyâ games in Play3, and was recommended to practice with the provided games for at least 20 minutes/day during four weeks. The intervention was evaluated with gaming diaries, physical activity monitors (SenseWear Armband), interviews with the parents, and the clinical motor tests Movement Assessment Battery for Children-2 (mABC-2), Bruininks-Oseretsky Test of Motor Proficiency subtest 5:6, and the 1 Minute Walk Test. In addition, 3D motion analysis was used to evaluate effects on quality of goal-directed arm movements towards virtual and real objects, respectively. Motivation for practice and compliance of training were high, although declining somewhat during the course of the four weeks. The children’s physical activity increased significantly during the intervention. However, four children were excluded from this analysis due to lack of complete data from the physical activity monitors. According to mABC-2 the children’s motor performance improved, but there were both floor and ceiling effects, indicating a low sensibility of this test. The two additional motor tests showed only non-significant progress. Results from the 3D motion analysis suggest that the children improved movement precision when playing the games, movement smoothness when reaching for real objects, and used a more economic reaching strategy with less trunk involvement. In the interviews the parents expressed the view that motion interactive games promote positive experiences of physical training and add elements of social interaction to the training. They also experienced less urge to take on a coaching role. The training provided by the games was considered unspecific and there was a desire for individualized games to better address the unique rehabilitative need of each child. In conclusion, it is feasible to use motion interactive games in home rehabilitation for children with cerebral palsy to promote short term motivation for practice and general physical training. Specific effects on motor control need to be further explored and there is also a need for reliable tests that are adequate and sensitive enough to capture changes in movement control. In future development of interactive games for rehabilitation purposes, it is a challenge to preserve the motivational and social features of games while at the same time optimizing an individualized physical training.
| Identifer | oai:union.ndltd.org:UPSALLA1/oai:DiVA.org:umu-42792 |
| Date | January 2011 |
| Creators | Sandlund, Marlene |
| Publisher | Umeå universitet, Sjukgymnastik, Umeå : Umeå university |
| Source Sets | DiVA Archive at Upsalla University |
| Language | English |
| Detected Language | English |
| Type | Doctoral thesis, comprehensive summary, info:eu-repo/semantics/doctoralThesis, text |
| Format | application/pdf |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | Umeå University medical dissertations, 0346-6612 ; 1419 |
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