Background Attention-deficit/hyperactivity disorder (ADHD) affects between 4% and 8% of children worldwide. The treatment of choice is multimodal treatment. Multimodal interventions for ADHD may be improved by incorporating new treatments, such as treatment via serious video games. The Secret Trail of Moon (TSTM) is a virtual reality serious video game that was designed for cognitive training related to core ADHD symptoms and executive dysfunction. Objective We aimed to describe the development and usability of TSTM. Methods The usability study included 37 children and adolescents who tested TSTM during the early usability stage (preinclusion) of a randomized controlled clinical trial for testing the effectiveness of TSTM. Chi-square tests were performed to compare patients with ADHD (ADHD combined subtype vs inattentive subtype) and to compare frequent and infrequent video game players in the second study. We used SPSS version 20 for Macintosh (IBM Corporation). Results A total of 31/37 (86%) and 30/37 (83%) of participants liked playing TSTM and wanted to continue playing TSTM, respectively. Further, 5/37 (14%) of participants reported that they experienced either perceived dizziness or virtual reality motion sickness. We found no statistically significant differences after comparing the ADHD combined subtype to the inattentive subtype and frequent video game players to infrequent video game players. Conclusions Serious video games, such as TSTM, may complement the current multimodal approach for treating ADHD. Trial Registration ClinicalTrials.gov NCT04355065; https://clinicaltrials.gov/ct2/show/NCT04355065
ObjectiveTo carry out a quasi-systematic review of the use of serious video games for health as a cognitive rehabilitative tool in patients diagnosed with attention-deficit hyperactivity disorder.MethodA quasi-systematic review of serious video games used as an evaluative and rehabilitative tool in patients with ADHD was conducted. It included behavioral patterns in the use of video games and addiction problems in this population. For its elaboration the PRISMA GUIDES were followed. The search was carried out in three PubMed databases, MEDLINE, and PsycInfo using the keywords: [game OR serious game OR computer game) AND (psychotherapy OR rehabilitation OR intervention OR mental disorders) AND (adhd)], [(adhd) AND (Video game addiction)]. All articles written in English, Spanish, or Portuguese from January 1970 to June 2021 were included: those in which reference was made to the use of video games and/or new technologies as a therapeutic and evaluative tool in children and adults diagnosed with ADHD, as well as those that referred to behavioral and clinical patterns in the use of video games.ResultsWe found 605 articles of which 128 were reviewed (44 observational studies, 26 quasi-experimental studies, 26 experimental studies, 8 systematic reviews, 9 narrative texts, 6 case reports, 7 pilot studies, 8 systematic reviews, and 2 meta-analyses). Serious video games can be used to ameliorate ADHD symptoms while improving adherence to treatment. Some serious video games show high accuracy properties assessing ADHD features.ConclusionSerious video games for health are increasingly being used as a cognitive rehabilitation tool in patients with attention-deficit hyperactivity disorder (ADHD).Systematic Review Registration[www.crd.york.ac.uk/prospero], identifier [CRD42021247784].
Video game–based therapeutic interventions have demonstrated some effectiveness in decreasing the symptoms of attention deficit hyperactivity disorder (ADHD). Compared with more traditional strategies within the multimodal treatment of ADHD, video games have certain advantages such as being comfortable, flexible, and cost-efficient. However, establishing the most appropriate type(s) of video games that should be used for this treatment remains a matter of debate, including the commercial existing video games or serious video games that are specifically constructed to target specific disorders. This guide represents a starting point for developing serious video games aimed at treating ADHD. We summarize the key points that need to be addressed to generate an effective and motivating game-based treatment. Following recommendations from the literature to create game-based treatments, we describe the development stages of a serious video game for treating ADHD. Game design should consider the interests of future users; game mechanics should be based on cognitive exercises; and therapeutic mechanisms must include the control of difficulty, engagement, motivation, time constraints, and reinforcement. To elaborate upon this guide, we performed a narrative review focused on the use of video games for the treatment of ADHD, and were inspired by our own experience during the development of the game “The Secret Trail of Moon.”
Background Compared with traditional approaches, gaming strategies are promising interventions for the treatment of attention-deficit/hyperactivity disorder (ADHD). We developed a serious game, The Secret Trail of Moon (TSTM), for ADHD treatment. Objective The main objective of this clinical trial was to demonstrate the effectiveness of an add-on, either TSTM or Therapeutic Chess (TC), in previously optimally drug-titrated, clinically stable patients with ADHD. Methods This study is a prospective, unicentric, randomized clinical trial in clinically stable patients with ADHD, aged 12 to 22 years. The TSTM (n=35) and TC groups (n=34) performed 12 weekly sessions of their respective treatments. The control group (CG) patients (n=35) were called by phone every week, but they received no cognitive intervention. The primary end point was the change from baseline to end point in the parent “Behavior Rating Inventory of Executive Function-2” (BRIEF-2; patients’ parents) in the per-protocol population (31 serious videogame: 24 TC and 34 CG). Results Our study failed to probe clear-cut improvements in the global score of the BRIEF-2. However, the TC group showed improvements in measures of emotional control, emotional regulation, and inattention. The TSTM group showed improvements in measures of emotional regulation, inattention, and school context. Conclusions TSTM and TC did not improve executive function symptoms, but they improved ADHD symptomatology related to emotional regulation. Further studies with bigger samples are required to confirm these preliminary findings. Trial Registration ClinicalTrials.gov NCT04355065; https://clinicaltrials.gov/ct2/show/NCT04355065
BACKGROUND Attention-Deficit/Hyperactivity Disorder (ADHD) affects between 4% and 8% of children worldwide. The treatment of choice is multimodal treatment. Unfortunately, multimodal treatment is usually insufficient to fully correct ADHD. Accordingly, the incorporation of new treatments such as serious video games may be a good strategy. Here, we present a Virtual Reality (VR) chess-based serious video game (“The Secret Trail of Moon”, TSTM), which was specifically designed to treat core ADHD symptoms and executive dysfunction. OBJECTIVE This study aims to describe the development, proof of concept and usability of TSTM. METHODS We included information about: 1) a brief market study (n=56) over the potential interest of professionals in using a serious video game such as TSTM, and 2) a proof-of-concept and usability study including 37 children and adolescents who tested the initial versions of TSTM during an ongoing randomized controlled clinical trial testing the effectiveness of TSTM. RESULTS Eighty-six percent and 83% of participants liked and would like to continue playing TSTM, respectively. Thirteen and nine-tenths percent were reported to have either perceived dizziness or VR motion sickness. We found no statistically significant differences after comparing either ADHD combined vs. inattentive subtypes or frequent vs. infrequent video game players. Furthermore, wearing glasses did not affect our results. CONCLUSIONS Serious video games such as TSTM may help educational and medical professionals to either diagnose or treat ADHD. TSTM, a VR chess gamified serious video game was well-tolerated and most participants liked and wanted to continue playing TSTM. CLINICALTRIAL ClinicalTrials.gov NCT04355065; https://clinicaltrials.gov/ct2/show/NCT04355065
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