Personalized balance games for children with cerebral palsy: A pilot study

Abstract

PURPOSE: To assess the changes in balance function in children with cerebral palsy (CP) after two weeks of daily training with personalized balance games. METHODS: Twenty-five children with CP, aged 5 to 18 years were randomly selected for experimental or control groups. Over a period of two weeks, all participants received 8–9 game sessions for 15–20 minutes, totaling 150–160 minutes. The experimental group used personalized balance games available from the GAmification for Better LifE (GABLE) online serious gaming platform. Children from the control group played Nintendo Wii games using a handheld Wii Remote. Both groups received the same background treatment. Recorded outcome measures were from a Trunk Control Measurement Scale (TCMS), Timed Up & Go Test (TUG), Center of Pressure Path Length (COP-PL), and Dynamic Balance Test (DBT). RESULTS: After two weeks of training in the experimental group TCMS scores increased by 4.5 points (SD = 3.5, p< 0.05) and DBT results increased by 0.88 points (IQR = 1.03, p< 0.05) while these scores did not change significantly in the control group. Overall, TUG and COP-PL scores were not affected in either group. CONCLUSION: This study demonstrates improvement of balancing function in children with CP after a two-week course of training with personalized rehabilitation computer games.

Effect of Virtual Reality on Balance Function in Children With Cerebral Palsy: A Systematic Review and Meta-analysis

“…All studies measured balance using at least one instrument, and five studies used two or more instruments to assess patients' balance ( 9 , 53 – 56 ). Eight studies used the PBS assessment tool ( 41 , 43 , 51 – 53 , 55 , 57 , 59 ), five studies used the CoP Kinematics system (balance force plate) ( 19 , 41 , 48 , 50 , 53 ), three studies used the TUG ( 54 – 56 ), two studies used the BOTMP ( 9 , 49 ), and one study used the MABC-2 ( 58 ), FRT ( 56 ), MFRT ( 60 ), PRT ( 42 ) and DBT ( 54 ).…”

“…The applied VR interventions could be categorized into two groups ( Figure 3 ). One group of 11 studies used the intervention with a game component ( 19 , 41 , 42 , 50 , 52 , 54 , 56 – 60 ), and the other seven used real-time feedback or interactive exercise in the virtual world ( 9 , 43 , 48 , 49 , 51 , 53 , 55 ). The interventions in all these studies were as follows: the total amount of treatment (160–1,680 min), duration of treatment (20–60 min), and intervention period (2–12 weeks).…”

“…Park et al further confirmed the effect of the intervention using the MFRT ( 60 ). Hsieh et al ( 53 ), Kachmar et al ( 54 ), and Lazzari et al ( 55 ) also used TUG to confirm further significant improvement. AlSaif et al also confirmed a significant effect of the Nintendo Wii intervention using the MABC-2 test ( 58 ).…”

“…Moreover, five articles used both methods for outcome measurement ( 9 , 53 – 56 ). Of these, two measured dynamic and static balance outcomes ( 41 , 53 ), and three were focused on dynamic balance ( 54 – 56 ). Sajan et al's study showed no significant difference between the experimental and control groups for either dynamic balance or static balance ( 41 ).…”

Game-Based Dual-Task Exercise Program for Children with Cerebral Palsy: Blending Balance, Visuomotor and Cognitive Training: Feasibility Randomized Control Trial

“…Several gaming systems have been used in the rehabilitation of balance in children with CP, which include Nintendo Wii Fit [ 14 , 15 , 16 ], Microsoft Xbox Kinect [ 16 , 17 ], Dance Mat [ 18 ], and PlayStation Eye Toy [ 19 ]. Other purpose-built rehabilitation gaming systems include various force platforms/pressure mats, which record the center of foot pressure signals (COPs), or video cameras to interact with computer games [ 20 , 21 , 22 ].…”