Upper Body Physical Rehabilitation for Children with Ataxia through IMU-Based Exergame

Abstract

Background: Children with ataxia experience balance and movement coordination difficulties and needs intensive physical intervention to maintain functional abilities and counteract the disorder. Exergaming represents a valuable strategy to provide engaging physical intervention to children with ataxia, sustaining their motivation to perform the intervention. This paper aims to describe the effect of a home-conducted exergame-based exercise training for upper body movements control of children with ataxia on their ataxic symptoms, walking ability, and hand dexterity. Methods: Eighteen children with ataxia were randomly divided into intervention and control groups. Participants in the intervention group were asked to follow a 12-week motor activity program at home using the Niurion® exergame. Blind assessments of participants’ ataxic symptoms, dominant and non-dominant hand dexterity, and walking ability were conducted. Results: On average, the participants performed the intervention for 61.5% of the expected time. At the end of the training, participants in the intervention group showed improved hand dexterity that worsened in the control group. Conclusion: The presented exergame enhanced the participants’ hand dexterity. However, there is a need for exergames capable of maintaining a high level of players’ motivation in playing. It is advisable to plan a mixed intervention to take care of the multiple aspects of the disorder.

The Care and Management of Children and Young People with Ataxia Telangiectasia Provided by Nurses and Allied Health Professionals: a Scoping Review

“…One study also suggested that the degree of benefit was dependent on the amount of training, demonstrating the need for continuous and frequent training to optimize subsequent outcomes [ 37 ]. Another study that used exergames for upper body rehabilitation reported improvement in hand dexterity of children with ataxia; the disease severity data, however, showed no significant change for participants [ 40 ]. Although A-T was only represented by three participants across all five studies [ 25 , 37 , 40 ], the positive outcomes following these interventions suggest they may warrant further study regarding their applicability to the management of children and young people with A-T.…”

“…Of particular note within the exercise-based research studies were six papers that examined the impact of technology. Although only three children with A-T were included within these studies [24,25,[37][38][39][40], the overall improvements observed in balance and ataxia highlight the potential for technology as a home-based rehabilitation strategy, reducing exposure to infections within acute healthcare settings and limiting travel-related fatigue. Hydrotherapy was also commonly recommended for A-T, including in combination with other exercises, and was the most frequent intervention recommended by parents for children with Friedreich ataxia.…”

“…The benefits of tailored virtual reality and exergamebased coordinative training (including a combined approach with physiotherapy) were explored in six studies which mostly reported reduced ataxia symptomology following their respective intervention [24,25,[37][38][39][40], and in many cases this was considered to be clinically meaningful. Furthermore, the reported effects of immersive virtual reality and videogaming were considered to translate into daily living [25,37].…”

Effect of Exercise on the Ability of Children with Cerebellar Ataxia to Perform Activities of Daily Living

“…program at home using the Niurion exergame) improved the hand dexterity, but not the SARA score and gait parameters, of children with ataxia, including cerebellum-related ataxia [37] .…”