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P 1152. Assessment of Therapeutically Guided Serious Gaming from the Point of View of the Treated Children and Adolescents—A Pilot Study
30 October 2018 (online)
Background: Important factors for successful rehabilitation are high motivation, high training intensity, and easy availability. Standard game consoles with motion sensors offer these benefits (e.g., Nintendo Wii, Microsoft Kinect), but are not individually configurable for therapeutic use. In recent years, “serious gaming” applications have been developed that are specifically tailored to the needs of rehabilitation (Knippenberg et al, J Neuroeng Rehabil). We have tested two software systems in collaboration with the software developers in our clinic on children with neurological movement disorders.
Goals: To test serious gaming in pediatric rehabilitation and to evaluate the current state of the art.
Question: Is there a subjectively measurable therapeutic success of the TGSG?
Methods: Sixteen children trained therapeutically guided twice a week in an inpatient setting for 15 to 30 minutes individually adjusted to their abilities and their physical and mental states on the day. VirtualRehab (Virtualware/EvolvRehab) and Gamo (reFit Systems) were deployed with the sensors Kinect (VirtualRehab/Gamo), LeapMotion (VirtualRehab), and Intel RealSense (Gamo). The children took turns training in small groups of two to three children. The cohort examined—consecutive inclusion of all children from 4 years of age with a minimum body size of 1 m—gave a representative picture of the patients of our clinic: the average age was 11 years, 10 children were female, 10 had cerebral palsy, and 6 children had acquired brain injury (traumatic brain injury, stroke, brain tumor). Based on GMFCS, nine children had Level I, three Level II, three Level III, and one child Level IV. The average AHA was 54. At the end of the training, the children received a questionnaire for the subjective assessment of their training success. A scale of 0 to 10 was used. We asked nine questions on the topics of fun in training, degree of challenge, whether the training was expedient, whether training alone or in a group made more sense, whether new movements were possible after training, and if the affected body parts have been used more in everyday life.
Results: Out of 16, 15 children had great fun in therapy, and just as many children have learned new movements with great success. Nine children felt that the therapy was a great challenge, that they were able to improve their stamina, and that they significantly increased the use of the affected body part. Eight children said that they reached their goals. The satisfaction in group training was significantly higher (12 children) than in individual training (6 children).
Conclusion: Serious gaming was perceived well by the children and rated very positively in regard to introduction of new movements. However, only 56% of children have reached their performance limit, increased stamina, and increased use of affected body parts. Fifty per cent of children have not worked directly on their rehabilitation goals through TGSG. The “serious” in the TGSG was partially accomplished, but the intensity should be increased. Studies that provide more quantitative and objective data are planned. A therapist is essential to increase motivation and individuality of training.