Video games as a rehabilitation strategy for children with cerebral palsy

Abstract

Video games have recently emerged as a potential motivational tool in rehabilitation. Research suggests that video games can enhance motivation to exercise and increase adherence to physical practice. Active video games (AVGs), also known as “exergames” require body movement beyond the conventional hand controller-based video games. AVGs have been used for rehabilitation purposes in population with neuromotor dysfunction such as stroke and Parkinson’s disease. There is emerging interest in using AVGs to augment rehabilitation with children with cerebral palsy. However, it is unclear whether AVGs are effective for improving rehabilitation outcomes for this group of children. This thesis comprised two parts; Part one is a systematic review and metaanalysis for the effectiveness of video games in the rehabilitation of children with Cerebral Palsy (CP) (Chapter 2). The systematic review is a summary of the evidence of effectiveness for AVGs used as a rehabilitation tool for improving outcomes including balance, executive functioning, reaction time, upper limb function, visual perceptual skills, and gross motor function. In total, 19 studies were included based on the eligibility criteria and were divided into three categories based on the comparisons in the study: 1) video games compared to no therapy, 2) video games compared to regular therapy, 3) video games and regular therapy compared to regular therapy. The evidence to support the effectiveness of AVGs for improving rehabilitation outcomes was weak and inconclusive due to issues in the quality of the included studies. The second part of this thesis is a description of a detailed process involved in the design, development, and preliminary evaluation of an AVG for lower limb strength training in children with CP. The reflection includes challenges and lessons learned through the process. A preliminary evaluation of the AVG provides an understanding of the feasibility and usability of the gaming system with respect to enjoyment, motivation, game engagement, and system usability.