Adaptive Gaming for Pediatric Upper Limb Differences

Overseen By Meghan C Guglich, C.P.(c), MSc.

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Manitoba

Disqualifiers: Bilateral limb difference, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

20 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new one-handed video game controller adapter to determine if it helps kids with an upper limb difference play and enjoy video games more. The study will assess whether the adapter improves game performance and user satisfaction. Kids aged 7 to 17 with a limb difference in one arm, regardless of the cause, might be suitable candidates. Participants will try the adapter at home for a week and share their experiences. Researchers will collect feedback and performance data before and after using the adapter to evaluate its effectiveness. As an unphased trial, this study offers participants a unique opportunity to contribute to innovative solutions that could enhance gaming experiences for kids with limb differences.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that this gaming adapter is safe for children with upper limb differences?

Research has shown that specially adapted video game controllers, like the one-handed adapter in this study, are generally safe. Studies have found that these controllers work well for individuals with various physical challenges, such as brain or spinal cord injuries. This suggests that the controllers are easy to use and do not pose major safety risks. Users have reported better gaming experiences without significant problems. While this specific adapter is still under testing, similar devices have been well-received by users, indicating their safety and ease of use. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the One Handed Video Game Controller Adapter because it offers a specialized solution for children with upper limb differences, allowing them to engage in gaming with greater ease. Unlike standard adaptive devices that often require significant customization or are limited in function, this adapter is designed specifically for seamless gaming integration, enhancing both speed and accuracy in gameplay. By providing a user-friendly tool that can be used with popular consoles like Xbox, this treatment not only fosters inclusivity in gaming but also helps in improving fine motor skills and coordination in a fun, engaging way.

What evidence suggests that this one-handed gaming adapter is effective for improving video game performance and enjoyment in children with an upper limb difference?

Research has shown that specially designed video game controllers enhance gaming for people with physical challenges. For example, one study found that these controllers improved hand movement and skill in children needing arm therapy. Other research indicates that adapted controllers provide a fun and easy way for individuals with movement difficulties, such as those with spinal cord injuries, to play games. In this trial, all participants will use a one-handed video game controller adapter to support one-handed gameplay. These studies suggest that such an adapter could help children with arm differences play better and enjoy games more. Early findings highlight how adaptive gaming tools can make video games more inclusive and enjoyable for everyone. ^{1 2 6 7 8}

Who Is on the Research Team?

Meghan C Guglich, C.P.(c), MSc.

Principal Investigator

Rehabilitation Centre for Children

Are You a Good Fit for This Trial?

This trial is for children aged 7-17 with one upper limb difference, regardless of its cause or whether they've used a prosthesis. They must speak English, be able to follow instructions, and live in or can travel to Winnipeg for two appointments.

Inclusion Criteria

You are able to converse in English.

I can understand and follow instructions.

I am between 7 and 17 years old.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 week

1 visit (in-person)

Initial Evaluation and Training

Participants complete a demographic questionnaire, are interviewed about their video game experiences, and receive training on using the adapter

1 day

1 visit (in-person)

Home Use and Tracking

Participants take the adapter home for 1 week, use it daily, and record their experiences in a tracking log

1 week

Final Evaluation

Participants return for a final evaluation, including outcome measurements and an exit interview

1 day

1 visit (in-person)

Follow-up

Participants are monitored for any additional feedback or long-term effects of using the adapter

2 weeks

What Are the Treatments Tested in This Trial?

Interventions

• One Handed Video Game Controller Adapter

Trial Overview The study tests a new one-handed video game controller adapter for kids with an arm difference. It evaluates if the adapter improves gaming performance and enjoyment through interviews and performance assessments before and after a week's use at home.

How Is the Trial Designed?

Group I: with adapter Experimental Treatment 1 Intervention

All participants are in the experimental group baseline speed and accuracy using minecraft videogame will serve as baseline data and each subject will be their own control. participants will be given an adapter to support onehanded game play and an xbox system to use at home for a week. Follow-up data (speed and accuracy of minecraft) will be reevaluated one week later. Qualitative interview data will assist in understanding facilitators and barriers for use. On baseline and reassessment, the QUEST 2.0 and VAS will be administered as the primary outcome measures in addition to secondary outcome measures (speed and accuracy of minecraft).

Who Is Running the Clinical Trial?

University of Manitoba

Lead Sponsor

Trials

628

Recruited

209,000+

Rehabilitation Centre for Children, Canada

Collaborator

Trials

3

Recruited

50+

Published Research Related to This Trial

About 18% of therapists currently use gaming, specifically the Nintendo Wii, for stroke upper limb rehabilitation, and 61% would consider using it if the equipment were available.

However, 51% of therapists reported observing adverse events like fatigue and pain, highlighting the need for careful consideration of dosage and potential risks when incorporating gaming into rehabilitation programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Commercial gaming devices for stroke upper limb rehabilitation: a survey of current practice. Thomson, K., Pollock, A., Bugge, C., et al.[2021]

The GAIMplank video game controller was found to be usable and enjoyable for individuals with mobility impairments, providing a light-to-moderate intensity exercise option during gameplay, with an average usability score of 74.8 out of 100.

Participants reported a positive experience while using the GAIMplank, with perceived exertion levels ranging from light to moderate, although some inconsistencies in controller responsiveness were noted, indicating areas for future improvement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Usability of the GAIMplank Video Game Controller for People With Mobility Impairments: Observational Study. Malone, LA., Mendonca, CJ., Mohanraj, S., et al.[2023]

In a study involving 16 youth with physical disabilities, including those using wheelchairs, higher heart rates during active video gaming (AVG) were linked to better gameplay quality and increased enjoyment, suggesting that AVG can be a fun and engaging way to promote physical activity.

Participants reported significantly higher enjoyment scores for specific games like Wii Punch-Out and PS3 Sports Champions compared to others, indicating that the choice of game can influence the overall experience and effectiveness of AVG as a health-enhancing activity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Active Videogaming in Youth with Physical Disability: Gameplay and Enjoyment. Malone, LA., Rowland, JL., Rogers, R., et al.[2019]

A low-cost gaming station designed for pediatric arm and hand therapy was found to be highly usable by therapists, scoring 76.7 on the System Usability Scale, indicating it is practical for clinical use.

Children with cerebral palsy using the gaming station showed significant improvements in therapy goals, with notable increases in performance and satisfaction scores on the Canadian Occupational Performance Measure after 12 weeks of therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Force Resistance Training in Hand Grasp and Arm Therapy: Feasibility of a Low-Cost Videogame Controller. Hernández, HA., Khan, A., Fay, L., et al.[2019]

In a study involving 19 children aged 10-12, playing real table tennis resulted in more precise and slower movements compared to playing on three different active virtual game consoles (Nintendo Wii, Xbox Kinect, Sony Move), indicating that virtual games may not effectively replicate real-world motor skills.

The differences in movement patterns between real and virtual table tennis suggest that current active virtual games may hinder the development of gross motor skills, highlighting the need for higher fidelity games that better mimic real-life activities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A comparison of the upper limb movement kinematics utilized by children playing virtual and real table tennis. Bufton, A., Campbell, A., Howie, E., et al.[2014]

A study involving 22 adults with severe cerebral palsy found that using the FAAST system with Kinect for active videogaming resulted in a high enjoyment score of 4.24 out of 5, indicating that the system is engaging and accessible for individuals with significant motor impairments.

The enjoyment of the videogaming system was consistent across various demographic factors, including ethnicity, gender, and severity of cerebral palsy, suggesting that it can be beneficial for a diverse group of users.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Active Videogaming for Individuals with Severe Movement Disorders: Results from a Community Study. Chung, PJ., Vanderbilt, DL., Schrager, SM., et al.[2019]

The study involved 78 individuals with mobility impairments, aged 12 to 60, and found that using an adapted gaming mat for active video gaming increased enjoyment and gameplay quality, especially for seated players.

Energy expenditure was generally higher for seated players using the off-the-shelf mat, while both seated and standing players experienced similar gameplay quality with the adapted mat, highlighting its effectiveness in promoting physical activity among individuals with mobility challenges.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Active Video Gaming Using an Adapted Gaming Mat in Youth and Adults With Physical Disabilities: Observational Study. Malone, LA., Davlyatov, GK., Padalabalanarayanan, S., et al.[2021]

Active video gaming (AVG) shows potential for improving motor function in children with movement disorders, as evidenced by 20 studies that reported positive outcomes, although the improvements were not always significantly better than conventional therapy.

The studies varied widely in quality, sample sizes, and treatment individualization, highlighting the need for further research to establish effective dosing and to explore AVG as a supplementary treatment in home settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of active video gaming in children with neuromotor dysfunction: a systematic review. Hickman, R., Popescu, L., Manzanares, R., et al.[2018]

In a study involving 240 stroke survivors, using the Nintendo Wii Sports™ for rehabilitation did not significantly improve arm function compared to traditional arm exercises after six weeks.

The Wii™ was well tolerated with no serious adverse events reported, but it was more expensive than standard arm exercises, suggesting it may not be a cost-effective option for home-based rehabilitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does the use of Nintendo Wii SportsTM improve arm function? Trial of WiiTM in Stroke: a randomized controlled trial and economics analysis. Adie, K., Schofield, C., Berrow, M., et al.[2021]

A smart calibration algorithm was developed to help people with movement impairments play video games by continuously adjusting the input device's calibration based on their range of motion.

This algorithm allows users to play off-the-shelf video games without needing special calibration protocols or altering the game software, making it accessible for a wider audience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Smart calibration for video game play by people with a movement impairment. Perez, S., Benitez, R., Reinkensmeyer, DJ.[2020]

A survey of 110 participants with at least 6 months of adaptive gaming experience revealed that 90.9% felt adaptive gaming significantly improved their quality of life, indicating its potential as a beneficial rehabilitation tool.

Participants who gamed more frequently and with others reported better social relationships and overall positive impacts from adaptive gaming, suggesting that social interaction and regular use of adaptive equipment enhance the benefits of this intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Influence of adaptive video gaming on quality of life and social relationships. Redepenning, DH., Huss, SA., Maddali, S.[2023]

Citations

1. cdn.clinicaltrials.gov cdn.clinicaltrials.gov/large-docs/64/NCT05981664/Prot_000.pdf

Level Up! Adaptive Gaming for Children with Upper Limb ... The aim of this research study is to explore whether a novel video game controller adapter designed at RCC can increase performance and/or user ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5088224/

Joint-Specific Play Controller for Upper Extremity Therapy The goal of this study was to evaluate a specially designed wrist flexion and extension play controller in a cohort of children with upper extremity motor ...

3. resna.org resna.org/sites/default/files/conference/2018/pdf_versions/emerging_tech/Jones.pdf

Adapted video game controller use following upper ... Half of the participants utilized adapted controllers secondary to non-amputation related injuries such as traumatic brain injury (2), spinal cord injury (2), ...

4. scholar.dominican.edu scholar.dominican.edu/cgi/viewcontent.cgi?article=1031&context=occupational-therapy-capstone-projects

Adaptive Gaming as an Occupation: Motor Phenomena and ... In a study focusing on hand dexterity and function, combining therapy with video games in a school environment can improve the efficiency of hand mobility. Page ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9947916/

Usability of the GAIMplank Video Game Controller for People ... The GAIMplank video game controller was found to be usable and accessible, providing an enjoyable option for light-to-moderate intensity exercise among adults ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6901786/

Assistive game controller for artificial intelligence-enhanced ... Artificial intelligence has a role in making controllers and therapeutic games adaptable to the disabled. Post-stroke rehabilitation outcomes can be enhanced by ...

7. ablegamers.org ablegamers.org/knowledge-base/gaming-with-one-hand/

Gaming with One-Hand The main challenge when gaming with one-hand is trying to replace one entire side of buttons. Whether on a controller or mouse and keyboard, there are buttons ...

8. reddit.com reddit.com/r/disabledgamers/comments/1955dwr/one_hand_controllers/

One hand controllers : r/disabledgamers Hi everyone! My friend has recently had his right arm amputated and is a big gamer. I know gaming is probably the least of his worries at ...