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

Trial Summary

What is the purpose of this trial?

The goal of this clinical trial is to test a new one-handed video game controller adapter to determine if it helps improve how video games are played and enjoyed in children with an upper limb difference on one side. The main questions it aims to answer are: * Is performance improved while playing video games with the adapter? * Is user satisfaction or enjoyment improved while playing video games with the adapter? Participants will: * Answer questions about their limb difference and other demographics * Be interviewed about their current and past video game playing experiences * Learn how to use the adapter and have their performance with it evaluated * Take the adapter home to use for 1 week, and be asked to record their experiences * Have their performance with the adapter re-evaluated after a week of practice * Be interviewed about their experience with the adapter

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 data supports the effectiveness of the treatment One Handed Video Game Controller Adapter, Adaptive Gaming Controller, One-Handed Gaming Adapter?

Research shows that active video gaming can help improve motor function in children with movement disorders, and using gaming devices like the Nintendo Wii has been explored for improving arm function after stroke. These findings suggest that adaptive gaming controllers might also be beneficial for children with upper limb differences. ^{1 2 3 4 5}

Is adaptive gaming safe for children with upper limb differences?

The research on adaptive gaming, including the use of specialized controllers, suggests it is generally safe and can be enjoyable for individuals with physical disabilities. While specific safety data for children with upper limb differences is not detailed, adaptive gaming has been positively received in related contexts without reported safety concerns. ^{1 6 7 8 9}

How is the One Handed Video Game Controller Adapter treatment different from other treatments for pediatric upper limb differences?

The One Handed Video Game Controller Adapter is unique because it allows children with upper limb differences to engage in video gaming using only one hand, making gaming more accessible and enjoyable for them. Unlike traditional therapies that may focus on physical exercises, this treatment integrates play and entertainment, potentially improving motor skills and coordination in a fun and engaging way. ^{1 7 8 10 11}

Research Team

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

Principal Investigator

Rehabilitation Centre for Children

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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 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]

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]

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 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 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]

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]

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]

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]

References

1. England pubmed.ncbi.nlm.nih.gov

Use of active video gaming in children with neuromotor dysfunction: a systematic review. [2018]

2. England 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. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

Force Resistance Training in Hand Grasp and Arm Therapy: Feasibility of a Low-Cost Videogame Controller. [2019]

4. Netherlands pubmed.ncbi.nlm.nih.gov

A comparison of the upper limb movement kinematics utilized by children playing virtual and real table tennis. [2014]

5. England pubmed.ncbi.nlm.nih.gov

Commercial gaming devices for stroke upper limb rehabilitation: a survey of current practice. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Active Videogaming in Youth with Physical Disability: Gameplay and Enjoyment. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Active Videogaming for Individuals with Severe Movement Disorders: Results from a Community Study. [2019]

8. Canada pubmed.ncbi.nlm.nih.gov

Usability of the GAIMplank Video Game Controller for People With Mobility Impairments: Observational Study. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

Influence of adaptive video gaming on quality of life and social relationships. [2023]

10. Canada pubmed.ncbi.nlm.nih.gov

Active Video Gaming Using an Adapted Gaming Mat in Youth and Adults With Physical Disabilities: Observational Study. [2021]

11. United States pubmed.ncbi.nlm.nih.gov

Smart calibration for video game play by people with a movement impairment. [2020]