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A biofeedback-enhanced therapeutic exercise video game intervention for young people with cerebral palsy: A randomized single-case experimental design feasibility study

PloS one, 2020-06, Vol.15 (6), p.e0234767-e0234767 [Peer Reviewed Journal]

COPYRIGHT 2020 Public Library of Science ;COPYRIGHT 2020 Public Library of Science ;2020 MacIntosh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Distributed under a Creative Commons Attribution 4.0 International License ;2020 MacIntosh et al 2020 MacIntosh et al ;ISSN: 1932-6203 ;EISSN: 1932-6203 ;DOI: 10.1371/journal.pone.0234767 ;PMID: 32569284

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Title:
A biofeedback-enhanced therapeutic exercise video game intervention for young people with cerebral palsy: A randomized single-case experimental design feasibility study
Author: MacIntosh, Alexander ; Desailly, Eric ; Vignais, Nicolas ; Vigneron, Vincent ; Biddiss, Elaine
Martinuzzi, Andrea
Subjects: Biofeedback ; Biofeedback training ; Biology and Life Sciences ; Biomedical engineering ; Biomedical materials ; Care and treatment ; Cerebral palsied children ; Cerebral palsy ; Cognitive science ; Computer & video games ; Computer science ; Design of experiments ; Disability ; Electromyography ; Electronic & video games ; EMG ; Engineering Sciences ; Exercise therapy ; Experimental design ; Families & family life ; Feasibility studies ; Feedback ; Forearm ; Grip strength ; Health aspects ; Inertial sensing devices ; Intervention ; Medicine and Health Sciences ; Methods ; Motivation ; Paralysis ; Pediatric research ; Quality ; Randomization ; Recruitment ; Rehabilitation ; Signal and Image processing ; Social Sciences ; Success ; Technology ; Therapists ; Therapy ; Training ; Video games ; Wrist ; Young adults
Is Part Of: PloS one, 2020-06, Vol.15 (6), p.e0234767-e0234767
Description: Importance/Background Movement-controlled video games have potential to promote home-based practice of therapy activities. The success of therapy gaming interventions depends on the quality of the technology used and the presence of effective support structures. Aim This study assesses the feasibility of a novel intervention that combines a co-created gaming technology integrating evidence-based biofeedback and solution-focused coaching (SFC) strategies to support therapy engagement and efficacy at home. Methods Following feasibility and single-case reporting standards (CONSORT and SCRIBE), this was a non-blind, randomized, multiple-baseline, AB, design. Nineteen (19) young people with cerebral palsy (8-18 years old) completed the 4-week home-based intervention in France and Canada. Participant motivations, personalized practice goals, and relevance of the intervention to daily activities were discussed in a Solution Focused Coaching-style conversation pre-, post-intervention and during weekly check-ins. Participants controlled a video game by completing therapeutic gestures (wrist extension, pinching) detected via electromyography and inertial sensors on the forearm (Myo Armband and custom software). Process feasibility success criteria for recruitment response, completion and adherence rates, and frequency of technical issues were established a priori. Scientific feasibility, effect size estimates and variance were determined for Body Function outcome measures: active wrist extension, grip strength and Box and Blocks Test; and for Activities and Participation measures: Assisting Hand Assessment (AHA), Canadian Occupational Performance Measure (COPM) and Self-Reported Experiences of Activity Settings (SEAS). Results Recruitment response (31%) and assessment completion (84%) rates were good and 74% of participants reached self-identified practice goals. As 17% of technical issues required external support to resolve, the intervention was graded as feasible with modifications. No adverse events were reported. Moderate effects were observed in Body Function measures (active wrist extension: SMD = 1.82, 95%CI = 0.85-2.78; Grip Strength: SMD = 0.63, 95%CI = 0.65-1.91; Box and Blocks: Hedge's g = 0.58, 95%CI = -0.11-1.27) and small-moderate effects in Activities and Participation measures (AHA: Hedge's g = 0.29, 95%CI = -0.39-0.97, COPM: r = 0.60, 95%CI = 0.13-0.82, SEAS: r = 0.24, 95%CI = -0.25-0.61). Conclusion A definitive RCT to investigate the effectiveness of this novel intervention is warranted. Combining SFC-style coaching with high-quality biofeedback may positively engage youth in home rehabilitation to complement traditional therapy. Trial registration ClinicalTrials.gov, U.S. National Library of Medicine: NCT03677193.
Publisher: San Francisco: Public Library of Science
Language: English
Identifier: ISSN: 1932-6203
EISSN: 1932-6203
DOI: 10.1371/journal.pone.0234767
PMID: 32569284
Source: Hyper Article en Ligne (HAL) (Open Access)
GFMER Free Medical Journals
PubMed Central
Public Library of Science (PLoS)
ProQuest Central
DOAJ Directory of Open Access Journals

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A biofeedback-enhanced therapeutic exercise video game intervention for young people with cerebral palsy: A randomized single-case experimental design feasibility study

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