Evaluation of a computer game‐assisted rehabilitation program for manual dexterity of children with cerebral palsy: Feasibility randomized control trial

Abstract

AbstractBackgroundThere is a need for innovation to improve the engagement and compliance of rehabilitation programs for children with upper extremity (UE) motor impairments due to cerebral palsy (CP); a computer games‐based rehabilitation platform (GRP) was developed to address this need. The GRP provides engaging task‐specific exercises targeting manual dexterity (object handling and manipulation).ObjectiveTo evaluate the therapeutic value and treatment effect size of an exercise program using the GRP in children with CP.MethodsA total of 63 children with CP, aged 4 to 10 years, were recruited. The Peabody Developmental Motor Scale‐2 (PDMS‐2) Grasp and Visual‐Motor Integration (VMI) subscores and Computer game‐based Upper Extremity (CUE) assessment of manual dexterity were used to assess participants before and after a 16‐week intervention program, delivered three times per week. The experimental group (XG) received a computer games‐based exercise program targeting object manipulation tasks. The active control arm (CG) consisted of task‐specific training similar to the tasks used in constrained induced movement therapy.ResultsThere were only a few dropouts during the 16‐week program, and compliance was high. Both groups showed significant improvements with medium to large effect sizes. Improvements in the PDMS‐2 Grasp and VMI subscores observed in the XG were significantly greater than that in the CG. There were significant improvements (p < .01) in PDMS‐2 grasp and VMI subscores for XG with moderate to large effect sizes (0.5–0.8). For CG, the Grasp and VMI subscores did improve but these changes were not statistically significant. There was a significant improvement observed in the majority of CUE object manipulation test scores for XG (p < .01) with moderate to large effect sizes (0.50–1.2) Although CG did show improvements in all CUE object manipulation test scores, the changes did not reach statistical significance (p < .01).ConclusionThis study demonstrates the utility of the GRP to practice a broad range of object manipulation tasks in children with CP. The present findings are positive and support further research and development. The long‐term effects of the GRP program in children with CP will need to be confirmed in a future randomized controlled trial. In addition to measures of structure and function, future trials should also include outcome measures such as health‐related quality of life and level of participation to validate the findings.