Effectiveness of an innovative computer game-based exercise and learning platform for rehabilitation of motor
and cognitive impairments in children with Cerebral Palsy.- A RCT Protocol
Anuprita Kanitkar, PT, M.Sc.¹, Dr. Tony Szturm, PT, Ph.D.¹, Dr. Sanjay Parmar, BPT, MPT, PhD² , Gina Rempel, MD¹, Gayle Restall, OT, PhD¹,
Dorcas Gandhi, BPT, MPT ³, Jeyaraj Pandian, MD, DM, FRACP ³, Dr. Nilashri Naik, BPT, MPT ²
¹ University of Manitoba, Canada., ² S.D.M. College of Physiotherapy, Dharwad, India, ³ Christian Medical College, Ludhiana, India
BACKGROUND
Cerebral Palsy (CP) and acquired brain injuries cause deficits in fine
and gross motor skills and often have co-occurring deficits in visualspatial processing skills.
Effective approaches that motivate children with CP to engage in longterm and repetitive task practice programs for neuro-rehabilitation are
required.
RESEARCH GOAL
To produce innovative and cost effective therapeutic approaches to
improve neurodevelopmental outcomes for children with CP.
Pre-Intervention
RESEARCH OBJECTIVES
An exploratory RCT to evaluate the feasibility of the computer game-based
rehabilitation (CGR) platform.
An experimental as well as a conventional group will receive therapy for 45
minutes thrice a week for 16 weeks.
OUTCOME MEASURES
PDMS-2 (FMQ and VMQ)
QUEST
The Computer Game-based Rehabilitation Platform (CGR) assessment
for fine and gross motor skills
INCLUSION & EXCLUSION CRITERIA
Children with CP (4-8 years of age) (n=140) with moderate upper extremity
impairments and fine motor control abnormalities after screening
GMFCS (Score2-4)
MACS (Score2-4)
Modified Ashworth Scale (1 to 1+)
MMSE (17 and above)
COMPONENTS OF THE COMPUTER GAME-BASED
REHABILITATION PLATFORM (CGR)
Wireless motion detecting mouse.
A designed software-based Assessment Game.
Treatment computer games
Automated Outcomes (See Figure 1)
Success rate
Response time
Execution time
Movement variation
Post-Intervention
Pre and post example result graphs of the assessment game
played with peanut ball by a child with spastic hemiplegia
Pre and post example result graphs of the assessment game
played with a soccer ball by a child with spastic diplegia
CGR is a Flexible and Client-centered platform
Many diverse object manipulation tasks with varied functional demands
(See Figure 2).
Take advantage of ergonomic properties to amplify small/limited voluntary
movements.
Common/modern games offered many levels of movement precision and
visuospatial processing skills.
EXPECTATIONS
Objective electronic evaluation for tele-monitoring (See Figure 3).
Pre and post example result graphs of the assessment game
played with a Cone by a child with spastic diplegia
Figure 2: Example object manipulation task used for
assessment and/or treatment. miniature, wireless motion
mouse is attached with Velcro to each object. Each objectmanipulation task has specific fine or gross motor skill
qualities for therapeutic exercise or ergonomic properties.
Figure 3: Results of pilot study of 3
children with CP who received the
game- based therapy program. Shown
are overlay plots of game
movements for medium amplitude
as in Fig 1. (left-pre, right-post)
Development of Canada-India research excellence and capacity in Telerehabilitation.
ACKNOWLEDGEMENT:
AACPDM 70th annual Meeting, Hollywood, Florida
Contact Information: Ms. Anuprita Kanitkar, M. Sc. PT.
Email: [email protected]
Figure 1: Top left panel: Game snapshot. Top right
panel: Overlay trajectories of segmented movements for
each game event. Bottom Left panel: Game movements
in the previous panel sorted by direction and amplitude to
obtain multiple responses of each movement direction and
amplitude. Bottom Right Panel: Features quantified (and
averaged) from each game movement.