Timed Up and Go article summary
Hsiech. Effects of a Gaming Platform on Balance Training for Children With Cerebral Palsy. Pediatric Physical Therapy. 2018. 303-308.
Children with cerebral palsy (CP) commonly experience difficulties with muscular coordination, motor control and balance deficits. The purpose of this study was to test the effects of training with a gaming platform on balance control; it was hypothesized that training with personal computer (PC) games will lead to greater motivation for learning.
This study was a randomized controlled trial with a total 40 participants aged 5-10 years. Inclusion criteria were a diagnosis of CP with resultant deficits in movement and balance or hemiparesis. The children were randomly assigned to either the intervention group (n=20) or to the control group (n=20); no significant differences among groups were present for age, gender, CP subtype, severity of hemiparesis or Gross Motor Function Classification System level.
The intervention group played PC games with a gaming platform invented by the researcher. The platform, connected as the main controller for the game, functioned via trunk movements in 3 directions: horizontal, vertical and multidirectional in standing. These movements corresponded with weight shifts detected by the platform: lateral weight shifts, anterior-posterior and full body combination shifts respectively. The control group played the same PC games with a computer mouse controller on a desk from a standing position. The PC game comprised of tasks such as watering flowers, dodging objects and swatting mosquitoes. Training sessions were conducted by a pediatric physical therapist. They lasted for 40 minutes and were completed 5 times per week for 12 weeks.
Primary outcome measures for this study included center of pressure (CoP) sway (anteroposterior sway, mediolateral sway, sway area and sway velocity), the Berg Balance Scale (BBS), the Fullerton Advanced Balance Scale (FAB) and the timed up and go (TUG). A MANOVA 2-way mixed analysis was conducted to determine the relationship between group and time variables.
Results of this study show significant differences between groups over time for AP sway, sway velocity, BBS scores and TUG scores. Significance in within-group differences was also calculated for all variables in the intervention group. The intervention group had significantly better results for the CoP sway, sway velocity, BBS scores and TUG scores as compared to the control group. No significant changes were made in FAB scores in either group. Mean scores for the post-test increased significantly as compared to pre-test in the intervention group, as denoted by significant improvements in all variables. The control group had no significant changes between pre-test and post-test.
The interactive and playful setting as provided by the game allowed for achievable challenge and also incorporated repetition and task-specific activity, allowing for optimal practice settings on improving balance control. Due to the lack in significant change in FAB scores, it is commented that the training period (12 weeks) may not be long enough to elicit acute changes in advanced balance skill. Overall, it can be understood that the use of the gaming platform, providing sensory feedback sensitive to weight shifts, can be used as a successful intervention for improving balance control in children with CP as compared to a standard computer mouse. This is supported by significant improvements in CoP sway measurements and BBS and TUG scores.
Leave a Reply
You must be logged in to post a comment.