Playing video games may benefit kids with cerebral palsy

According to a study published online in the Archives of Physical Medicine and Rehabilitation, children with cerebral palsy (CP) may benefit from playing active video games (AVG), such as Nintendo's Wii. The researchers found that not only did children enjoy playing AVGs, the games can also help children attain moderate levels of physical activity and could potentially be used in rehabilitation therapy. Lead researcher Elaine Biddiss, Ph.D., of Toronto's Bloorview Research Institute at Holland Bloorview Kids Rehabilitation Hospital, and the University of Toronto, Canada, explained: "Active video games (AVG) provide a low-cost, commercially available system that can be strategically selected to address specific therapeutic goals. While our results did not show that AVG game play can be regarded as a replacement for more vigorous physical activity or muscle strengthening, we found that some games may provide targeted therapy focused on specific joints or movements." The researchers examined 17 children with CP whilst they played four AVGs: Wii Boxing, Tennis, Bowling, and Dance Dance Revolution (DDR). The team recorded data on energy, muscle activity and motion. Study participants were given a survey in order to mark their level of enjoyment playing the games. In addition, the team assessed the therapeutic potential of AVG play, the intensity of the physical activity, as well as the practical considerations surrounding the of active video games to promote physical activity. The researchers found that although the games were not vigorous enough to build endurance or strength, children with mild CP were able to attain moderate levels of physical activity with games such as Wii Boxing and DDR that require full body movements. According to the researchers, AVG play could promote neuroplastic change as they encourage repetitive movements and provide feedback to the player via on-screen game scores and avatars. The children rated enjoyment levels of AVG game play as high, which also improves neuroplasticity. Wii Boxing may be a good choice for encouraging and training faster wrist movements, the researchers note, which is vital, as children with GP often have difficulty extending their wrists. Furthermore, the team found that children with hemiplegia (a form of CP that affects the limbs on one side of the body) who played Wii Boxing or DDR engaged both upper limbs when playing. Dr. Biddiss said: "Wii boxing, or similar games, may be an effective motivational environment for encouraging increased movement speed of the hemiplegic limb, in addition to the bilateral use of the limbs, because in-game success is strongly linked to these two metrics." According to the researchers, the range of motion of the dominant limb was well within the typical norms associated with upper limb movements in able-bodied individuals. Although further studies regarding safety are required, this study indicates that AVG should be a fairly low impact activity for children with the disorder. The team found significant differences in the strategies used by the children to succeed in the game. They discovered that children may adapt a movement that reduces physical effort in order to maximize in-game rewards. In a therapeutic setting, it may be necessary to train and provide rewards for appropriate movement styles. Dr. Biddiss concludes: "While not a replacement for structured exercise and physical therapy, AVGs may encourage children with CP to be physically active and to practice complex motor activities. There are many opportunities for further research. Further development and optimization of AVG technologies may usher in a new age in physical rehabilitation where virtual environments provide an arena for neuroplastic change in the comfort of one's home."