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Finding Effective Adjustment Levels for Upper Limb Exergames: Focus Group Study With Children With Physical Disabilities

BACKGROUND: We developed the Blexer system consisting of a database and a web interface for therapists that can host different types of adaptive and personally configurable virtual reality exergames based on Kinect (Microsoft Corp) motion capture to provide entertaining exercises for children with m...

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Autores principales: Eckert, Martina, Domingo Soria, Beatriz, Terroso Gil, Noelia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947823/
https://www.ncbi.nlm.nih.gov/pubmed/36637882
http://dx.doi.org/10.2196/36110
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author Eckert, Martina
Domingo Soria, Beatriz
Terroso Gil, Noelia
author_facet Eckert, Martina
Domingo Soria, Beatriz
Terroso Gil, Noelia
author_sort Eckert, Martina
collection PubMed
description BACKGROUND: We developed the Blexer system consisting of a database and a web interface for therapists that can host different types of adaptive and personally configurable virtual reality exergames based on Kinect (Microsoft Corp) motion capture to provide entertaining exercises for children with motor disabilities. It allows for parameter adjustment and the monitoring of results remotely, thereby providing a useful tool to complement traditional physical therapy sessions with home exercises. OBJECTIVE: The aim of this study was to observe the motor benefits achieved through the use of a video exergame and the importance and implications of correctly setting the game’s difficulty parameters. METHODS: This was an observational case study of 6 children with different physical disabilities receiving physical therapy at school combined with the use of a fully configurable exergame under research that forms a part of the Blexer environment. The game integrates 4 repeatedly appearing upper limb exercises with individually adjustable difficulties (intermittent arm rising, arm forward and backward movement, rising and holding of one arm, and trunk control in all directions). The outcomes were 3 assessments of 2 efficacy measures: Box and Block Test and Jebsen Taylor Hand Function Test. RESULTS: A total of 5 children with cerebral palsy (mean 8.4, SD 2.7 years; Gross Motor Function Classification II—2/5, 40%; III—2/5, 40%; and IV—1/5, 20%) and 1 child with obstetric brachial plexus palsy (aged 8 years; Mallet Classification III) received between 8 and 11 sessions of training (10-20 minutes per session), depending on age, motivation, and fatigue. Significant associations were observed between game parameter settings and improvements in motor function, on the one hand, and between the type of improvement and disability severity, on the other: with adjusted game parameters goal and time in the range of 70% to 100%, only less affected children improved in the Box and Block Test (+11 blocks vs −1 block), and more affected children improved more in the Jebsen Taylor Hand Function Test (+90 seconds vs +27 seconds). CONCLUSIONS: When defining the difficulty parameters for an exergame, we suggest a classification in levels ranging from very easy to very hard. For practical use, we suggest setting the difficulty for the player to an easy or medium level rather than high-commitment goals, as this leads to a longer playtime with more fun and, therefore, seems to improve the results of the game and, consequently, mobility.
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spelling pubmed-99478232023-02-24 Finding Effective Adjustment Levels for Upper Limb Exergames: Focus Group Study With Children With Physical Disabilities Eckert, Martina Domingo Soria, Beatriz Terroso Gil, Noelia JMIR Serious Games Original Paper BACKGROUND: We developed the Blexer system consisting of a database and a web interface for therapists that can host different types of adaptive and personally configurable virtual reality exergames based on Kinect (Microsoft Corp) motion capture to provide entertaining exercises for children with motor disabilities. It allows for parameter adjustment and the monitoring of results remotely, thereby providing a useful tool to complement traditional physical therapy sessions with home exercises. OBJECTIVE: The aim of this study was to observe the motor benefits achieved through the use of a video exergame and the importance and implications of correctly setting the game’s difficulty parameters. METHODS: This was an observational case study of 6 children with different physical disabilities receiving physical therapy at school combined with the use of a fully configurable exergame under research that forms a part of the Blexer environment. The game integrates 4 repeatedly appearing upper limb exercises with individually adjustable difficulties (intermittent arm rising, arm forward and backward movement, rising and holding of one arm, and trunk control in all directions). The outcomes were 3 assessments of 2 efficacy measures: Box and Block Test and Jebsen Taylor Hand Function Test. RESULTS: A total of 5 children with cerebral palsy (mean 8.4, SD 2.7 years; Gross Motor Function Classification II—2/5, 40%; III—2/5, 40%; and IV—1/5, 20%) and 1 child with obstetric brachial plexus palsy (aged 8 years; Mallet Classification III) received between 8 and 11 sessions of training (10-20 minutes per session), depending on age, motivation, and fatigue. Significant associations were observed between game parameter settings and improvements in motor function, on the one hand, and between the type of improvement and disability severity, on the other: with adjusted game parameters goal and time in the range of 70% to 100%, only less affected children improved in the Box and Block Test (+11 blocks vs −1 block), and more affected children improved more in the Jebsen Taylor Hand Function Test (+90 seconds vs +27 seconds). CONCLUSIONS: When defining the difficulty parameters for an exergame, we suggest a classification in levels ranging from very easy to very hard. For practical use, we suggest setting the difficulty for the player to an easy or medium level rather than high-commitment goals, as this leads to a longer playtime with more fun and, therefore, seems to improve the results of the game and, consequently, mobility. JMIR Publications 2023-01-13 /pmc/articles/PMC9947823/ /pubmed/36637882 http://dx.doi.org/10.2196/36110 Text en ©Martina Eckert, Beatriz Domingo Soria, Noelia Terroso Gil. Originally published in JMIR Serious Games (https://games.jmir.org), 13.01.2023. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Serious Games, is properly cited. The complete bibliographic information, a link to the original publication on https://games.jmir.org, as well as this copyright and license information must be included.
spellingShingle Original Paper
Eckert, Martina
Domingo Soria, Beatriz
Terroso Gil, Noelia
Finding Effective Adjustment Levels for Upper Limb Exergames: Focus Group Study With Children With Physical Disabilities
title Finding Effective Adjustment Levels for Upper Limb Exergames: Focus Group Study With Children With Physical Disabilities
title_full Finding Effective Adjustment Levels for Upper Limb Exergames: Focus Group Study With Children With Physical Disabilities
title_fullStr Finding Effective Adjustment Levels for Upper Limb Exergames: Focus Group Study With Children With Physical Disabilities
title_full_unstemmed Finding Effective Adjustment Levels for Upper Limb Exergames: Focus Group Study With Children With Physical Disabilities
title_short Finding Effective Adjustment Levels for Upper Limb Exergames: Focus Group Study With Children With Physical Disabilities
title_sort finding effective adjustment levels for upper limb exergames: focus group study with children with physical disabilities
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947823/
https://www.ncbi.nlm.nih.gov/pubmed/36637882
http://dx.doi.org/10.2196/36110
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