Joint-Specific Play Controller for Upper Extremity Therapy: Feasibility Study in Children With Wrist Impairment

Area of Science:

• Pediatric Rehabilitation
• Assistive Technology
• Motor Control

Background:

• Child therapeutic programs often face challenges with engagement and adherence.
• Play is a primary learning avenue for children, offering a potential solution for therapeutic interventions.
• Novel controllers designed for therapeutic play can activate toys/games through specific, repetitive joint movements.

Purpose of the Study:

• To evaluate a wrist flexion and extension play controller for children with upper extremity motor impairments (UEMIs).
• To explore the relationship between controller play activity, wrist/forearm range of motion (ROM), spasticity, and perceived fun/difficulty.

Main Methods:

• Cross-sectional study involving 21 children (ages 4-12) with UEMIs.
• Children engaged in structured play sessions using the controller with toys and games.
• Wrist motion, ROM, and spasticity were measured; children provided feedback on enjoyment and difficulty.

Main Results:

• Children repeatedly achieved goal wrist movements (flexion/extension) at an average frequency of 0.27 Hz.
• Estimated 1,700 targeted joint motions per week with 15 minutes of daily play.
• Play activity showed association with supination ROM, but enjoyment/difficulty ratings did not correlate with clinical measures.

Conclusions:

• Therapeutic controllers successfully elicited repetitive, goal-directed movements in children with UEMIs.
• The controllers were adaptable, enjoyable, and challenging across various ages and UEMI severities.
• Results may not generalize to children with more severe UEMIs.