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

Martina Eckert¹, Beatriz Domingo Soria², Noelia Terroso Gil²

¹Group of Acoustics and Multimedia Applications, Department ot Audiovisual Engineering, Universidad Politécnica de Madrid, Madrid, Spain.

JMIR Serious Games

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Summary

Virtual reality exergames can improve motor function in children with disabilities. Adjusting game difficulty is key, with easier settings promoting longer, more engaging play for better results.

Keywords:

Kinect cerebral palsy exergames obstetric brachial plexus palsy physical therapy rehabilitation serious games

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Area of Science:

Pediatric rehabilitation
Assistive technology
Virtual reality in healthcare

Background:

The Blexer system, featuring a database and web interface, hosts adaptive virtual reality exergames for children with motor disabilities.
Utilizing Kinect motion capture, the system offers configurable exercises and remote monitoring to supplement traditional physical therapy.

Purpose of the Study:

To evaluate the motor benefits of a video exergame in children with physical disabilities.
To assess the impact of correctly setting game difficulty parameters on therapeutic outcomes.

Main Methods:

An observational case study involving 6 children with diverse physical disabilities.
The study employed a configurable virtual reality exergame with adjustable difficulty for upper limb and trunk exercises.
Outcomes were measured using the Box and Block Test and the Jebsen Taylor Hand Function Test.

Main Results:

Children with cerebral palsy and obstetric brachial plexus palsy showed varying improvements based on disability severity and game parameter adjustments.
Less affected children improved in the Box and Block Test (+11 blocks) with higher parameter settings (70-100%).
More affected children showed greater improvement in the Jebsen Taylor Hand Function Test (+90 seconds) with adjusted parameters.

Conclusions:

Difficulty parameter adjustment is crucial for optimizing exergame effectiveness in pediatric motor rehabilitation.
Setting exergames to easy or medium difficulty levels encourages longer playtime, enhances engagement, and improves functional outcomes.
Personalized difficulty settings in virtual reality exergames can lead to significant improvements in mobility for children with motor impairments.