Understanding a videogame home intervention for children with hemiplegia: a mixed methods multi-case study

Area of Science:

• Pediatric Rehabilitation
• Assistive Technology
• Game-Based Therapy

Background:

• Access to pediatric rehabilitation is a growing concern for children with cerebral palsy (CP).
• Home-based interventions are increasingly explored to supplement traditional therapy.
• Videogames offer a novel approach to encourage functional exercise at home.

Purpose of the Study:

• To evaluate a home-based, movement-tracking videogame (Bootle Blast) for children with hemiplegic cerebral palsy (HCP).
• To assess children's adherence to self-directed play-time goals over 12 weeks.
• To measure changes in upper limb (UL) motor function and explore user experiences.

Main Methods:

• A mixed-methods case series involving four children with HCP and their parents.
• Participants engaged with the Bootle Blast videogame at home for 12 weeks.
• Data collected included game logs for playtime, clinical assessments (baseline, post-intervention, follow-up), and post-intervention interviews.

Main Results:

• Three of four participants completed the intervention, with most achieving or exceeding play-time goals.
• Consistent improvements were noted in the Canadian Occupational Performance Measure and Box and Blocks Test.
• Qualitative analysis revealed themes of intrinsic motivation, virtual play for real-world gains, and "therapy on demand."

Conclusions:

• Bootle Blast is a feasible home-based intervention for children with HCP, demonstrating potential for improved UL function.
• The videogame effectively engaged children, shifting the focus from parental burden to game-directed therapy.
• Preliminary evidence supports further investigation of game-based rehabilitation for pediatric CP.