Serious games for arm rehabilitation of persons with multiple sclerosis. A randomized controlled pilot study

Johanna Jonsdottir, Rita Bertoni, Michael Lawo, Angelo Montesano, Thomas Bowman, Silvia Gabrielli

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objectives The feasibility and preliminary evidence for efficacy of a serious games platform compared to exergame using the Wii for arm rehabilitation in persons with multiple sclerosis (MS) was investigated. Methods A pilot single-blind randomized (2:1) controlled in clinic trial was carried out. Sixteen persons with MS participated (age years 56.8 (SD 12.3), MS-onset years 19.4 (SD 12.3), EDSS 6.5). Ten participants used a serious games platform (Rehab@Home) while 6 participants played with the commercial Wii platform, for four weeks (40 min, 12 sessions/4 weeks). Feasibility and user experience measures were collected. Primary outcomes were the 9 Hole Peg Test (9HPT) and the Box and Block test (BBT). Secondary outcomes were the EQ-5D visual analogue scale (EQ-VAS) and the SF-12. Nonparametric analysis was used to verify changes from pre to post rehabilitation within group and treatment effect was verified with Mann-Whitney U test. P value was set at 0.10 and clinical improvement was set at 20% improvement from baseline. Results Serious games were perceived positively in terms of user experience and motivation. There were clinically significant improvements in arm function in the serious games group as measured by 9HPT (38–29.5 s, P = 0.046, > 20%) and BBT 32–42 cubes, P = 0.19, > 20%) following the 12 gaming sessions while the exergame group did not improve on either test (9HPT 34.5–41.5 s, P = 0.34; BBT 38,5 to 42 cubes, P = 0.34). Only the exergame group perceived themselves as having improved their health. There was a significant between groups treatment effect only in perception of health (EQ-VAS) (Z = 1.93, P = 0.06) favouring the exergame group. Conclusions Virtual reality in a serious gaming approach was feasible and beneficial to arm function of persons with MS but motivational aspects of the approach may need further attention.

Original languageEnglish
Pages (from-to)25-29
Number of pages5
JournalMultiple Sclerosis and Related Disorders
Volume19
DOIs
Publication statusPublished - Oct 2017

Fingerprint

Multiple Sclerosis
Rehabilitation
Visual Analog Scale
Health
Nonparametric Statistics
Motivation
Therapeutics

Keywords

  • Kinect
  • Multiple Sclerosis
  • Rehabilitation
  • Serious games
  • Upper extremity
  • Virtual Reality

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Serious games for arm rehabilitation of persons with multiple sclerosis. A randomized controlled pilot study. / Jonsdottir, Johanna; Bertoni, Rita; Lawo, Michael; Montesano, Angelo; Bowman, Thomas; Gabrielli, Silvia.

In: Multiple Sclerosis and Related Disorders, Vol. 19, 10.2017, p. 25-29.

Research output: Contribution to journalArticle

@article{9b6049aba06c4e01a61d8e688d197877,
title = "Serious games for arm rehabilitation of persons with multiple sclerosis. A randomized controlled pilot study",
abstract = "Objectives The feasibility and preliminary evidence for efficacy of a serious games platform compared to exergame using the Wii for arm rehabilitation in persons with multiple sclerosis (MS) was investigated. Methods A pilot single-blind randomized (2:1) controlled in clinic trial was carried out. Sixteen persons with MS participated (age years 56.8 (SD 12.3), MS-onset years 19.4 (SD 12.3), EDSS 6.5). Ten participants used a serious games platform (Rehab@Home) while 6 participants played with the commercial Wii platform, for four weeks (40 min, 12 sessions/4 weeks). Feasibility and user experience measures were collected. Primary outcomes were the 9 Hole Peg Test (9HPT) and the Box and Block test (BBT). Secondary outcomes were the EQ-5D visual analogue scale (EQ-VAS) and the SF-12. Nonparametric analysis was used to verify changes from pre to post rehabilitation within group and treatment effect was verified with Mann-Whitney U test. P value was set at 0.10 and clinical improvement was set at 20{\%} improvement from baseline. Results Serious games were perceived positively in terms of user experience and motivation. There were clinically significant improvements in arm function in the serious games group as measured by 9HPT (38–29.5 s, P = 0.046, > 20{\%}) and BBT 32–42 cubes, P = 0.19, > 20{\%}) following the 12 gaming sessions while the exergame group did not improve on either test (9HPT 34.5–41.5 s, P = 0.34; BBT 38,5 to 42 cubes, P = 0.34). Only the exergame group perceived themselves as having improved their health. There was a significant between groups treatment effect only in perception of health (EQ-VAS) (Z = 1.93, P = 0.06) favouring the exergame group. Conclusions Virtual reality in a serious gaming approach was feasible and beneficial to arm function of persons with MS but motivational aspects of the approach may need further attention.",
keywords = "Kinect, Multiple Sclerosis, Rehabilitation, Serious games, Upper extremity, Virtual Reality",
author = "Johanna Jonsdottir and Rita Bertoni and Michael Lawo and Angelo Montesano and Thomas Bowman and Silvia Gabrielli",
year = "2017",
month = "10",
doi = "10.1016/j.msard.2017.10.010",
language = "English",
volume = "19",
pages = "25--29",
journal = "Multiple Sclerosis and Related Disorders",
issn = "2211-0348",
publisher = "Elsevier",

}

TY - JOUR

T1 - Serious games for arm rehabilitation of persons with multiple sclerosis. A randomized controlled pilot study

AU - Jonsdottir, Johanna

AU - Bertoni, Rita

AU - Lawo, Michael

AU - Montesano, Angelo

AU - Bowman, Thomas

AU - Gabrielli, Silvia

PY - 2017/10

Y1 - 2017/10

N2 - Objectives The feasibility and preliminary evidence for efficacy of a serious games platform compared to exergame using the Wii for arm rehabilitation in persons with multiple sclerosis (MS) was investigated. Methods A pilot single-blind randomized (2:1) controlled in clinic trial was carried out. Sixteen persons with MS participated (age years 56.8 (SD 12.3), MS-onset years 19.4 (SD 12.3), EDSS 6.5). Ten participants used a serious games platform (Rehab@Home) while 6 participants played with the commercial Wii platform, for four weeks (40 min, 12 sessions/4 weeks). Feasibility and user experience measures were collected. Primary outcomes were the 9 Hole Peg Test (9HPT) and the Box and Block test (BBT). Secondary outcomes were the EQ-5D visual analogue scale (EQ-VAS) and the SF-12. Nonparametric analysis was used to verify changes from pre to post rehabilitation within group and treatment effect was verified with Mann-Whitney U test. P value was set at 0.10 and clinical improvement was set at 20% improvement from baseline. Results Serious games were perceived positively in terms of user experience and motivation. There were clinically significant improvements in arm function in the serious games group as measured by 9HPT (38–29.5 s, P = 0.046, > 20%) and BBT 32–42 cubes, P = 0.19, > 20%) following the 12 gaming sessions while the exergame group did not improve on either test (9HPT 34.5–41.5 s, P = 0.34; BBT 38,5 to 42 cubes, P = 0.34). Only the exergame group perceived themselves as having improved their health. There was a significant between groups treatment effect only in perception of health (EQ-VAS) (Z = 1.93, P = 0.06) favouring the exergame group. Conclusions Virtual reality in a serious gaming approach was feasible and beneficial to arm function of persons with MS but motivational aspects of the approach may need further attention.

AB - Objectives The feasibility and preliminary evidence for efficacy of a serious games platform compared to exergame using the Wii for arm rehabilitation in persons with multiple sclerosis (MS) was investigated. Methods A pilot single-blind randomized (2:1) controlled in clinic trial was carried out. Sixteen persons with MS participated (age years 56.8 (SD 12.3), MS-onset years 19.4 (SD 12.3), EDSS 6.5). Ten participants used a serious games platform (Rehab@Home) while 6 participants played with the commercial Wii platform, for four weeks (40 min, 12 sessions/4 weeks). Feasibility and user experience measures were collected. Primary outcomes were the 9 Hole Peg Test (9HPT) and the Box and Block test (BBT). Secondary outcomes were the EQ-5D visual analogue scale (EQ-VAS) and the SF-12. Nonparametric analysis was used to verify changes from pre to post rehabilitation within group and treatment effect was verified with Mann-Whitney U test. P value was set at 0.10 and clinical improvement was set at 20% improvement from baseline. Results Serious games were perceived positively in terms of user experience and motivation. There were clinically significant improvements in arm function in the serious games group as measured by 9HPT (38–29.5 s, P = 0.046, > 20%) and BBT 32–42 cubes, P = 0.19, > 20%) following the 12 gaming sessions while the exergame group did not improve on either test (9HPT 34.5–41.5 s, P = 0.34; BBT 38,5 to 42 cubes, P = 0.34). Only the exergame group perceived themselves as having improved their health. There was a significant between groups treatment effect only in perception of health (EQ-VAS) (Z = 1.93, P = 0.06) favouring the exergame group. Conclusions Virtual reality in a serious gaming approach was feasible and beneficial to arm function of persons with MS but motivational aspects of the approach may need further attention.

KW - Kinect

KW - Multiple Sclerosis

KW - Rehabilitation

KW - Serious games

KW - Upper extremity

KW - Virtual Reality

UR - http://www.scopus.com/inward/record.url?scp=85032732427&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85032732427&partnerID=8YFLogxK

U2 - 10.1016/j.msard.2017.10.010

DO - 10.1016/j.msard.2017.10.010

M3 - Article

AN - SCOPUS:85032732427

VL - 19

SP - 25

EP - 29

JO - Multiple Sclerosis and Related Disorders

JF - Multiple Sclerosis and Related Disorders

SN - 2211-0348

ER -