Clinic-based muscle strengthening programs have achieved positive outcomes in children with cerebral palsy.However these programs can be expensive and may place an undue burden on patients and their families due to travel time and interference with usual social activities and participation(Dodd, Taylor, & Graham, 2003).While in-home strength training would resolve these concerns, it presents additional challenges related to adequately monitoring patient progress and ensuring adherence to therapy protocol.One possible solution, following a trend in other areas of rehabilitation, is to combine strength training with a virtual reality system.
Virtual reality (VR) has been demonstrated as, “an entertaining and engaging rehabilitation intervention, motivating children to repeatedly practice goal-directed tasks, providing sensory feedback and potentially improving motor skill performance(Levac & Galvin, 2011).”In Fall 2010 a Washington University Biomedical Engineering Senior Design team under the mentorship of Dr. Jack Engsberg designed a Wii Controlled Gaming System for Therapy(An, Boccio, & Bolano, 2010).This project culminated in the creation of a software interface that allows a Nintendo WiiMote to be used to control internet-based computer games.While the scope of their project was to design such a system for stroke rehabilitation, the system’s success creates exciting opportunities for its application to other therapies and patient populations.
Interfacing ankle strength training for children with CP with online video games may be an effective method to both motivate and monitor participation in an at-home setting.Dr. Jack Engsberg and colleagues have presented a 12-week interventional case study suggesting that an ankle strength training device with video game interface is both appealing to patients and effective in improving ankle strength and motor function(Cioi, et al., 2011).Although the addition of video game interfaces introduces new complexities to rehabilitation systems, the advantages of increased patient motivation and monitoring make this an attractive possibility for the design of future strength training systems.
Works Cited An, T., Boccio, E., & Bolano, A. (2010). "Wii Controlled Gaming System for Therapy". St. Louis: Washington University in St. Louis.
Cioi, D., Kale, A., Burdea, G., Engsberg, J., Janes, W., & Ross, S. (2011). Ankle Control and Strength Training for Children with Cerebral Palsy using the Rutgers Ankle CP. IEEE International Conference on Rehabilitation Robotics, (pp. 654-659). Zurich.
Dodd, K., Taylor, N., & Graham, H. (2003). A randomized clinical trial of strength training in young people with cerebral palsy. Developmental Medicine and Child Neurology, 652-657.
Levac, D., & Galvin, J. (2011). Facilitating clinical decision-makign about the use of virtual reality within paediatric motor rehabilitation: Application of a classification framework. Developmental Neurorehabilitation, 177-184.