
The ability to move joints independently without triggering involuntary muscle activity in other body parts is called selective voluntary motor control (SVMC). Impairments in SVMC can significantly impact patients’ daily activities. Few treatments specifically address these impairments. A team led by Hubertus van Hedel from the University Children’s Hospital Zurich explored a game-based method to treat SVMC impairments in children.
The study involved 18 children with an average age of 12.7 years, all experiencing reduced SVMC due to various neurological disorders. Alongside their standard rehabilitation programs, the children participated in the game-based treatment. The intervention consisted of ten 45-minute gaming sessions to train SVMC.
In the game, participants controlled an avatar that navigated a virtual world, collected coins and avoided obstacles. The game included additional incentives, like unlocking new levels, completing extra challenges, and customizing the avatar. For each child, a specific joint or muscle group was targeted. Activating the target muscle or joint allowed the avatar to move through the game. However, any involuntary activity in other muscles triggered an alarm. The study consisted of an initial phase without SVMC-specific training, followed by the gaming sessions and a 3-month follow-up. SVMC was repeatedly assessed throughout the study.
The results showed no overall improvement in SVMC due to the game-based treatment – the standard rehabilitation program alone led already to gains in SVMC. However, the study identified specific conditions under which children were most likely to benefit from the game-based therapy: children who suffered from spasticity in the movement that they had to train during the game and those children training the more affected limb showed the most significant improvements.
Reference: Fahr, A., Kläy, A., Coka, L.S., van Hedel, H.J.A: Effectiveness of Game-Based Training of Selective Voluntary Motor Control in Children With Upper Motor Neuron Lesions: Randomized Multiple Baseline Design Study. JMIR Form Res (2024), 8, e47754 https://doi.org/10.2196/47754
Image: Adapted from Fahr et al. BMC Pediatrics. 2021;21:505