Virtual Reality and Active Video Games to Improve Balance in Children With Brain Injury

Sponsor

Blythedale Children's Hospital (Other)

Overall Status

Completed

CT.gov ID

NCT03386968

Collaborator

(none)

Enrollment

Location

Arms

Actual Duration (Months)

0.1

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

The purpose of this pilot feasibility study is to assess the feasibility of using the Playstation Xbox 360 and Rutgers V-step via a Kinect Sensor with active video game software as a part of a physical therapy intervention to improve obstacle negotiation, gait speed, and stair negotiation in ambulatory children with Cerebral Palsy (CP) hemiparesis or spastic diplegia, or non-progressive brain injury (BI). Children will be assessed using perceptual, balance, functional and gait assessments.

Condition or Disease	Intervention/Treatment	Phase
Cerebral Palsy Acquired Brain Injury	Behavioral: Active video gaming Behavioral: Usual care physical therapy	N/A

Study Design

Study Type:

Interventional

Actual Enrollment :

4 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Intervention Model Description:

A Randomized Block Design will be utilized in order to attempt to "match" subjects according to functional level and diagnosis (cerebral palsy or acquired brain injury). Upon signing consent the subjects will be grouped based on their diagnosis. At that time gait speed for the 10 M Walk Test will be utilized to categorize all participants into a "fast" and "slow" group. (subjects performing the 10 M Walk Test at a speed less than .4 m/s will be placed in the "slow" group, and subjects testing at a speed greater than or equal to .4 m/s will be placed in the "fast" group After this determination is made, subjects will be randomized to "control" (usual care), and "intervention" one therapy session replaced with a session utilizing Active video games and the Rutger's V-step. A minimum of 2 subjects per grouping will be sought in order to analyze for differences.A Randomized Block Design will be utilized in order to attempt to "match" subjects according to functional level and diagnosis (cerebral palsy or acquired brain injury). Upon signing consent the subjects will be grouped based on their diagnosis. At that time gait speed for the 10 M Walk Test will be utilized to categorize all participants into a "fast" and "slow" group. (subjects performing the 10 M Walk Test at a speed less than .4 m/s will be placed in the "slow" group, and subjects testing at a speed greater than or equal to .4 m/s will be placed in the "fast" group After this determination is made, subjects will be randomized to "control" (usual care), and "intervention" one therapy session replaced with a session utilizing Active video games and the Rutger's V-step. A minimum of 2 subjects per grouping will be sought in order to analyze for differences.

Masking:

None (Open Label)

Primary Purpose:

Treatment

Official Title:

Use of Low-Cost Virtual Reality and Active Video Games to Improve Balance and Perceptual Skills in Children With Cerebral Palsy and Brain Injury

Actual Study Start Date :

Dec 7, 2017

Actual Primary Completion Date :

Jan 6, 2022

Actual Study Completion Date :

Jan 6, 2022

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Video gaming A child's usual physical therapy session will be replaced with a session utilizing Active video games and the Rutger's V-step.	Behavioral: Active video gaming Children will visit Blythedale for 8 sessions, one 45-session visit per week, in place of one of the child's typical physical therapy sessions. During each session, children will play a video game on the X-Box Kinect system, using the games "Kinect Adventures" and "Kinect Sports". The child will first play a "Kinect Adventures" game, which requires ambulating, ducking, and dodging one's way through an obstacle course.
Active Comparator: Usual care Children will receive their usual care in the physical therapy program at Blythedale.	Behavioral: Usual care physical therapy Children will attend their usual care physical therapy appointments at Blythedale.

Arm

Intervention/Treatment

Experimental: Video gaming

A child's usual physical therapy session will be replaced with a session utilizing Active video games and the Rutger's V-step.

Behavioral: Active video gaming

Children will visit Blythedale for 8 sessions, one 45-session visit per week, in place of one of the child's typical physical therapy sessions. During each session, children will play a video game on the X-Box Kinect system, using the games "Kinect Adventures" and "Kinect Sports". The child will first play a "Kinect Adventures" game, which requires ambulating, ducking, and dodging one's way through an obstacle course.

Active Comparator: Usual care

Children will receive their usual care in the physical therapy program at Blythedale.

Behavioral: Usual care physical therapy

Children will attend their usual care physical therapy appointments at Blythedale.

Outcome Measures

Primary Outcome Measures

Change in Pediatric Evaluation of Disability Inventory Computer Adaptive Test [From before intervention to immediately after intervention]
The PEDI-CAT measures abilities in three functional domains: Daily Activities, Mobility and Social/Cognitive.

Secondary Outcome Measures

Change in 10 Meter walk test [From before intervention to immediately after intervention]
Measures time taken for a participant to walk 10 meters
Change in Gross Motor Function Measure (GMFM) subtest D and E [From before intervention to immediately after intervention]
The GMFM is a standardized observational instrument designed and validated to measure change in gross motor function over time in children with cerebral palsy.
Change in Four Square Step Test [From before intervention to immediately after intervention]
Measures how well a patient can change directions while stepping.
Change in Functional Gait Assessment (FGA) [From before intervention to immediately after intervention]
10-item test that assesses dynamic balance and postural stability during gait.
Change in Motor Free Visual Perceptual Test (MVPT)-4 [From before intervention to immediately after intervention]
The MVPT-4 assesses five categories of visual perception: Visual Discrimination: Ability to discriminate dominant features of different objects, including the ability to discriminate position, shapes, and forms.
Change in Visually guided weight shift ability as measured by the Smart Balance Master® [From before intervention to immediately after intervention]
Force platform system that tests balance
Change in Children's Assessment of Participation and Enjoyment [From before intervention to immediately after intervention]
Self-report measures of children's participation in recreation and leisure activities outside of mandated school activities.

Eligibility Criteria

Criteria

Ages Eligible for Study:

7 Years to 17 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Age 7-17
Diagnosis of Cerebral Palsy or Diagnosis of Acquired Brain Injury
Ambulatory with or without an assistive device x 150 feet
Cognition and attention ability sufficient to be successful in video game play and to follow instructions of the investigator.
Able to complete testing process.
Current patient at Blythedale Children's Hospital program (Expected Length of Stay/availability for study of approximately 8 weeks)

Exclusion Criteria:

Any history of photosensitive epilepsy or seizures triggered by exposure to flashing lights, television or video games
Attention or behavior problems that prevent the successful completion of game play
Any acute musculoskeletal injury that limits weight bearing on one lower extremity (due to orthopedist concerns for fracture or injury)
Any medical condition that prevents the child from tolerating exercise due to cardiovascular conditions