Video games carefully designed to improve the upper limbs — including grip strength, dexterity, and coordination — may be a rehabilitation aid for people with Parkinson’s disease (PD), a small study in patients suggests.
The study, “Leap motion controlled video game-based therapy for upper limb rehabilitation in patients with Parkinson’s disease: a feasibility study,” was published in the Journal of NeuroEngineering and Rehabilitation.
Rehabilitation is an important therapy approach in addressing motor symptoms in PD. In recent years, video games that use virtual reality technologies have grown in interest in this field — the basic idea being that these games, which involve the player moving their body as a means to play, allows for rehab-like tasks to be done in a more fun and engaging setting.
However, common commercial systems — like the Nintendo Wii, Playstation Move, and Kinect plus XBOX 360 — aren’t especially well-suited for Parkinson’s rehabilitation; they tend to move too quickly or be too difficult. The need, instead, is for “specific serious” video games, which the researchers defined as, “games designed for a primary purpose other than that of pure entertainment, and which promote learning and behavior changes for PD patients.”
For the study, 23 people (11 male, 12 female; average age 66.65) with PD were recruited from a Parkinson’s association based in Madrid. All had disease stages of 2, 3, or 4 based on the Hoehn and Yahr scale (a 0–5 scale, with higher stages correlating with more advanced disease).
Patients were divided into two groups; 11 completed upper limb-focused conventional physical therapy as a control group, while 12 played serious video games designed by the researchers. Both groups had two 30-minute sessions of their respective therapy each week for six weeks.
These video games utilized the Leap Motion Controller System (LCM), which tracks an individual’s hands as the means of controlling the game, without the need for additional sensors or controllers. “This system presents important advantages over other motion capture systems, namely thanks to its portability, ease of use, commercial availability, low cost and non-invasive nature,” the researchers wrote.
They designed six “serious” games, each of which involved performing tasks akin to what is done in conventional therapy. For instance, one involves playing a virtual piano, which necessitates flexing individual fingers. In another game, players must move virtual blocks into a particular order, requiring the player to reach for different blocks. The researchers noted that “different interventions can be designed by combining two or more games that focus on a specific pathology and patient population.”
Both before and after the six-week intervention, participants underwent a battery of tests assessing physical abilities.
Both groups showed significant improvements in grip strength on both sides of the body.
Scores on the Purdue Pegboard Test (PPT, which measures coordination and dexterity) improved significantly in both groups. But in the control group, only the more affected side of the body showed a significant improvement, whereas significant improvements were seen on both body sides in the video game group.
Although both groups’ scores before the intervention were similar, PPT scores in the video games group were significantly higher than in the conventional therapy group after the respective interventions.
Significant improvements on the Box and Blocks Test (BBT, another coordination test) were also seen in both groups, but only on the more heavily impaired side of the body.
Both groups reported high subjective satisfaction with their therapy. “Furthermore,” the researchers wrote, “compliance to the interventions was excellent (100%) and no adverse side-effects were observed for both groups.”
This study has some limitations, the researchers noted: it was done in quite a small sample size, and only on people with mild-to-moderate PD. As such, more studies are needed to validate its findings.
“The LMC system and the serious games designed and used in this study represent a rehabilitation tool that may benefit certain PD patients for the improvement of coordination, speed of movements and fine dexterity in [upper limb] interventions,” the researchers concluded.