Serious Games for Serious Outcomes: Enhancing Cognition, Balance, and Quality of Life in Children With Cerebral Palsy

Официальное название

Effects of Serious Games on Cognitive Function, Balance, and Quality of Life in Children With Cerebral Palsy: a Randomized Controlled Trial

Обзор

Children with cerebral palsy (CP) often face challenges with balance, movement, and skills such as memory, problem-solving, and attention. These difficulties can affect not only daily activities but also their quality of life. Rehabilitation usually focuses on physical therapy, but recent research shows that combining movement training with cognitive tasks may be even more effective. What we are studying. This study is focused at whether serious games from the Vana Vital platform-that was specifically designed for rehabilitation-can improve balance, cognition, and quality of life in children with CP. These games are not ordinary video games: they were created to encourage children to move, focus, and solve problems at the same time (dual-tasking). The expected benefits include: * Better trunk control and stability. * Improved memory, attention, and reasoning. * Enhanced participation in daily life and overall well-being. Takeaway. This study is exploring an innovative approach to rehabilitation: using technology and games not only to strengthen the body but also to train the mind. If successful, this method may provide a fun, effective, and family-friendly addition to traditional therapies for children with CP.

Подробное описание

Background. Cerebral palsy (CP) is one of the most common causes of movement difficulties in children. It is a lifelong condition that affects posture, coordination, and the ability to control movements. Many children with CP also experience challenges in other areas, such as attention, memory, and problem-solving. These challenges can make everyday tasks, school activities, and social participation more difficult.

Traditional rehabilitation programs focus on improving physical functions, especially motor control and balance. Training only movement may not be enough. Children may benefit from approaches that combine movement and cognitive training-practicing how to move while also thinking, remembering, or making quick decisions.

This idea is called dual-tasking: doing two things at the same time, such as walking while answering a question, or maintaining balance while remembering a sequence. In real life, dual-tasking is what we do constantly-walking while talking to a friend, keeping balance while carrying a schoolbag, or focusing in class while sitting upright. For children with CP, dual-tasking can be particularly difficult, but also particularly beneficial to practice.

Serious games are a new, innovative way to provide this training. Unlike ordinary video games, serious games are designed specifically for therapeutic purposes. They are meant to be engaging and motivating for children, while at the same time targeting key skills in motor and cognitive development.

What Makes This Study Unique. This study is among the first randomized controlled trials to test the Vana Vital platform-a suite of computer-based serious games that combine physical movements with cognitive tasks. Instead of repetitive exercises, children engage in playful adventures that require them to move their bodies while also solving challenges.

Study Design in Practice. The study follows the structure of a prospective, single-blind randomized controlled trial, which means that children are randomly assigned to groups, and the evaluators do not know which group each child belongs to (to reduce bias).

Group allocation:

Experimental Group 1: Standard rehabilitation program + serious games. Control Group 1: Standard rehabilitation program only. Control Group 2: Standard program + 30 extra minutes of physical therapy daily.

This design allows researchers to see whether serious games add benefits beyond standard care.

Expected outcomes for children include:

Stronger trunk control and better stability when sitting, standing, or walking. Improved memory, attention, and problem-solving skills. A more positive experience of rehabilitation, making therapy feel less like work and more like play.

Potential improvements in everyday life, such as sitting upright in school, playing with peers, or participating in family activities.

What Health Care Providers Can Expect For clinicians, this study provides structured evidence on the feasibility and effectiveness of adding game-based dual-task training to rehabilitation.

Conclusion This study represents a step forward in child-centered rehabilitation. Instead of seeing therapy as hard work, children can experience it as an adventure with Woo in fun, interactive worlds. By training both the body and the mind, serious games have the potential to improve balance, cognition, and overall quality of life for children with cerebral palsy.

The results of this randomized controlled trial will help healthcare providers understand whether game-based dual-tasking should become a regular part of rehabilitation programs-and will give families hope for more enjoyable, effective, and innovative ways to support their children's development.

Вмешательства

• Процедура Serious games
  Participants in the experimental groups engage in daily sessions of serious games from the Vana Vital Platform (Super Surfer, Hungry Woo, Paddle Waddle, Woo's Wonderful World Adventure). Each child will for 30 minutes per day over 10 training days.
• Процедура Intensive rehabilitation
  Participants receive their intensive rehabilitation program, which includes: 30 minutes of physical therapy (PT) 20 minutes of occupational therapy 5 minutes of spinal manipulative therapy 60 minutes of full-body massage with reflexotherapy 15 minutes of joint mobilization 15 minutes of treadmill gait training (with or without suspension) 15 minutes of strength training 30 minutes of group rhythmic gymnastics
• Процедура Physical therapy
  Participants receive an additional 30 minutes of physical therapy (PT)

Первичные конечные точки

• Score of the Trunk control measurement scale (TCMS) [Срок оценки: Baseline and 2 weeks]

Вторичные конечные точки (4)

• Characteristics of the Static Balance Test [Срок оценки: Baseline and 2 weeks]
• Score of the cognitive tests from Sway Medical platform [Срок оценки: Baseline and 2 weeks]
• Score of the RAVEN's coloured progressive matrices (RCMP) [Срок оценки: Baseline and 2 weeks]
• Score of the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q) [Срок оценки: Baseline and 2 weeks]

Критерии участия

Критерии включения

• Diagnosis of cerebral palsy
• Ability to attend the educational institutions
• GMFCS I, II, III

Критерии исключения

• GMFCS IV, V
• Uncooperative behaviour
• Uncontrolled seizures

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Да

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Двойное слепое

Основная цель

Лечение

Центры проведения

Украина · 1 центр

• Elita Rehabilitation Center — Lviv

Публикации

• Endicott J, Nee J, Yang R, Wohlberg C. Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q): reliability and validity. J Am Acad Child Adolesc Psychiatry. 2006 Apr;45(4):401-7. doi: 10.1097/01.chi.0000198590.38325.81. PMID 16601644
• Pueyo R, Junque C, Vendrell P, Narberhaus A, Segarra D. Raven's Coloured Progressive Matrices as a measure of cognitive functioning in Cerebral Palsy. J Intellect Disabil Res. 2008 May;52(Pt 5):437-45. doi: 10.1111/j.1365-2788.2008.01045.x. Epub 2008 Feb 28. PMID 18312310
• Heyrman L, Molenaers G, Desloovere K, Verheyden G, De Cat J, Monbaliu E, Feys H. A clinical tool to measure trunk control in children with cerebral palsy: the Trunk Control Measurement Scale. Res Dev Disabil. 2011 Nov-Dec;32(6):2624-35. doi: 10.1016/j.ridd.2011.06.012. Epub 2011 Jul 14. PMID 21757321
• Kushnir A, Kachmar O. Intensive Neurophysiological Rehabilitation System for children with cerebral palsy: a quasi-randomized controlled trial. BMC Neurol. 2023 Apr 20;23(1):157. doi: 10.1186/s12883-023-03216-4. PMID 37081406
• Kachmar O, Kushnir A, Fedchyshyn B, Cristiano J, O'Flaherty J, Helland K, Johnson G, Puig D. Personalized balance games for children with cerebral palsy: A pilot study. J Pediatr Rehabil Med. 2021;14(2):237-245. doi: 10.3233/PRM-190666. PMID 33720857
• Szturm T, Parmar ST, Mehta K, Shetty DR, Kanitkar A, Eskicioglu R, Gaonkar N. Game-Based Dual-Task Exercise Program for Children with Cerebral Palsy: Blending Balance, Visuomotor and Cognitive Training: Feasibility Randomized Control Trial. Sensors (Basel). 2022 Jan 19;22(3):761. doi: 10.3390/s22030761. PMID 35161508
• Stadskleiv K. Cognitive functioning in children with cerebral palsy. Dev Med Child Neurol. 2020 Mar;62(3):283-289. doi: 10.1111/dmcn.14463. Epub 2020 Jan 9. PMID 32010976

Идентификаторы

NCT: NCT07158424 · ElitaRehab

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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