Tool to Assess Video Game Movement in Kids with Cerebral Palsy Shows Promise for Clinical Decision Making

While video games are increasingly popular tools to improve motor skills in children with cerebral palsy, therapists need education and tools to choose games suited to the needs of individual patients. A recently developed instrument to evaluate movement linked to video games has the potential to aid therapists in their decisions, but research shows the rating tool needs to be refined before introduction in clinical practice.

Various games and virtual reality applications for motoric training focus on different types and frequencies of movement. It is, therefore, understandable that a particular game suits only some patients. For a busy clinician, adequate tools for assessing game and patient combinations are a need.

Researchers at Northeastern University in Massachusetts developed an instrument called the Movement Rating Instrument for Virtual Reality Game Play — a 25-item quantification of movements in the upper and lower extremities, as well as whole body movements, described in a report titled “Development and Reliability Evaluation of the Movement Rating Instrument for Virtual Reality Video Game Play.”

To evaluate the feasibility and reliability of the Movement Rating Instrument, three raters trained in the use of the tool rated 176 videotaped 90-second sessions of seven typically developing children and four children with cerebral palsy playing video games intended to improve movement. The assessment included eight video games on two virtual reality and active video game systems.

In addition to rating the movements, the three raters were asked to quantify how difficult they thought it was to rate each specific item, and their confidence in the rating.

The report, published in the journal JMIR Serious Games, showed that for 17 of the 25 items, each rater tended to give the same ratings when tested repeatedly. There was more variation between raters, however. Upper extremity, as well as squat and jump movements, were most often rated in a similar way by the three raters, while they did not agree as often about 12 other items. There were also four movements that were rated very differently among the three raters.

Such difficulties were often associated with poor quality of the recorded videos, differences in interpreting the instrument items, and difficulties in quantifying high-speed movements.

The research team concluded that if the Movement Rating Instrument is further refined, it could be a valuable tool to help clinicians in choosing the right games for individual patients.