Effects of video game-based therapy in an adolescent with cerebral palsy: A case report

Table 1 Components and tasks involved in the video game-based intervention

Component	Movements	Game
Warm up	Upper limb movements side	Dance central: Poker face
	Stepping	Kinect adventures: Space pop
	Marching	Motion explosion: Balance beam
Balance	Single leg stance	Kinect adventures: 20000 leaks
	Weight shifting	Kinect sports: Target kick
		Ice age 4: Slip slider
Strength	Kicking	Kinect sports: Target kick
	Jumping	Kinect adventures: River rush
	Marching	Kinect sports: Hurdles
		Kinect sports: Sprint
Endurance	Combination of marching, squatting, jumping, and upper limb movements	Ice age 4: Glacier hopper
		Kinect adventures: Rally ball
Cool down	Upper limb movements Stepping	Kinect adventures: Space pop Motion explosion: Balance beam

Table 2 Changes after the video game-based therapy in muscle strength, gross motor, and quality of life

Outcome measure		Pre-intervention	Post-intervention	Change (%)
Muscle strength (N)	Left hip extensor	199.3	541.3	34 (> 100)
	Right hip extensor	147.2	535.4	388.2 (> 100)
	Left hip abductor	201.1	743.3	542.2 (> 100)
	Right hip abductor	212.6	752.2	539.6 (> 100)
	Left knee extensor	216.2	1017.9	801. (> 100)
	Right knee extensor	290.1	1035.6	745.5 (> 100)
GMFM-88 score	Dimension D standing (0-39)	36	35	1 (2.7)
	Dimension E walking, running, jumping (0-72)	65	65	-
Walking distance (m)	6 MWT	368	450	82 (5.0)
Quality of life	PedsQL in physical (0-100)	71.9	81.3	9.4 (13.0)
	PedsQL in emotion (0-100)	50.0	60.0	10 (20)
	PedsQL in social (0-100)	35.0	65.0	30 (85.7)
	PedsQL in schooling (0-100)	70.0	85.0	15 (21.4)
	PedsQL in total (0-100)	58.7	73.9	15.2 (25.9)

N: Newton; GMFM: Gross Motor Function Measure; m: Meter; 6 MWT: Six-min walk test; PedsQoL: Pediatric quality of life.

Table 3 The pros and cons between standard care and video game-based therapy for adolescents with cerebral palsy

	Standard care for cerebral palsy	Video game-based therapy for cerebral palsy
	Functional training; Facilitation of normal patterns of movement; Passive range of motion; Stretching exercise; Strengthening exercise; Positioning; Manual technique; Functional electrical stimulation; Splinting; Maintenance training	Refer to Table 1
Pros	Basic technique and well-known by physiotherapists; Most of the essential equipment available in the physiotherapy department	Active motor training with progressive challenges; Motivational and fun activities; Games were tailored to patients' ability, preference, and functional goals; Bi-weekly training with a structured program and assessments
Cons	Patients tend to get bored with repetitive treatment	Physiotherapists need to be trained on how to operate the games; Not all physiotherapy department has the equipment and space for the VBT

VBT: Video game-based therapy.