Award Date

5-1-2017

Degree Type

Professional Paper

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

Abstract

Background and Purpose: Active video games (AVG) are gaining popularity as a strategy for improving motor function in children with neurologically-based movement disorders, but there is no consensus regarding AVG’s utility or effectiveness in this population. The purpose of this systematic review was to examine current evidence on the use of AVG to improve motor function in children 2-17 years of age with neurologically-based movement disorders. Methods: Authors followed standard criteria for systematic review conduct and rating quality of evidence including the PRISMA checklist. Databases searched were Scopus, MEDLINE, Cochrane Library, EMBASE, and CINAHL. Systematic reviews, randomized control trials, or longitudinal studies were included if they investigated AVG for improving movement-related outcomes in children aged 2-17 years with neurologically-based movement disorders. Parameters studied included: health condition, strength of evidence, delivery methods or systems for AVG, capacity for adjusting to individual needs and skill levels, outcomes addressed with AVG, effectiveness for achieving targeted outcomes [primarily activity-level motor outcomes (n=36)], and challenges/limitations. Results: The 20 articles included in the review varied in quality from high (n=6), to moderate (n=4) to low (n=8) with two strong quality single subject research design (SSRD) studies. Studies involved children with 6 neurologic conditions using AVG in clinical, home or school settings for 49 different outcomes. Frequency and duration of dosage varied. Choice of games played and difficulty level were controlled by therapists (n=6) or the child (n=14). The most commonly reported limitations were small sample sizes and difficulty providing task-specific practice of functional movements via AVG. All studies reported improvement with AVG, though differences were not consistently significant compared to traditional therapy. Discussion: Heterogeneity of measurement tools and target outcomes prevented meta-analysis or development of formal recommendations. However, AVG has demonstrated feasibility and shows potential for improving activity-level outcomes (including those assessing balance, gross motor function, and upper and lower limb function) of children with neuromotor disorders, and should be considered when developing plans of care for this population. Additional research with larger samples, and investigations that explore dosing variables and utility for extending practice by home programming are merited.

Language

English


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