Automated functional upper limb evaluation of patients with Friedreich ataxia using serious games rehabilitation exercises.
Bruno Bonnechère, Bart Jansen, Inès Haack and 4 others
PMID 30286776WHAT IT FOUND
People with Friedreich ataxia took 44 seconds to wipe a virtual screen, compared with 25 seconds for healthy controls, and scored 88% accuracy versus 94%.
The game may help track upper limb impairment, but it was not tested as treatment.
Key findings
01In the wiping game, patients with Friedreich ataxia took 44 seconds on average to clean 90% of the screen, while healthy controls took 25 seconds.
02Patients were less accurate, scoring 88% compared with 94% for controls, and their wrist movement was slower in both sideways and up-down directions.
03Game scores related to clinical severity: longer disease duration was associated with slower game performance, and some movement measures correlated with daily living scores and nine-hole peg test times.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The game was measured only once, at one annual visit, so the study cannot tell whether the results would repeat or whether practice, fatigue or habituation changed them. The data are cross-sectional, so the study cannot show that the game predicts disease progression or works as a trial outcome measure over time. The patient group was small and had a wide age range, and some clinical and genetic measures were available for fewer patients than the full group of 27. The Kinect sensor has known limitations for measuring upper limb joint angles in people using wheelchairs, so the movement values may not be exact clinical measurements. The study tested assessment during game play, not whether the game improves upper limb function or daily activities.
Declared interests
The work was funded by Innoviris. The supplied text reports no other author conflicts of interest.
The easy way to misread this
Do not read the 44-second versus 25-second game result as evidence that serious games improve upper limb function. The study measured one game session in patients and controls; it did not test a treatment effect.