Video game–based coordinative training improves ataxia in children with degenerative ataxia

ABSTRACT

Objective: Degenerative ataxias in children present a rare condition where effective treatments are lacking. Intensive coordinative training based on physiotherapeutic exercises improves degenerative ataxia in adults, but such exercises have drawbacks for children, often including a lack of motivation for high-frequent physiotherapy. Recently developed whole-body controlled video game technology might present a novel treatment strategy for highly interactive and motivational coordinative training for children with degenerative ataxias.

Methods: We examined the effectiveness of an 8-week coordinative training for 10 children with progressive spinocerebellar ataxia. Training was based on 3 Microsoft Xbox Kinect video games particularly suitable to exercise whole-body coordination and dynamic balance. Training was started with a laboratory-based 2-week training phase and followed by 6 weeks training in children’s home environment. Rater-blinded assessments were performed 2 weeks before laboratory-based training, immediately prior to and after the laboratory-based training period, as well as after home training. These assessments allowed for an intraindividual control design, where performance changes with and without training were compared.

Results: Ataxia symptoms were significantly reduced (decrease in Scale for the Assessment and Rating of Ataxia score, p = 0.0078) and balance capacities improved (dynamic gait index, p = 0.04) after intervention. Quantitative movement analysis revealed improvements in gait (lateral sway: p = 0.01; step length variability: p = 0.01) and in goal-directed leg placement (p = 0.03).

Conclusions: Despite progressive cerebellar degeneration, children are able to improve motor performance by intensive coordination training. Directed training of whole-body controlled video games might present a highly motivational, cost-efficient, and home-based rehabilitation strategy to train dynamic balance and interaction with dynamic environments in a large variety of young-onset neurologic conditions.

Classification of evidence: This study provides Class III evidence that directed training with Xbox Kinect video games can improve several signs of ataxia in adolescents with progressive ataxia as measured by SARA score, Dynamic Gait Index, and Activity-specific Balance Confidence Scale at 8 weeks of training.

GLOSSARY

ABC=
Activity-specific Balance Confidence Scale;
DGI=
dynamic gait index;
INAS=
Inventory of Non-Ataxia Symptoms;
SARA=
Scale for the Assessment and Rating of Ataxia

Footnotes

  • Study funding: Supported by the Oliver-Vaihinger-Fonds, Stiftung für kranke Kinder, Tübingen, Germany; Ataxia UK; Ataxia Ireland; the German Hereditary Ataxia Foundation (DHAG); and the Volkswagenstiftung (grant VW II/85 158 awarded to M.S.)

    full article http://www.neurology.org/content/79/20/2056

You know I use the wii and it has games and exercises that I do. I play them with my Grandchildren and we have lot's of fun at the same time I know it's really helping my cognative thinking, coordination, fatigue, and my ballance, they have really improved too! So I belive that it helps everyone's mind young and older, any age!

I was getting a MRI every year since 2006 to keep tabs on the degeneration of my cerebellum. As of March my Nerologist told me that clearly what I'm doing (exercising on the wii etc and my nutrition) has been making a huge diffrence (I graduated to getting one ever two years now) because my MRI's show that I do not have degeneration of my cerebellum since I started doing everything regularly.So I believe that this CAN be done at any age.

Thank you for sharing this! :0)

Very interesting JC...thanks!

That's great Jeannie!!! Keep up the good work, as it's obviously paying off big-time!!! ;o)