Accepted for/Published in: JMIR Formative Research
Date Submitted: Apr 2, 2023
Date Accepted: Sep 19, 2024
Effectiveness of Game-Based Training of Selective Voluntary Motor Control in Children with Upper Motor Neuron Lesions: Randomized Multiple Baseline Design Study
ABSTRACT
Background:
Selective voluntary motor control (SVMC) is the ability to control joint movements independently. Impairments in SVMC can affect functional activities, but only a few interventions target SVMC. Therefore, we have developed a game-based intervention for children with upper motor neuron lesions to improve SVMC. The intervention trained selective activation of a muscle or joint movement while providing immediate feedback about involuntarily occurring muscle activations or movements at another joint.
Objective:
Our aim was to investigate the effectiveness of this game-based intervention and explore treatment-response-related factors of children with impaired SVMC undergoing inpatient neurorehabilitation.
Methods:
We used a randomized, non-concurrent, multiple baseline design study. After the random-length baseline phase, participants completed ten 45-minute sessions with our game-based SVMC training. SVMC was measured repeatedly throughout both phases with a short custom-made assessment.
Results:
Eighteen children with upper motor neuron lesions participated (mean age 12.7 (SD 2.9) years, mostly spastic cerebral palsy). A linear mixed-effects model revealed a significant trend for improved SVMC already in the baseline phase that did not change significantly between the phases. Although we could not find an overall treatment effect, we could explain 89.4% of the random variation by patient and therapy characteristics. Children with better SVMC at baseline, increased muscle tone, and who trained the more affected side benefitted from the intervention.
Conclusions:
Already the regular concomitant rehabilitation program yielded improvements in SVMC. While the game-based intervention did not show a group effect, we could identify patients who profited from the intervention. Clinical Trial: German Clinical Trials Register, DRKS00025184.
Citation

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