Accepted for/Published in: JMIR Formative Research
Date Submitted: Jul 3, 2023
Date Accepted: Aug 24, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Serious Game for Fine Motor Control Rehabilitation for Children with Epileptic Encephalopathy: Development and Evaluation study.
ABSTRACT
Background:
One of the main disturbances in Epileptic Encephalopathy (EE) is in the coordination of the upper extremities and hands. Traditional Rehabilitation (TR) in this type of pathology focuses on the alleviation of gross/fine motor disability. In the last few years, the use of low-cost devices together with customized serious games has shown improvements in motor disorders and enrichments in Activities of Daily Living (ADL).
Objective:
The primary aim of this study was to explore the feasibility of a new Serious Game to improve fine motor control in children with EE.
Methods:
The participants were four children with EE (two males and two females), who were classified as Level 1 in the Gross Motor Classification System (GMCS). The children were tested during 10 sessions in the intervention period (pretreatment and post-treatment). The clinical tests were the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2). Only four subscales of BOT-2 were considered: Fine Motor Precision (FMP), Fine Motor Integration (FMI), Manual Dexterity (MD), and Upper-Limb Coordination (ULC). Pittsburgh Rehabilitation Participation Scale (PRPS) was used to evaluate participants’ participation. kinematic outcomes of our study were evaluated based on the time-session movements. Finally, we used the User Satisfaction Evaluation Questionnaire (USEQ) to analyze participants’ satisfaction.
Results:
The outcomes for the t-Student test were the following: a p-value of 0.009 in FMP, a p-value of 0.0015 in FMI, a p-value of 0.56 in MD, and a p-value of 1.90 in ULC. Results show a significant difference before and after intervention only in FMP and FMI. Kinematics outcomes show initial progress in manual dexterity, which measures fine motor speed and accuracy required to complete ADL. The participation rate on the PRPS was between Good and Very Good, which shows the participant's interest and motivation in using the serious game. The mean score on the USEQ was 27.50 (the maximum value is 30).
Conclusions:
Results support that the proposed serious game could be used as a complement in the rehabilitation sessions of fine motor control (fine motor precision and fine motor integration) for children with EE. Significant improvements in fine motor control and ADL revealed that the proposed serious game is enriching for fine disorders of this pathology
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