Innovative Game-Based Rehabilitation Platform for Children With Motor and Cognitive Impairments Due to Neuro-developmental Disorders and Acquired Brain Injuries

This research project focuses on the evaluation of an innovative, engaging computer game-based exercise system for use in rehabilitation of young children with cerebral palsy, and its transition for use in home. The goal of this research program is to produce high quality therapeutic point-of-care approaches and cost-effective delivery systems leading to better long-term health outcomes. At present, the challenges entailed in providing therapy services continue to put identified children at risk of missing opportunities to maximize their neuro-developmental capacities, sustain any behavioral recovery and prevent future complications.

Canada and India face a growing population of children with neuro-developmental disabilities distributed across broad geographic regions. Cerebral palsy is the most common neuro-developmental disability in childhood. The prevalence of cerebral palsy (CP) in developing countries is estimated to be 5 to 10 times greater than in North America. Children with CP can result in deficits in fine and gross motor skills and often have co-occurring deficits in attention and cognitive functions. Half of these children with CP have impaired upper extremity function (reaching, grasping and manipulating objects). The ability to perform functional tasks with the upper extremities is an important predictor of success in daily activities and participation in school, leisure and other aspects of community life.

There are many things to consider when developing therapy programs designed to improve motor and psychomotor skills for affected children to maximize their neuro-developmental capacities and to prevent the development of secondary disabilities. Intense repetitive task practice such as, constraint-induced movement therapy is one of the few effective neuro-rehabilitative strategies shown to improve upper extremity motor function in children with CP, with potential to overcome developmental difficulties. Constraint induced movement therapy consists of constraining the use of the unaffected upper limb to encourage use of the affected upper limb. However it is often difficult to engage children in therapy and sustain motivation to engage in intense repetitive task practice in using the affected upper limb. Thus, there is a need for effective approaches and tools that motivate young children with CP to complete long-term neuro-rehabilitation programs and to provide developmental opportunities.

Digital media and gaming have received considerable interest from researchers and clinicians as a model for learning a broad range of complex tasks and facilitating the transfer of skills to daily life. These emerging rehabilitation technologies have the potential to improve clinical outcomes and child participation because they are engaging, motivating and now accessible. For this purpose investigators have developed a computer game-based rehabilitation and learning platform (CRP). This approach combines fine and gross motor exercises and cognitive activities appropriate for children with neuro- developmental disorders. The approach is designed to provide engaging, high-quality, personalized therapy in the clinical rehabilitation setting, and which could also be implemented in the school and home via Tele rehabilitation.

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