The impact of exergames on the functional balance of a teenager with cerebral palsy – a case report

To understand the impact of an intensive rehabilitation program based on exergames in balance and lower limb function in a teenager with cerebral palsy. The rehabilitation program comprised different customised exergames and was delivered in 5 weekly sessions of 30 min for 4 weeks. Pre-, post-, and 1-month Follow-up assessments included the following metrics: Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Gross Motor Function Measure (GMFM), Posturography, and Gait analysis. We observed increased scores after the intervention of 9/72 points in GMF – Module E (Walk, Run and Jump) and of 9/56 points in BBS, sustained at Follow-up. Changes in function, specifically in the quality and independence of the performance of specific movements such as turning 360°, increased distance reaching forward, walk behind, step over obstacles, and step stairs up and down were also observed. Gait kinematics and Spatio-temporal parameters tended to get closer to the 50^th percentile. We observed positive changes in motor function of a teenager with cerebral palsy, with sustained increased scores at a 1-month Follow-up. Findings are suggestive that intensive rehabilitation programs using exergames with high customisation features are a potentially valuable rehabilitation tool for training balance in teenagers with Cerebral Palsy.Implications for rehabilitationExergames may be a useful for providing balance training for teenagers who have a mixed form of cerebral palsy.Exergames that require body displacement may be suitable for modulating gait kinematics and spatio-temporal parameters.The customisation of virtual rehabilitation tools seems to impact the motivation and effort of the user positively. Exergames may be a useful for providing balance training for teenagers who have a mixed form of cerebral palsy. Exergames that require body displacement may be suitable for modulating gait kinematics and spatio-temporal parameters. The customisation of virtual rehabilitation tools seems to impact the motivation and effort of the user positively.

本研究旨在探究基于运动体感游戏（exergames）的强化康复方案对青少年脑性瘫痪患者平衡功能与下肢运动功能的影响。该康复方案包含多款定制化运动体感游戏，实施周期为4周，每周开展5次训练，每次时长30分钟。研究分别于干预前、干预后及1个月随访时实施评估，所用评估指标包括：伯格平衡量表（Berg Balance Scale, BBS）、动态步态指数（Dynamic Gait Index, DGI）、粗大运动功能评估量表（Gross Motor Function Measure, GMFM）、姿势图检查（Posturography）以及步态分析。研究结果显示，干预后GMF-E模块（行走、奔跑与跳跃）得分提升9/72分，伯格平衡量表得分提升9/56分，且该得分提升在1个月随访时仍得以维持。此外还观察到患者运动功能的改善，具体表现为特定动作的完成质量与独立性提升，例如360°转身、向前最大伸展距离增加、后退行走、跨越障碍物以及上下楼梯等。步态运动学参数与时空参数均呈现出向第50百分位靠拢的趋势。本研究观察到青少年脑性瘫痪患者的运动功能出现正向改善，且该改善在1个月随访时仍持续存在。研究结果提示，采用具备高定制化特征的运动体感游戏开展强化康复方案，或可成为针对青少年脑性瘫痪患者开展平衡训练的极具价值的康复工具。康复启示：运动体感游戏可用于为混合型脑性瘫痪青少年提供平衡训练。需要身体位移的运动体感游戏或可用于调节步态运动学参数与时空参数。虚拟康复工具的定制化似乎可正向提升使用者的训练动机与投入程度。运动体感游戏可用于为混合型脑性瘫痪青少年提供平衡训练。需要身体位移的运动体感游戏或可用于调节步态运动学参数与时空参数。虚拟康复工具的定制化似乎可正向提升使用者的训练动机与投入程度。