Background There is a need for innovation to improve compliance and accessibility of rehabilitation programs for individuals with acquired brain injuries. A computer game‐assisted tele‐rehabilitation platform (GTP) has been developed to address this need. With the novel application of a miniature inertial computer mouse and taking advantage of the wide variety of computer games, the GTP can provide engaging exercises for rehabilitation of upper extremity motor skills. Objective To determine the feasibility and acceptability of the game‐assisted home exercise program for upper extremity rehabilitation for people with stroke. The treatment effect was also measured after 16 weeks of intervention. Design A feasibility study. Setting College of Rehabilitation Science, University of Manitoba. Participants Ten stroke clients. Intervention Participants received three to four initial clinically supervised therapy sessions for training with the game assisted therapy program. Once trained, participants continued the program at the home for 16 weeks, four times per week. Main Outcome Measures Feasibility was evaluated based on retention rate and compliance. Semistructured interviews after the completion of the program were done to assess acceptability of the program. Quantitative analysis included (1) the Wolf Motor Function Test A and B and (2) a computerized performance‐based assessment of specific object manipulation tasks that required a combination of finger, wrist, elbow and shoulder motion. Results Findings demonstrated the feasibility and acceptability of the home tele‐rehab program. Eight of the 10 participants fully complied with the 16‐week exercise program. Two participants had difficulty with computer operations and did not complete the program. For the eight participants who completed the program, there was a substantial improvement from pre‐ to postintervention. Conclusion Although some difficulties with the technology were reported, the findings demonstrate feasible trial procedures, acceptable game‐assisted task‐oriented home training with a high compliance rate and positive outcomes. These findings and the theoretical evidence direct the next phase of a full‐scale randomized controlled trial.

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The common occurrence of age decline in mobility and cognition does cause a decrease in the level of physical activity and an increased falls risk. Consequently, dual -task (DT) assessment that simultaneously addresses both mobility skills and cognitive functions are important because, continued difficulties and fall injuries will have a sizable impact in this population. The first objective of the present study was to assess test-retest reliability of a computerized DT treadmill walking protocol and concurrent outcome measures of gait and visuospatial executive function in a group of healthy older adults. Secondly, discriminative validity was evaluated by examining the effect of DT conditions (single task vs. dual-task) on; (a) spatiotemporal gait measures (average and coefficient of variation) and (b) visuomotor and visuospatial executive performance measures. Twenty-five community-dwelling individuals median age 65 (range 61–67) were recruited from a Fitness Facility. Participants performed a computerized visuomotor tracking task and a visuospatial executive game task in standing and while treadmill walking. Testing was conducted on two occasions, 1 week apart. Moderate to high test-retest reliability (ICC values of 0.65–0.88) were observed for spatiotemporal gait variables. No significant differences between the group means were observed between test periods in any gait variable. Moderate test-retest reliability (ICC values of 0.6–0.65) was observed for measures of visuomotor and visuospatial executive performance during treadmill walking. Significant DT effects were observed for both spatiotemporal gait variables and visuospatial executive performance measures. This study demonstrates the reliability and reproducibility of the computer-based assessment tool for dual task treadmill walking. The high to moderate ICC values and the lack of systematic errors in the measures indicate that this tool has the ability to repeatedly record reliable data from community-dwelling older adults. The present computerized dual-task protocols broaden the types of standardized visuomotor and visuospatial executive activities for use with DT treadmill walking that has previously been reported.

BackgroundIt is difficult to engage young children with cerebral palsy (CP) in repetitive, tedious therapy. As such, there is a need for innovative approaches and tools to motivate these children. We developed the low-cost, computer game-based rehabilitation platform CGR that combines fine manipulation and gross movement exercises with attention and planning game activities appropriate for young children with CP.ObjectiveThe objective of this study is to provide evidence of the therapeutic value of CGR to improve upper extremity (UE) motor function for children with CP.MethodsThis randomized controlled, single-blind, clinical trial with an active control arm will be conducted at 4 sites. Children diagnosed with CP between the ages of 4 and 10 years old with moderate UE impairments and fine motor control abnormalities will be recruited.ResultsWe will test the difference between experimental and control groups using the Quality of Upper Extremity Skills Test (QUEST) and Peabody Developmental Motor Scales, Second Edition (PDMS-2) outcome measures. The parents of the children and the therapist experiences with the interventions and tools will be explored using semi-structured interviews using the qualitative description approach.ConclusionsThis research protocol, if effective, will provide evidence for the therapeutic value and feasibility of CGR in the pediatric rehabilitation of UE function.Trial RegistrationClinicaltrials.gov NCT02728375; http:https://clinicaltrials.gov/ct2/show/NCT02728375 (Archived by WebCite at http://www.webcitation.org/6qDjvszvh)

Objective: Physical and cognitive impairments are common with aging and often coexist. Changes in the level of physical and mental activity are prognostic for adverse health events and falls. Dual-task (DT) training programs that can improve mobility and cognition simultaneously can bring significant improvements in rehabilitation. The objective of this mixed methods exploratory RCT was to provide evidence for the feasibility and therapeutic value of a novel game-assisted DT exercise program in older adults.Methods: Twenty-two community dwelling participants, between the ages of 70–85 were randomized to either dual-task treadmill walking (DT-TR) or dual-task recumbent bicycle (DT-RC). Both groups viewed a standard LED computer monitor and performed a range of cognitive game tasks while walking or cycling; made possible with the use of a “hands-free”, miniature, inertial-based computer mouse. Participants performed their respective 1-h DT exercise program twice a week, for 12 weeks at a community fitness centre. Semi-structured interviews and qualitative analysis was conducted to evaluate the participant’s experiences with the exercise program. Quantitative analysis included measures of standing balance, gait function (spatiotemporal gait variable), visuomotor and executive cognitive function, tested under single and DT walking conditions.Results: Compliance was 100% for all 22 participants. Four themes captured the range of participant’s experiences and opinions: 1) reasons for participation, 2) difficulties with using the technologies, 3) engagement with the computer games, and 4) positive effects of the program. Both groups showed significant improvements in standing balance performance, visuomotor and visuospatial executive function. However, significant improvement in dual task gait function was observed only in the DT-TR group. Medium to large effect sizes were observed for most balance, spatiotemporal gait variables, and cognitive performance measure.Conclusion: With only minor difficulties with the technology being reported, the findings demonstrate feasible trial procedures and acceptable DT oriented training with a high compliance rate and positive outcomes. These findings support further research and development, and will direct the next phase of a full-scale RCT.