Feasibility of Pediatric Game-Based Neurorehabilitation Using Telehealth Technologies: A Case Report

Abstract

This case report is the first in a series of reports designed to determine the feasibility of implementing game-based neurorehabilitation using telehealth technologies (GbN+TT) for children with cerebral palsy, evaluate the responsiveness of relevant outcome measures to changes in motor impairment and activity participation after intervention, and identify technological challenges associated with implementation of GbN+TT. The participant completed more than 56 hr of game-based neurorehabilitation over 8 wk using the Timocco platform in his home. The primary measures of motor impairment (Bruininks-Oseretsky Test of Motor Proficiency, Second Edition) and function (Pediatric Motor Activity Log) were both sensitive to change. Results indicate that it is feasible to administer GbN+TT to a child with cerebral palsy and monitor outcomes using standardized assessments.

Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: Designing a user-experience

“…The evidence literature provides support for the use of a telehealth service-delivery model in occupational therapy (OT) practice within various settings. The use of telehealth in pediatric occupational therapy has been shown to be effective by increasing access to specialist care and preventing delays in provision of services (Cason, 2014), increasing collaboration and carry-over of treatment strategies (Gibbs & Toth-Cohen, 2011), and improving overall therapist/client satisfaction (Ashburner, 2016;Criss, 2013;Reifenberg, et al, 2017;Zylstra, 2013). Despite the effectiveness of a telehealth service-delivery model, the use of telehealth in occupational therapy practice is limited, potentially due to a lack of knowledge about telehealth.Education is a critical factor necessary to promote successful implementation of telehealth in clinical practice (Nissen & Brockevelt, 2016).…”

O uso de jogos interativos por crianças com síndrome de Down

“…The games have levels as the child performs well at the previous level. It is a supportive tool to strengthen children's motor, cognitive and communicative skills (TRESSER, 2012;CABRAL et al, 2016;REIFENBERG et al, 2017).…”

“…Studies like Tresser´s study (2012) who used the Timocco platform with a child of 5 years and 2 months old, diagnosed with dyspraxia, used the game Falling fruit; Reifenberg et al (2017) study used the platform in the rehabilitation work of a child with cerebral palsy in their home; and Benham and Gibbs (2017) study used it with two children aged 5 and 7 years old, with difficulties in fine motor coordination, carried out at school, showed that the use of playful tools in working with children with disabilities increases the interest and motivation in performing rehabilitation activities through games, and the use of the Timocco Platform enabled the development of motor coordination skills.…”

“…The use of virtual reality games is becoming more frequent in the rehabilitation programs for people with disabilities; however, the virtual reality games available in the market have many stimuli in general, requiring the speed and the use of multiple movements from the player, which may impair the rehabilitation process when it is used without supervision (TRESSER, 2012;REIFENBERG et al, 2017).…”

“…Games may be available on different platforms and in the literature there have been studies in which they were used for motor, cognitive or social rehabilitation (WUANG et al, 2011;MONTEIRO et al, 2011;TRESSER, 2012;TAVARES et al, 2013;COSTA, 2014;ROCHA et al, 2015;CRUZ;D'ALENCAR;MENUCHI, 2015;CAIANA;NOGUEIRA;LIMA, 2016;MEDEIROS et al, 2017;REIFENBERG et al, 2017;BENHAM;GIBBS, 2017).…”