Home-Based Functional Electrical Stimulation-Assisted Hand Therapy Video Games for Children with Hemiplegia: Development and Proof-of-Concept

Michael J. Fu*, Anna Curby, Ryan Suder, Benjamin Katholi, Jayme S. Knutson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

We describe the development and three case reports of a home-based intervention for children with hand hemiplegia that integrates custom video games with contralaterally controlled functional electrical stimulation (CCFES). With CCFES, stimulated opening of the more-affected hand is modulated by volitional opening of the less-affected hand. Video games that solicit goal-oriented, skill-requiring movement have shown promise for treating hemiplegia, but they have not previously been combined with electrical stimulation in children. Three children ages 8, 9, and 11 with moderate-to-severe hand hemiplegia were assigned six weeks of therapy in lab and at home. The goal was to determine if children could tolerate 9 lab treatment sessions and administer up to 7.5 hrs/wk of CCFES video game therapy at home. The feasibility of this intervention for home use was assessed by device logs, end-of-treatment interviews, and motor function/impairment assessments. With caregiver help, the children were all able to attend 9 lab sessions and built up to 7.5 hrs/wk of therapy by week 3. They averaged 5-7 hrs/wk of home intervention overall. Motor outcomes improved for all three participants at treatment end, but mostly regressed at 4-weeks follow-up. Individual improvements at treatment end exceeded minimum detectable or clinically important thresholds for Assisting Hands Assessment, Fugl-Meyer Assessment, and Melbourne Motor Assessment 2. We found preliminary indications that CCFES-integrated video game therapy can provide a high dose of hand motor control therapy at home and in the lab. Improvements in motor outcomes were also observed, but more development and study is needed.

Original languageEnglish (US)
Article number9091015
Pages (from-to)1461-1470
Number of pages10
JournalIEEE Transactions on Neural Systems and Rehabilitation Engineering
Volume28
Issue number6
DOIs
StatePublished - Jun 2020

Keywords

  • Haptic interfaces
  • Human-computer interfaces
  • Pediatrics
  • Rehabilitation robotics
  • Telemedicine

ASJC Scopus subject areas

  • Internal Medicine
  • Neuroscience(all)
  • Biomedical Engineering

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