Game System May Be Effective Rehabilitation Option for Parkinson Disease, Study Finds

The Leap Motion Controller (LMC) system used with serious games may be an effective option for a rehabilitation tool for improving coordination, speed of movements, and fine upper limb (UL) dexterity in patients with Parkinson disease (PD), according to a recent study, published by the Journal of NeuroEngineering and Rehabilitation.

The researchers aimed to assess patient compliance and effectiveness of the LMC system when used with serious games designed for the UL in patients with mild-to-moderate stages of the disease. Twenty-three patients with PD in stages II to IV on the Hoehn & Yahn scale were randomized into 2 groups.

"Video games based on [virtual reality] technology are emerging as valid tools used in neurorehabilitation for patients with neurological disorders, and as a low cost and easily accepted adjunct to traditional therapy," the authors explained. However, standard games can be too difficult and progress too quickly for patients with PD. "Therefore, it is necessary to develop specific serious games for PD patients. Serious games are defined as games designed for a primary purpose other than that of pure entertainment, and which promote learning and behavior changes for PD patients."

The experimental group, consisting of 12 patients, received treatment based on serious games designed by the research team using the LMC system for the UL, while the control group received a specific intervention for the UL, according to the study. The researchers also recorded grip muscle strength, coordination, speed of movements, fine and gross UL dexterity, and satisfaction and compliance for both groups during pre- and posttreatment.

The experimental group demonstrated significant improvements in all posttreatment assessments, except for the Box and Blocks Test for the less affected side. The BBT is a quick, simple, and reliable measuremebt of manual dexterity that asks participants to move the maximum number of blocks from one box to another, one by, one, over the course of a minute. Additionally, the results demonstrated clinical improvements for all assessments in the control group. Following the statistical intergroup analysis, there were significant improvements in coordination, speed of movements, and fine motor dexterity scores on the more affected side of patients in the experimental group.

“These positive results may indicate that LMC could be an interesting tool for the UL rehabilitation of PD patients in the mild to moderate stages of the disease, however further studies are needed with longer training periods and a larger sample size,” concluded the authors.

The researchers suggested that future studies should verify the effectiveness of the tool and determine whether there is an ideal patient type who would benefit most from these interventions.

Reference

Fernandez-Gonzalez P, Carratala-Tejada M, et al. Leap motion controlled video game-based therapy for upper limb rehabilitation in patients with Parkinson’s disease: a feasibility study [published online November 6, 2019]. Journal of NeuroEngineering and Rehabilitation. doi: 10.1186/s12984-019-0593-x.