1. COMPUTER GAMES IN CEREBRAL PALSY (CP) THERAPY RYAN JACKSON, JEN FAITH, TARA SILIANOFF, LAURA MANSON, KATIE EMERY, DIANA AZOSE, ANJALI NIGAM

2. THE HUMAN PERFORMANCE LAB @ PARAQUAD Marisa Sevick and Matt Foreman, under the supervision of Dr. Jack Engsberg Focusing on the use of internet video games with the Microsoft Kinect system to improve upper extremity function in children with cerebral palsy Specific Aim: adapting existing internet computer games for CP therapy

3. WHAT IS CEREBRAL PALSY? A multi-symptomatic, non-progressive neurological disorder Caused by damage to the developing motor control regions of the brain Later affects the peripheral nerves, leading to differences in development in muscles, bones & joints Lack of selective muscle control Abnormal muscle tone Affects 1/500 children in infancy or early childhood No existing cure

4. OBJECTIVES OF THE STUDY Objective 1: Develop simple methods to assume control of internet games with the Kinect sensor. Objective 2: Develop simple methods to use full range of upper extremity joint motion for internet game play. Objective 3: Assess the feasibility of using existing internet games for improving movement, function, quality of life and participation in children with CP.

5. METHODS Research participants: children with CP, ages 5-18 12 week training program Mircrosoft Kinect as the sensory apparatus Using modified, popular computer games

6. PROCEDUREPROCEDURE

7. EXPECTED OUTCOMES With intervention, participants will improve in: strength range of motion motor control function quality of life participation

8. A plethora of games readily available online for free Varying in complexity to fit client’s needs Various genres of games to fit client’s interests Adapting existing games = less expensive Limited number of games Lacking complexity with client’s therapeutic progress Decreased interest and motivation Expensive to develop THIS STUDY VS. OTHERS

9. PROJECT STATUS

10. STATUS Development stage Grants are being written for funding from various agencies ISSUES Coding needs to be simplified for clinical or home use Not able to enter the range of motion limits in degrees Functionally, no gradations in movement of trunk or arms

11. ANALYSIS METHODS Facilitators developed their own software using MATLAB Records joint movement and orientation during game play Allows for simple motion analysis Mathematically manipulates joint translation and rotation Records the range of motion achieved Records the number of repetitions exerted

12. BIOMECHANICAL ANALYSIS Goal Directed: Using the Kinect to produce functional movement in clients with CP who may have limited range of motion, strength or motor control. Meaningful: Allows young children with CP to participate in age- appropriate games that they choose and find interesting. Participation: Participants are actively engaged mentally and physically throughout the game. Designed to improve motor skills and strength in performing daily occupations. Adaptable, gradable, and age appropriate

13. WHAT’S NEXT?

14. WHAT NOW? Next Steps Continue grant-writing for funding Reaching out to the medical community for referrals Have 2 players simultaneously competing to enhance social participation Comprehensive computer program for better user interface Suggestions Incorporate other populations of children with disabilities Comfortable, kid-friendly environment to conduct study

15. QUESTIONS?