Video game technology can help measure upper extremity movement in children with muscular dystrophy

Researchers at Nationwide Children’s Hospital have developed a method for measuring upper extremity movement in patients with muscular dystrophy using video game technology, according to a press release.

The researchers found scores in an interactive game were highly correlated with parent reports of daily activities, mobility and social and cognitive skills.

“We developed this game because there was not an accepted outcome measure for boys with muscular dystrophy who couldn’t walk. So, we needed an outcome measure that would be reliable, valid and also give discrete quantitative measurements so they could measure small change or big change over time,” Linda Lowes, PT, PhD, director of clinical therapies at Nationwide Children’s, said in the release.

The study measured the mobility of 61 male patients recruited from the Nationwide Children’s Hospital Muscular Dystrophy Association Clinic. Although the study focused on patients with Duchenne Muscular Dystrophy — a type of muscular dystrophy that is most common in children, specifically young boys — the researchers hope the technology will also demonstrate utility in patients with other conditions that result in lack of mobility, such as cerebral palsy.



Cole Eichelberger, 13, helps test a new video game developed by experts at Nationwide Children`s Hospital. Eichelberger has Duchenne muscular dystrophy, which often confines patients to wheelchairs at an early age and prevents them from taking part in clinical trials.

Source:Nationwide Children’s Hospital


“As a clinical trial outcome measure, we really wanted this to be as universal as possible. We want to be able to use this across sites, both in the U.S. and internationally, because most of the clinical trials are international at this point,” Lindsay Alfano, PT, a physical therapist at Nationwide Children’s, said in the release. “Having something that’s commercially available, low cost and easy to implement was really a huge goal for us.”

Ability Captured Through Interactive Video Evaluation, or ACTIVE-seated technology, utilizes a Kinect gaming camera, found in Xbox consoles. With a patient-requested zombie theme, the game requires the boys to reach with their arms in various directions to push forward a force field. The Kinect camera and ACTIVE-seated software measure how far and how long the boys reach. Measuring change over time is a primary goal. The development of the game relied almost entirely on the patients, according to the release.

“The game allows them to disintegrate aliens, which they love,” Alfano said. “In clinical trials we need to see that they’re getting better with all of their activities. They have to spend hours with us doing nothing that’s easy, only hard things. Looking at their faces after they play this game where they get to just play and be kids is a lot of fun to see.”


Lowes LP, et al. Reliability and validity of ACTIVE-seated: an outcome in dystrophinopathy. Muscle Nerve. 2014;doi:10.1002/mus.24557.

Disclosure: The study was funded by the Department of Technology Development and Commercialization in the Research Institute at Nationwide Children’s Hospital.

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