research-article

Designing action-based exergames for children with cerebral palsy

Authors:

Hamilton A. Hernandez,

T.C. Nicholas Graham,

Darcy Fehlings,

Lauren SwitzerAuthors Info & Claims

CHI '13: Proceedings of the SIGCHI Conference on Human Factors in Computing Systems

Pages 1261 - 1270

https://doi.org/10.1145/2470654.2466164

Published: 27 April 2013 Publication History

Abstract

Children with cerebral palsy (CP) want to play fast-paced action-oriented videogames similar to those played by their peers without motor disabilities. This is particularly true of exergames, whose physically-active gameplay matches the fast pace of action games. But disabilities resulting from CP can make it difficult to play action games. Guidelines for developing games for people with motor disabilities steer away from high-paced action, including recommendations to avoid the need for time-sensitive actions and to keep game pace slow. Through a year-long participatory design process with children with CP, we have discovered that it is in fact possible to develop action-oriented exergames for children with CP at level III on the Gross Motor Function Classification Scale. We followed up the design process with an eight-week home trial, in which we found the games to be playable and enjoyable. In this paper, we discuss the design of these games, and present a set of design recommendations for how to achieve both action-orientation and playability.

References

[1]

Adams, E. Fundamentals of Game Design. New Riders, (2010).

Digital Library

[2]

Anderson, F., Annett, M., F. Bischof, W., and Bischof, W.F. Lean on Wii: physical rehabilitation with virtual reality Wii peripherals. Studies in Health Technology and Informatics 154; (2010), 229--234.

[3]

Burke, J.W., McNeill, M.D.J., Charles, D.K., Morrow, P.J., Crosbie, J.H., and McDonough, S.M. Optimising engagement for stroke rehabilitation using serious games. The Visual Computer 25, 12 (2009), 1085--1099.

Digital Library

[4]

Chen, Y.-P., Kang, L.-J., Chuang, T.-Y., Doong, J.-L., Lee, S.-J., et al., Use of virtual reality to improve upperextremity control in children with cerebral palsy: a single-subject design. Physical Therapy 87, 11 (2007), 1441--1457.

[5]

Deutsch, J.E., Borbely, M., Filler, J., Huhn, K., Guarrera, P., and Guarrera-Bowlby, P. Use of a lowcost, commercially available gaming console (Wii) for rehabilitation of an adolescent with cerebral palsy. Physical Therapy 88, 10 (2008), 1196--1207.

[6]

Eliasson, A.-C., Krumlinde-Sundholm, L., Rösblad, B., Beckung, E., Arner, M., et al., The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Developmental Medicine and Child Neurology 48, 7 (2006), 549--54.

[7]

Ellis, B., Ford-Williams, G., Graham, L., Grammenos, D., Hamilton, I., et al., Game Accessibility Guidelines. 2012. http://www.gameaccessibilityguidelines.com/.

[8]

GARv2--25. Game Accessibility: Recommendations. 2012. http://www.gameaccessibility.de/.

[9]

Garvey, M.A, Giannetti, M.L., Alter, K.E., and Lum, P.S. Cerebral palsy: new approaches to therapy. Current neurology and neuroscience reports 7, 2 (2007), 147--55.

[10]

Geurts, L., Vanden Abeele, V., Husson, J., Windey, F., Van Overveldt, M., et al., Digital games for physical therapy: fulfilling the need for calibration and adaptation. Proc. of TEI'11, ACM (2011), 117--124.

Digital Library

[11]

Grammenos, D., Savidis, A., and Stephanidis, C. Designing universally accessible games. Computers in Entertainment 7, 1 (2009), 8:1--8:29.

Digital Library

[12]

Hanna, S.E., Rosenbaum, P.L., Bartlett, D.J., Palisano, R.J., Walter, S.D., et al., Stability and decline in gross motor function among children and youth with cerebral palsy aged 2 to 21 years. Developmental Medicine and Child Neurology, (2009), 295--302.

[13]

Hernandez, H.A., Graham, T.C.N., Fehlings, D., Switzer, L., Ye, Z., et al., Design of an exergaming station for children with cerebral palsy. Proc of CHI'12, ACM Press (2012), 2619--2628.

Digital Library

[14]

Kirby, R.S., Wingate, M.S., Van Naarden Braun, K., et al., Prevalence and functioning of children with cerebral palsy in four areas of the USA in 2006: a report from the Autism and Developmental Disabilities Monitoring Network. Research in Developmental Disabilities 32, 2 (2011), 462--9.

[15]

Kozeis, N., Anogeianaki, A., Mitova, D.T., Anogianakis, G., Mitov, T., and Klisarova, A. Visual function and visual perception in cerebral palsied children. Ophthalmic & physiological optics: the journal of the British College of Ophthalmic Opticians (Optometrists) 27, 1 (2007), 44--53.

[16]

Kutner, L. and Olson, C. Grand Theft Childhood. Simon and Schuster, 2008.

[17]

Lee, E. BBC - Future Media Standards & Guidelines Accessible Games Standard v1.0. 2010. http://www.bbc.co.uk/guidelines/futuremedia/accessibili ty/games.shtml.

[18]

National Center on Birth Defects and Developmental Disabilities. Facts about Cerebral Palsy. 2012. http://www.cdc.gov/NCBDDD/cp/facts.html.

[19]

Notelaers, S., Weyer, T.D., Robert, K., and Raymaekers, C. Design Aspects for Rehabilitation Games for MS Patients. Proceedings of DEnG-VE (2010).

[20]

Odle, B.M., Irving, A., and Foulds, R. Usability of an adaptable video game platform for children with cerebral palsy. 35th IEEE Annual Northeast Bioengineering Conference, (2009), 1--2.

[21]

Palisano, R., Rosenbaum, P., Bartlett, D., and Livingston, M. Gross Motor Function Classification System, Expanded and Revised. Developmental Medicine and Child Neurology, 2007, 1--4. http://www.canchild.ca/en/measures/gmfcs.asp.

[22]

Rosenbaum, P., Paneth, N., Leviton, A., Goldstein, M., Bax, M., et al., A report: the definition and classification of cerebral palsy April 2006. Developmental Medicine and Child Neurology Supplement, (2007), 8--14.

[23]

Saavedra, S., Joshi, A., Woollacott, M., and van Donkelaar, P. Eye hand coordination in children with cerebral palsy. Experimental Brain Research. 192, 2 (2009), 155--65.

[24]

Spence, I. and Feng, J. Video games and spatial cognition. Review of General Psychology 14, 2 (2010), 92--104.

[25]

Warburton, D.E.R., Bredin, S.S.D., Horita, L.T.L., Zbogar, D., Scott, J.M., et al., The health benefits of interactive video game exercise. Applied Physiology, Nutrition, and Metabolism 32, 4 (2007), 655--663.

[26]

Widman, L., McDonald, C., and Abresch, T. Effectiveness of an upper extremity exercise device integrated with computer gaming for aerobic training in adolescents with spinal cord dysfunction. The Journal of Spinal Cord Medicine 29, (2006), 363--370.

[27]

Yuan, B., Folmer, E., and Harris, F.C. Game accessibility: a survey. Universal Access in the Information Society 10, 1 (2010), 81--100.

Digital Library

Cited By

Iversen NErnstsen MIversen OIivari NKinnula MSharma SEriksson E(2024)"We are in this together": Supporting Neurodiverse Children in Participatory Design through Design PartneringProceedings of the 23rd Annual ACM Interaction Design and Children Conference10.1145/3628516.3659385(732-737)Online publication date: 17-Jun-2024
https://dl.acm.org/doi/10.1145/3628516.3659385
Pothong KLivingstone SColvert APschetz L(2024)Applying children’s rights to digital products: Exploring competing priorities in designProceedings of the 23rd Annual ACM Interaction Design and Children Conference10.1145/3628516.3655789(93-104)Online publication date: 17-Jun-2024
https://dl.acm.org/doi/10.1145/3628516.3655789
Tikkanen RIivari NPaananen P(2023)Play—An essential part of children’s lives and their computational empowermentFrontiers in Education10.3389/feduc.2022.10887167Online publication date: 21-Feb-2023
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Index Terms

Designing action-based exergames for children with cerebral palsy
1. Human-centered computing
  1. Human computer interaction (HCI)
2. Social and professional topics

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cover image ACM Conferences

CHI '13: Proceedings of the SIGCHI Conference on Human Factors in Computing Systems

April 2013

3550 pages

ISBN:9781450318990

DOI:10.1145/2470654

General Chair:
Wendy E. Mackay
INRIA
,
Program Chairs:
Stephen Brewster
Glasgow University
,
Susanne Bødker
University of Aarhus

Copyright © 2013 ACM.

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Published: 27 April 2013

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CHI '13: CHI Conference on Human Factors in Computing Systems

April 27 - May 2, 2013

Paris, France

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CHI '13 Paper Acceptance Rate 392 of 1,963 submissions, 20%;

Overall Acceptance Rate 6,199 of 26,314 submissions, 24%

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Cited By

Iversen NErnstsen MIversen OIivari NKinnula MSharma SEriksson E(2024)"We are in this together": Supporting Neurodiverse Children in Participatory Design through Design PartneringProceedings of the 23rd Annual ACM Interaction Design and Children Conference10.1145/3628516.3659385(732-737)Online publication date: 17-Jun-2024
https://dl.acm.org/doi/10.1145/3628516.3659385
Pothong KLivingstone SColvert APschetz L(2024)Applying children’s rights to digital products: Exploring competing priorities in designProceedings of the 23rd Annual ACM Interaction Design and Children Conference10.1145/3628516.3655789(93-104)Online publication date: 17-Jun-2024
https://dl.acm.org/doi/10.1145/3628516.3655789
Tikkanen RIivari NPaananen P(2023)Play—An essential part of children’s lives and their computational empowermentFrontiers in Education10.3389/feduc.2022.10887167Online publication date: 21-Feb-2023
https://doi.org/10.3389/feduc.2022.1088716
Schneider AGraham T(2023)Supporting Aim Assistance Algorithms through a Rapidly Trainable, Personalized Model of Players’ Spatial and Temporal Aiming AbilityProceedings of the 2023 CHI Conference on Human Factors in Computing Systems10.1145/3544548.3581293(1-17)Online publication date: 19-Apr-2023
https://dl.acm.org/doi/10.1145/3544548.3581293
Aufheimer MGerling KGraham TNaaris MKonings MMonbaliu EHallez HOrtibus E(2023)An Examination of Motivation in Physical Therapy Through the Lens of Self-Determination Theory: Implications for Game DesignProceedings of the 2023 CHI Conference on Human Factors in Computing Systems10.1145/3544548.3581171(1-16)Online publication date: 19-Apr-2023
https://dl.acm.org/doi/10.1145/3544548.3581171
Castro-García JMolina-Cantero AMerino-Monge MLebrato-Vázquez CGómez-Gónzalez I(2023)The Effect of Demanding Mental Tasks on Electrodermal Activity and Heart Rate During Physical Activity: A Pilot StudyIEEE Access10.1109/ACCESS.2023.327330311(46665-46677)Online publication date: 2023
https://doi.org/10.1109/ACCESS.2023.3273303
Ben Itzhak NFranki IJansen BKostkova KWagemans JOrtibus E(2023)Usability and user experience of an individualized and adaptive game-based therapy for children with cerebral visual impairmentInternational Journal of Child-Computer Interaction10.1016/j.ijcci.2022.10055135:COnline publication date: 1-Mar-2023
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Roxo GNóbrega RMadeira R(2023)Dance Mat Fun - A Participatory Design of Exergames for Children with DisabilitiesPervasive Computing Technologies for Healthcare10.1007/978-3-031-34586-9_34(513-527)Online publication date: 11-Jun-2023
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Lagu AThaha RSyafar MHadju VKurniati Y(2022)Using Games to Promote Healthy Behavior in Children: A Narrative ReviewOpen Access Macedonian Journal of Medical Sciences10.3889/oamjms.2022.885110:E(1904-1910)Online publication date: 24-Dec-2022
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Sarsenbayeva ZVan Berkel NVelloso EGoncalves JKostakos V(2022)Methodological Standards in Accessibility Research on Motor Impairments: A SurveyACM Computing Surveys10.1145/354350955:7(1-35)Online publication date: 15-Dec-2022
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