Force Resistance Training in Hand Grasp and Arm Therapy: Feasibility of a Low-Cost Videogame Controller

Objective: To design and evaluate a low-cost gaming station that supports force resistance training in pediatric arm/hand grasp therapies through mainstream videogame play. Methods: The gaming station was developed through an iterative participatory design process and includes a force feedback game controller (Novint Falcon), custom grips, arm/wrist supports, and software to interface with mainstream games and manage difficulty settings in the controller. The station was tested for usability and feasibility with six therapists and six children with cerebral palsy, 7–16 years of age, attending weekly therapy sessions over 12 weeks. Pre- and post-assessments of perceived performance and satisfaction on self-identified goals were measured on the Canadian Occupational Performance Measure (COPM). Results: The gaming station was considered highly usable by therapists with a score of 76.7 (standard deviation [SD] = 6.1) on the System Usability Scale. Overall, children enjoyed the games, achieved high repetition rates for wrist extensions and arm movements, and all made clinically significant progress on therapy goals. Increases of 3.13 (SD = 1.69) on the performance scale and 2.97 (SD = 0.98) on the satisfaction scale were reported on the COPM. Conclusiion: In-clinic force resistance training for development of upper limb functional capacities is feasible using low-cost video game components adapted to therapy through a participatory design process.