title: Using a virtual reality game to assess goal-directed hand movements in children: A pilot feasibility study.
abstract: BACKGROUND
  Virtual reality gaming environments may be used as a supplement to the motor performance assessment tool box by providing clinicians with quantitative information regarding motor performance in terms of movement accuracy and speed, as well as sensory motor integration under different levels of dual tasking.
  
  
  OBJECTIVE
  To examine the feasibility of using the virtual reality game `Timocco' as an assessment tool for evaluating goal-directed hand movements among typically developing children.
  
  
  METHODS
  In this pilot study, 47 typically-developing children were divided into two age groups, 4-6 years old and 6-8 years old. Performance was measured using two different virtual environment games (Bubble Bath and Falling Fruit), each with two levels of difficulty. Discriminative validity (age effect) was examined by comparing the performance of the two groups, and by comparing the performance between levels of the games for each group (level effect). Test-retest reliability was examined by reassessing the older children 3-7 days after the first session.
  
  
  RESULTS
  The older children performed significantly better in terms of response time, action time, game duration, and efficiency in both games compared to the younger children. Both age groups demonstrated poorer performance at the higher game level in the Bubble Bath game compared to the lower level. A similar level effect was found in the Falling Fruit game for both age groups in response time and efficiency, but not in action time. The performance of the older children was not significantly different between the two sessions at both game levels.
  
  
  CONCLUSIONS
  The discriminative validity and test-retest reliability indicate the feasibility of using the Timocco virtual reality game as a tool for assessing goal-directed hand movements in children. Further studies should examine its feasibility for use in children with disabilities.
authors.affiliation: Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
authors.forename: M Elboim
authors.initials: ME
authors.lastname: Gabyzon
authors.affiliation: Occupational Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
authors.forename: B
authors.initials: B
authors.lastname: Engel-Yeger
authors.affiliation: Timocco Ltd, Tel Aviv, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Tresser
authors.affiliation: Physical Therapy Department, Ariel University, Ariel, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Springer
mesh_terms: D002648:Child; D002657:Child Development; D002675:Child, Preschool; D003198:Computer Simulation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity; D009069:Movement Disorders / Q000175:diagnosis*; D010865:Pilot Projects; D015203:Reproducibility of Results; D014584:User-Computer Interface; D018910:Video Games
keywords: Timocco; Virtual reality; assessment; children; feasibility; goal-directed hand movement