title: Preparing a neuropediatric upper limb exergame rehabilitation system for home-use: a feasibility study.
abstract: BACKGROUND
  Home-based, computer-enhanced therapy of hand and arm function can complement conventional interventions and increase the amount and intensity of training, without interfering too much with family routines. The objective of the present study was to investigate the feasibility and usability of the new portable version of the YouGrabber® system (YouRehab AG, Zurich, Switzerland) in the home setting.
  
  
  METHODS
  Fifteen families of children (7 girls, mean age: 11.3y) with neuromotor disorders and affected upper limbs participated. They received instructions and took the system home to train for 2 weeks. After returning it, they answered questions about usability, motivation, and their general opinion of the system (Visual Analogue Scale; 0 indicating worst score, 100 indicating best score; ≤30 not satisfied, 31-69 average, ≥70 satisfied). Furthermore, total pure playtime and number of training sessions were quantified. To prove the usability of the system, number and sort of support requests were logged.
  
  
  RESULTS
  The usability of the system was considered average to satisfying (mean 60.1-93.1). The lowest score was given for the occurrence of technical errors. Parents had to motivate their children to start (mean 66.5) and continue (mean 68.5) with the training. But in general, parents estimated the therapeutic benefit as high (mean 73.1) and the whole system as very good (mean 87.4). Children played on average 7 times during the 2 weeks; total pure playtime was 185 ± 45 min. Especially at the beginning of the trial, systems were very error-prone. Fortunately, we, or the company, solved most problems before the patients took the systems home. Nevertheless, 10 of 15 families contacted us at least once because of technical problems.
  
  
  CONCLUSIONS
  Despite that the YouGrabber® is a promising and highly accepted training tool for home-use, currently, it is still error-prone, and the requested support exceeds the support that can be provided by clinical therapists. A technically more robust system, combined with additional attractive games, likely results in higher patient motivation and better compliance. This would reduce the need for parents to motivate their children extrinsically and allow for clinical trials to investigate the effectiveness of the system.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT02368223.
authors.affiliation: Pediatric Rehab Research Group, Rehabilitation Center for Children and Adolescents, Mühlebergstrasse 104, CH-8910, Affoltern am Albis, Switzerland. corinna.gerber@kispi.uzh.ch.|Department of Health Sciences and Technology, ETH Zurich, Rämistrasse 101, CH-8092, Zurich, Switzerland. corinna.gerber@kispi.uzh.ch.|Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, CH-8032, Zürich, Switzerland. corinna.gerber@kispi.uzh.ch.
authors.forename: Corinna N
authors.identifier: http://orcid.org/0000-0002-3353-0038
authors.initials: CN
authors.lastname: Gerber
authors.affiliation: Pediatric Rehab Research Group, Rehabilitation Center for Children and Adolescents, Mühlebergstrasse 104, CH-8910, Affoltern am Albis, Switzerland.|Department of Health Sciences and Technology, ETH Zurich, Rämistrasse 101, CH-8092, Zurich, Switzerland.|Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, CH-8032, Zürich, Switzerland.
authors.forename: Bettina
authors.initials: B
authors.lastname: Kunz
authors.affiliation: Pediatric Rehab Research Group, Rehabilitation Center for Children and Adolescents, Mühlebergstrasse 104, CH-8910, Affoltern am Albis, Switzerland.|Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, CH-8032, Zürich, Switzerland.
authors.forename: Hubertus J A
authors.initials: HJ
authors.lastname: van Hedel
mesh_terms: D002648:Child; D005081:Exercise Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D000066530:Neurological Rehabilitation / Q000379:methods*; D009468:Neuromuscular Diseases / Q000534:rehabilitation*; D010349:Patient Compliance / Q000706:statistics & numerical data; D018910:Video Games
keywords: Cerebral palsy; Children and adolescents; Clinical utility; Data glove; Game-based; Neurorehabilitation; Pediatrics; Tele-rehabilitation; Upper extremities; User satisfaction; YouGrabber