<blockquote> <h3>Fast Facts</h3> <ul> <li>Juvenile idiopathic arthritis (JIA) is an umbrella term for several subtypes of arthritis. Some describe the number of joints that are affected; others have nasty accompanying symptoms like scaly rashes behind the ear or elsewhere on the body.</li> <li>We don’t know the exact cause of JIA. What we do know is that it is some kind of autoimmune disorder, meaning the body attacks itself by mistake. Environmental and genetic factors are likely at play.</li> <li>We don’t have a cure for JIA, so doctors aim for remission, i.e., long periods where there are little to no symptoms. This way, kids can live relatively normal and healthy lives without being bogged down too much by the disease. Early and effective treatment is the best way to achieve remission.</li> <li>Exercise is important in general for kids with JIA, and yes, most of them can play sports just fine. It’s a matter of getting the disease under control first, and the best part is that physical activity presents unique benefits for these kids.</li> <li>JIA is a chronic condition, so it could last weeks, months, years, or a lifetime. Many teens with JIA enter full remission with little to no damage to their joints, so they don’t wind up with permanent damage for the rest of their lives.</li> </ul> </blockquote> <p>Remember when the Nintendo Wii came out and even your grandparents were getting in on the action? Motion-based gaming has been around in one form or another for decades, but it wasn’t until this console (which catapulted Nintendo back to a prime position in the market) that it became a huge deal.</p> <p>The Wii launched with a bunch of sports games that replicated the movements you perform in real life via the motion-based controllers. So, for example, if you were playing a boxing game, you’d literally punch the air to make your character in the game strike; if it were golf, you’d swing it like a club, and so on.</p> <p>Watching curiously from the sidelines were rehabilitation experts, who saw potential in this trend as a new way to get kids with debilitating conditions to be motivated with their exercise regimen.</p> <h2>The world of exergaming</h2> <p>Kids with conditions like cerebral palsy and arthritis are often enrolled in exercise programs to improve the functionality of their bodies. In the case of the latter, reducing pain and stiffness in joints helps them with performing daily activities (eating, personal care, dressing, etc.), which can be limited if symptoms are severe.</p> <p>The problem is that, as much as it helps to improve fine motor skills and muscle recovery, exercise programs for rehabilitating joints and muscles are, well, frankly boring. While their friends are off having a laugh with Super Mario, kids with arthritis are stuck doing these dull routines.</p> <p>What the rehab people saw in game consoles like the Wii was an opportunity to marry the correct movements with an engaging platform that cuts through the drudgery of regular rehab practices, thereby killing two birds with one stone.</p> <p>Over the last decade or so, these technologies have gained significant momentum among healthcare professionals as a means to address challenges. Although mainstream consoles like the Wii sparked the idea and studies have focused on their benefits with various populations, customized consoles and games have been developed independently for specific target audiences like those with arthritis.</p> <p>“Exergaming” is the buzzword for it, and you can find curious devices that involve, for example, a set of pedals for a makeshift bike that helps kids with cerebral palsy get their weaker leg into shape. The pedaling makes the in-game avatar move and complete the task at hand, so it gives the child something to focus on while they exercise.</p> <p>Devices like the Home VRT System were specifically designed so that target muscles are the ones that are worked — the game can tell if they’re using their dominant limbs to cheat, so the child is forced to use the one that needs the work.</p> <p>“Exergaming is a fun way to get up and moving,” said Rachel Proffitt, an assistant professor at the University of Missouri, to Juvenile Arthritis News. “Exergames can improve strength and range of motion. For people with arthritis, it can also take their mind off of their joint pain.”</p> <p>Another important in-built feature with the specialized consoles is adaptability with difficulty according to the limitations of the patient. One’s abilities can vary greatly, so making things easier for people with more severe limitations is vital to maintain engagement. If it’s too hard, they’ll get bored.</p> <h2>Leap Motion Controller</h2> <p>One system that’s made noise with the arthritis community is the Leap Motion Controller (LMC), a USB device that can be plugged into your computer. This low-cost, straightforward gaming console can track hand and finger movements with extreme accuracy.</p> <figure><img alt src="https://cdn.storymd.com/optimized/Qd93RMtgAg/thumbnail.jpg" /> <figcaption>Leap Motion Orion Controller. <em>Source: SkywalkerPL/Wikimedia</em></figcaption> </figure> <p>One study examined the benefits of an eight-week program involving LMC games for upper-extremity (your arms) rehabilitation. They compared the results against a set of children undergoing conventional training methods.</p> <p>All study participants lived with physically limiting conditions including juvenile idiopathic arthritis (JIA), cerebral palsy, and brachial plexus palsy. Across one-hour sessions, three times a week, participants had to complete their respective training programs, and for the LMC cohort, they played the games Leapball and CatchAPet.</p> <p>There were 92 participants in total, 43 of which had JIA, and out of this group 18 were assigned to the LMC games while the remainder were placed in conventional training.</p> <p>Similar to the sporty Wii games, Leapball has the player grabbing a virtual ball with all fingers and throwing it into a target bucket with the right color. Meanwhile, CatchAPet encourages wrist flexion and extension movements by tasking the player with tapping rabbits as they emerge randomly from holes (kind of like whack-a-mole except your hand is the mallet).</p> <p>LMC games like these were designed to improve muscle strength, coordination, joint range of motion, and fine motor functionality of the hands and wrists. The movements conducted in the games reflect those of daily life to stay in line with rehabilitation goals. This is different from mainstream games, which don’t cater to these needs specifically, and this is among several reasons why there are limits to the utility of consoles like the Wii.</p> <p>Although both groups ended up benefitting from their respective therapy modes, the video game group showed significantly better therapeutic effects in hand and pinch grips, fine motor skills, and finger dexterity.</p> <p>“This study has quantitatively shown that [leap motion controller-based training] should be used as an effective alternative treatment option in children and adolescents with physical disabilities,” wrote the researchers.</p> <p>Research into exergames and related tools continues across many disciplines and diseases. It’s an emerging area, but it’s shown promise with a variety of conditions including stroke and mobility issues in the elderly. With VR creeping in as an increasingly dominant medium, a whole host of amazing innovations likely awaits us in the years to come.</p> <h2>More on Exergaming</h2><ul><li><a href="https://soulivity.storymd.com/journal/m9zn3qrsgw-exergaming" target="_blank">The Benefits of Exergaming for All Ages</a></li><li><a href="https://soulivity.storymd.com/journal/xjnp9qvirm-juvenile-idiopathic-arthritis" target="_blank">Juvenile Idiopathic Arthritis (JIA): Causes, Symptoms, Treatment</a></li><li><a href="https://soulivity.storymd.com/journal/xjnp9bourm-exercise-for-children" target="_blank">Exercise for Children</a></li></ul>