Digital Gaming for Improving the Functioning of People With Traumatic Brain Injury: Randomized Clinical Feasibility Study

• Published in: Journal of medical Internet research 2018-03, Vol.20 (3), p.e77-e77
• Main Authors: Välimäki, Maritta, Mishina, Kaisa, Kaakinen, Johanna K, Holm, Suvi K, Vahlo, Jukka, Kirjonen, Markus, Pekurinen, Virve, Tenovuo, Olli, Korkeila, Jyrki, Hämäläinen, Heikki, Sarajuuri, Jaana, Rantanen, Pekka, Orenius, Tage, Koponen, Aki
• Format: Article
• Language: English
• Subjects: Adults; Age; Brain injured people; Clinical research; Clinical trials; Cognition & reasoning; Cognitive functioning; Computer & video games; Dropping out; Entertainment; Executive function; Feasibility; Feasibility studies; Games; Health problems; Intelligence; Intelligence tests; Intervention; Measurement; Memory; Mental depression; Original Paper; Quality of life; Questionnaires; Rehabilitation; Rehearsal; Self-efficacy; Short term memory; Systematic review; Test scores; Traumatic brain injury; Well being
• ISSN: 1438-8871; 1439-4456; 1438-8871
• DOI: 10.2196/jmir.7618

Traumatic brain injury (TBI) is a major health problem that often requires intensive and long-term rehabilitation. The aim of this study was to determine whether rehabilitative digital gaming facilitates cognitive functioning and general well-being in people with TBI. A total of 90 Finnish-speaking adults with TBI (18-65 years) were recruited from an outpatient neuroscience clinic. The participants were randomly allocated to one of the three groups: a rehabilitation gaming group (n=29, intervention), an entertainment gaming group (n=29, active control), or a passive control group (n=32). The gaming groups were instructed to engage in gaming for a minimum of 30 min per day for 8 weeks. Primary and secondary outcomes were measured at three time points: before the intervention, after the intervention, and 3 months following the intervention. The primary outcome was cognitive status measured by processing speed and visuomotor tasks (The Trail Making Test; Wechsler Adult Intelligence Scale-Fourth Edition, WAIS-IV, symbol search, coding, and cancellation tasks). Secondary outcomes were attention and executive functions (Simon task), working memory (WAIS-IV digit span and Paced Auditory Serial Addition Test, PASAT), depression (Patient Health Questionnaire-9), self-efficacy (General Self-efficacy Scale), and executive functions (Behavior Rating Inventory of Executive Function-Adult Version). Feasibility information was assessed (acceptability, measurement instruments filled, dropouts, adherence, usability, satisfaction, and possible future use). Cognitive measurements were conducted in face-to-face interviews by trained psychologists, and questionnaires were self-administered. The effects of rehabilitation gaming did not significantly differ from the effects of entertainment gaming or being in a passive control group. For primary outcomes and PASAT tests, the participants in all three groups showed overall improvement in test scores across the three measurement points. However, depression scores increased significantly between baseline and after 8 weeks and between baseline and after 3 months in the rehabilitative gaming group. No differences were found in patients' self-efficacy between the three measuring points in any of the groups. Participants did use the games (rehabilitation group: 93%, 27/29; entertainment group 100%, 29/29). Games were seen as a usable intervention (rehabilitation group: 70%, 14/29; entertainment group: 83%, 20/29). The rehabilitation gr