More than half of the people with Parkinson’s disease who took part in a small pilot study led by the University of California – San Francisco (UCSF) School of Nursing and Red Hill Studios showed small improvements in walking speed, balance and stride length after three months of playing computer-based physical therapy games.

A UCSF press release dated 19 October describes how the specialized games are not like off-the-shelf computer games. They have been designed to encourage scientifically tested physical movements to help people whose motor skills have been affected, for instance as in Parkinson’s disease.

Parkinson’s disease is a chronic, progressive neurological disorder of unknown cause that targets cells in the brain that control movement. It affects about 1 million people in the United States. Symptoms include tremors, slowness of movement, poor balance, and stiffness in the limbs and trunk.

UCSF and Red Hill Studios, a California serious games developer, were the first US research team to be awarded federal funds to develop low-cost computerized physical therapy games, which the UCSF statement describes as a “burgeoning field”.

Teams from both organizations worked together to design nine “clinically inspired” games that aim to improve coordination in people with Parkinson’s disease.

In earlier work, the team at UCSF had already established which specific body movements and gestures are beneficial for slowing the physical progression of Parkinson’s.

The team at Red Hill developed the games around these movements. The games are similar to the motion sensing games you can play on the Wii and the XBox (Kinect). The players have to win points by moving their bodies in certain ways.

Each game has several levels of difficulty, and the clinical team was also able to tailor them to suit each patient’s particular ability range.

Bob Hone, creative director of Red Hill Studios and the lead principal investigator of the study, said each participant was able to find his or her gaming “sweet spot”, the point where the physical challenge was neither too hard nor too easy, but “just right”.

And when they successfully completed one game level, they “often moved on to harder levels for more beneficial effect. The subjects improved their games scores while improving their gait and balance,” he added.

For this pilot trial, the researchers recruited 20 people living in northern California who had moderate levels of Parkinson’s disease.

After 12 weeks of playing the games three times a week, 65% of the participants showed improvements in stride length, 55% showed improvements in gait velocity and 55% reported improved balance and confidence.

In terms of equipment, the participants, who played the games in their own homes, wore a customized sensor suit containing nine tracking devices that analyzed their movements. These are more accurate and more sensitive than those you normally get in consumer gaming platforms.

The PC-based analyzer sent encrypted data to a secure database located at the research labs, where the researchers could then analyze the participants’ performance day by day.

Hone said:

“From the data tracking we could see that there were some subjects who were playing the games more than the specified three times a week.”

“Because this was a highly structured research study, we actually had to ask them to play less than they wanted,” he explained.

Dr Glenna Dowling, professor and chair of the UCSF Department of Physiological Nursing, is one of the clinical team leaders. She told the press:

“These initial studies show the promise of custom-designed physical therapy games promoting specific movements and gestures that can help patients get better.”

“Now that we have this preliminary positive result, we want to conduct a longer term clinical trial with more subjects to confirm these initial findings.”

Two Small Business Innovative Research grants totaling $1.1 million from the National Institute of Neurological Disorders and Stroke (part of the National Institutes of Health) paid for the trial.

The statement did not say whether the trial will be published in a peer-reviewed journal.

Written by Catharine Paddock PhD