Question
Can you provide some insight on using gaming as an intervention for trunk control?
Answer
When working with a patient on trunk control, first determine which segments are involved: head or neck control, upper trunk, or lower trunk. Next, decide what function you are going to work on at each segment: trunk stability or trunk movement. The trunk stability could range from being fairly unchallenging (standing still or sitting without a lot of movement), to more challenging (a lot of arm movement or trunk movement superimposed). If trunk movement is the goal, those movements can be small or large. You can move from slower movements to faster movements; from movements in a single plane to movements in multiple directions. When choosing a game or a platform, not only will you choose based on your client’s goals, but you will also want to avoid games that may be too challenging, or that include movements that you want your client to refrain from.
Games like Boxing require stability at the upper and lower trunk with superimposed arm movements. Games like Reflex Ridge (Kinect) involve movement of the upper and lower trunk, and also a lot of movement of the head and neck. Some games like Soccer require switching back and forth from stability while you are kicking, to movement while you turn to run or to look, or in some games even switching from offense to defense. Games like Golf (within either Wii or Kinect platforms) require both arm movement superimposed on a stable trunk, but also a rotating stable trunk. When you are looking at the parameters of the motion, you are going to look at the amplitude, the arc or how big the motion, the speed and the planes.
