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Gaming and Interventions for the Trunk

Deborah Espy, PT, PhD

July 19, 2016



Can you provide some insight on using gaming as an intervention for trunk control?


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.

deborah espy

Deborah Espy, PT, PhD

Debbie Espy, PT, PhD received her MSPT from Virginia Commonwealth University in 1992 and her PhD in Human Movement Science from the University of Illinois at Chicago in 2010.  She has practiced in the areas of acute care, neuro rehab and outpatient, and assistive technology before taking a faculty position at Cleveland State University, where she is currently an Assistant Professor in the Physical Therapy Program.  She teaches courses in Professional Issues, Functional Anatomy, Adult Neurological Dysfunction, and Neuro-motor Interventions.  Her research interests are in the areas of motor learning, and postural control and falls.  Her current lines of research are in the use of video gaming as a therapeutic exercise modality; in novel uses of sensor technology in therapeutic exercise; in balance training for fall prevention; and in educational models to enhance DPT education.  

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