Customized gaming system engages young children in reaching and balance training.

Purpose: Trunk stability, an important prerequisite for many activities of daily living, can be impaired in children with movement disorders. Current treatment options can be costly and fail to fully engage young participants. We developed an affordable, smart screen-based intervention and tested if it engages young children in physical therapy goal driven exercises.

Methods: Here we describe the ADAPT system, Aiding Distanced and Accessible Physical Therapy, which is a large touch-interactive device with customizable games. One such game, "Bubble Popper," encourages high repetitions of weight shifts, reaching, and balance training as the participant pops bubbles in sitting, kneeling, or standing positions.

Results: Sixteen participants aged 2-18 years were tested during physical therapy sessions. The number of screen touches and length of game play indicate high participant engagement. In trials lasting less than 3 min, on average, older participants (12-18 years) made 159 screen touches per trial while the younger participants (2-7 years) made 97. In a 30-min session, on average, older participants actively played the game for 12.49 min while younger participants played for 11.22 min.

Conclusion: The ADAPT system is a feasible means to engage young participants in reaching and balance training during physical therapy.