Title: Increasing physical activity in children with long term physical disabilities using a personalised gaming system
Funder: Department of Health and Social Care

Abstract: 18% of the 6% of children in the UK who have a disability have mobility limitations (DWP, 2012). Reducing sedentary time and increasing physical activity should be a primary aim of rehabilitation to reduce risk of cardio-metabolic disease (Ryan 2014). It is known that 1 in 400 children is born with Cerebral Palsy (CP) in UK (Cerebral Palsy Website, 2016) and 31% of school-children suffering from long-term conditions are missing school (Brooks et al., 2012). Our proposal seeks to build substantially upon a clinically validated platform (MIRA) to develop a suite of child-centred interactive video games (&ldquo;exergames&rdquo;) which can be used to contribute to physical and cognitive development. The games will be for children with long term physical and cognitive disabilities to use at home, school and alongside clinicians. The MIRA system has been designed for use with children with disabilities. Initial public and patient involvement feedback shows promise; children responded positively to the system, but accessibility and appeal needs improvement (Farr et al 2017b).The improvements we propose are: 1) An adaptive user experience/user interface (UI/UX) to make the system accessible to children with a wide range of ages, learning, and communication abilities (including development of exergames adapted for children with abnormal movement patterns and focused to facilitate exploration and experiential learning: e.g. painting, flying). 2) Improve UI/UX on the system calibration for children in wheelchairs and standing frames. 3) Develop a tool box approach to game structure that therapists or users can configure and allows individualisation of games. In close partnership with experts clinicians specialised in rehabilitation of children with long term physical and cognitive disabilities, we are committed to create a solution to address the still unmet needs of this group of patients, in a manner that is able to improve quality of life as well as reduce major costs through being a flexible home based solution. We plan to involve children and their families throughout the development of the system to ensure it meets their needs and then to evaluate it with a larger group upon completion of development work. We expect this solution to save significant costs by increasing adherence to treatment, quality of life and wellbeing in children with physical long term conditions. The system currently allows clinicians to remotely monitor compliance and performance, and store data to track progress. The clinical partners will further investigate what the most appropriate outcome measurement data is for this system so this function could be utilised for audit purposes and for future research.

Lay abstract: 18% of the 6% of children in the UK who have a disability have mobility limitations (DWP, 2012). Reducing sedentary time and increasing physical activity should be a primary aim of rehabilitation to reduce risk of cardio-metabolic disease (Ryan 2014). It is known that 1 in 400 children is born with Cerebral Palsy (CP) in UK (Cerebral Palsy Website, 2016) and 31% of school-children suffering from long-term conditions are missing school (Brooks et al., 2012). Our proposal seeks to build substantially upon a clinically validated platform (MIRA) to develop a suite of child-centred interactive video games (&ldquo;exergames&rdquo;) which can be used to contribute to physical and cognitive development. The games will be for children with long term physical and cognitive disabilities to use at home, school and alongside clinicians. The MIRA system has been designed for use with children with disabilities. Initial public and patient involvement feedback shows promise; children responded positively to the system, but accessibility and appeal needs improvement (Farr et al 2017b).The improvements we propose are: 1) An adaptive user experience/user interface (UI/UX) to make the system accessible to children with a wide range of ages, learning, and communication abilities (including development of exergames adapted for children with abnormal movement patterns and focused to facilitate exploration and experiential learning: e.g. painting, flying). 2) Improve UI/UX on the system calibration for children in wheelchairs and standing frames. 3) Develop a tool box approach to game structure that therapists or users can configure and allows individualisation of games. In close partnership with experts clinicians specialised in rehabilitation of children with long term physical and cognitive disabilities, we are committed to create a solution to address the still unmet needs of this group of patients, in a manner that is able to improve quality of life as well as reduce major costs through being a flexible home based solution. We plan to involve children and their families throughout the development of the system to ensure it meets their needs and then to evaluate it with a larger group upon completion of development work. We expect this solution to save significant costs by increasing adherence to treatment, quality of life and wellbeing in children with physical long term conditions. The system currently allows clinicians to remotely monitor compliance and performance, and store data to track progress. The clinical partners will further investigate what the most appropriate outcome measurement data is for this system so this function could be utilised for audit purposes and for future research.

Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING;7.1 INDIVIDUAL CARE NEEDS
Health categories: GENERIC HEALTH RELEVANCE