Recommendations for the Use of Serious Games in Neurodegenerative Disorders: 2016 Delphi Panel

Valéria Manera ,Teun Aalbers,Sylvie Serret,Carlos Crispim-Junior,Frank Knoefel,Pierre Foulon,Hovannes Agopyan,Susanne Thümmler,Grégory Ben-Sadoun,Auriane Gros,Adam Gazzaley,Bob De Schutter,Jonathan Bredin,Stéphanie Hun,Renaud David,David Bensamoun,Guillaume Sacco,J Kaci Fairchild ,A.-S Rigaud ,Antonio Politis ,J Bourgeois ,Minh Khue Phan Tran ,Florence Askénazy ,Marie Laure Welter ,Marcel G M Olde Rikkert ,François Brémond ,Éric Ettore ,Michel Benoît ,Robert Pierpoint

doi:10.3389/fpsyg.2017.01243

Abstract

The use of Serious Games (SG) in the health domain is expanding. In the field of neurodegenerative disorders (ND) such as Alzheimer’s disease, SG are currently employed both to support and improve the assessment of different functional and cognitive abilities, and to provide alternative solutions for patients’ treatment, stimulation, and rehabilitation. As the field is quite young, recommendations on the use of SG in people with ND are still rare. In 2014 we proposed some initial recommendations (Robert et al., 2014). The aim of the present work was to update them, thanks to opinions gathered by experts in the field during an expert Delphi panel. Results confirmed that SG are adapted to elderly people with mild cognitive impairment (MCI) and dementia, and can be employed for several purposes, including assessment, stimulation, and improving wellbeing, with some differences depending on the population (e.g., physical stimulation may be better suited for people with MCI). SG are more adapted for use with trained caregivers (both at home and in clinical settings), with a frequency ranging from 2 to 4 times a week. Importantly, the target of SG, their frequency of use and the context in which they are played depend on the SG typology (e.g., Exergame, cognitive game), and should be personalized with the help of a clinician.

Highlights

The use of Information and Communication Technologies (ICT) in the health domain is progressively expanding
Repeated-measures ANOVA confirmed that Serious Games (SG) were rated as more adapted to people with Mild Cognitive Impairment (MCI) compared to people with dementia [F(1,21) = 16.87, p = 0.001], suggesting that SG are considered as more adapted to people with initial cognitive decline than to people which are already loosing autonomy in activities of daily living
Repeated-measures ANOVAs (Bonferroni corrected) conducted to compare people with MCI and dementia for each category suggested that SG were considered as more adapted to people with MCI compared to people with dementia to train cognitive functions [F(1,20) = 17.44, p < 0.001], to improve autonomy [F(1,20) = 10.80, p = 0.004] and wellbeing [F(1,21) = 9.32, p = 0.006] and to teach contents [F(1,20) = 15.42, p = 0.001]

Summary

Introduction

The use of Information and Communication Technologies (ICT) in the health domain is progressively expanding. The features typical of SG, such as the presence of a game challenge and of long-term goals, have been proposed to make SG more adapted than classical computerbased training to sustain generalization of learnt activities to real life situations (Whyte et al, 2015) For this reason, recommendations for the design of SG targeting ND are starting to emerge (e.g., Bouchard et al, 2012; Fua et al, 2013; Mader, 2015). Based on these new works and on the experience gained by different research centers involved in the use of SG in people with ND in the last years (e.g., the CoBTeK research laboratory of the Université Côte d’Azur, France; the Hopital Broca in Paris, France; the Radboud Alzheimer Center, Nijmegen, the Netherlands; Neuroscape in San Francisco, CA, United States) the aim of the present work is to update the recommendations published in 2014, thanks to a Delphi expert panel

Objectives

Results

Conclusion