App supports pediatric movement therapy

Gamification is becoming ever more popular in rehabilitation. Yet it’s not easy to design games that increase motivation and engagement. Fabienne Erben is a student at the Munich University of Applied Sciences who accepted the challenge and homed in on a difficult target group: children. As part of the KORA project, which is short for "Kostengünstige aktive Orthese zur Rehabilitation und Analytik von kindlichen Bewegungsstörungen" (English: Cost-effective active orthosis for the rehabilitation and analysis of pediatric movement disorders), she developed a gaming app to help children improve their movement behavior in a playful way.

In this MEDICA-tradefair.com interview, she described the objective of the project, explained the important aspects of this particular app design, and revealed the potential she sees in the digitization of assistive devices.

Ms. Erben, your app is part of the KORA project scope. Could you briefly sum up what the project is about and describe the role of your app within this context?

Fabienne Erben: KORA is a research project of the Munich University of Applied Sciences and was initiated by Professor Ulrich Wagner. The goal is to develop a cost-effective active orthosis for the rehabilitation and analysis of pediatric movement disorders. Along with the KORA app, we want to make it possible for children, their parents, and caregivers to train movement behavior in a playful way.

You are a UX designer. What motivated you to develop an app for children that encourages gait training?

Erben: Design isn't just about making things look beautiful. Design can also make our lives easier in many ways because it can solve complex problems. As a designer, you are often an intermediary between different groups, and you try to find the best and most effective solution that satisfies the concerns of all parties. The KORA research project has given me the chance to support affected children, their parents, and caregivers as they navigate therapy.

How can parents or physiotherapists track and monitor the child’s progress?

Erben: Movement disorders are neurological conditions that rarely develop overnight. It is a gradual process that parents cannot be expected to notice right away. It is also perfectly normal for children to develop and progress at their own pace within a given framework. That is why professionals such as physiotherapists track the child’s developmental progress over months or even years. We want to provide an additional therapeutic and diagnostic benefit by having the orthosis track the movement behavior and provide a visual representation of the data for parents, doctors, and physiotherapists. It enables you to quickly see exactly how the child landed with his/her foot or how many correct movement patterns there are compared to the previous day.

There are six games for children ages three to six. It’s the age when children make big strides in development. How did you make the games engaging and motivating for children in this age group?

Erben: We should first point out that every child is different. Although we want to offer every child a game that is fun and simultaneously provides the best therapeutic benefit, it’s not always feasible. The development and testing of the first six games gives us our first chance to tackle this issue.

The games were tested on four children between the ages of three and six in different sequential arrangement. It’s important for children to get comfortable and get to know you first. Of course, this takes place under the supervision and with the consent of the parent or legal guardian. Some children are slow to warm up to unfamiliar situations or people and are cautious about playing with someone they just met. If you add an unfamiliar environment to this setting, the children quickly become overstimulated by too many new experiences and will find it difficult to focus on the games. That’s why I tested the games with the children in their own homes and spent some time with them prior to embarking on the testing process. This gave them the chance to get to know me and vice versa. It also allows you to get a glimpse at the child’s personality. Oftentimes you know within a few seconds by reading their body language whether they enjoy playing a game.

What possibilities and opportunities do you see for this type of movement therapy in the coming years?

Erben: I hope that the potential of this type of adjunct therapy will be realized. The idea is not to replace conventional treatment but to give children and parents the option of continuing the therapy outside the medical office in a simple and playful manner. The digitization of assistive devices for daily living and their potential are far from being exhausted!