A Review Evaluating the Validity of Motion Based Gaming Platforms to Measure Clinical Outcomes in Clinical Research
OBJECTIVES: Motion based video game platforms provide the capability to track 3D body movements and may offer a versatile, easy to use and low cost approach to measuring objective clinical outcomes. We reviewed published validation studies comparing clinical outcomes derived from video game platforms to gold standard approaches. METHODS: We categorized studies in our review into three areas of application and summarized validation findings. We confined our review to studies using the Microsoft Kinect platform due to the volume of work in this area. RESULTS: Gait and balance: Five validation studies reported varied findings. One study in MS reported good correlation of most parameters with ClinROs; and a second study reported good validation of walk test parameters in Stroke patients. A treadmill test in healthy volunteers found Kinect underestimated joint flexion and over estimated extension; and a further study was able to detect gait disturbances in MS during a speed walking test compared to healthy volunteers although correlation to clinician assessment was modest (r=0.447) Kinect use during a battery of balance and dexterity tests in PD accurately measured the timing (ICCs: 0.940 0.999) and gross spatial characteristics of clinically relevant movements, but spatial accuracy for smaller movements, such as toe tapping (ICC 0.038) was poor. Upper extremity movement: Eight studies reported good validity in measurement of shoulder range of motion (r's 0.8, ICCs 0.864) Spirometry: One study reported strong correlation of spirometry parameters (r>0.866) estimated using multiple sensors to generate a 3D image of the chest. CONCLUSIONS: Motion based video gaming platforms offer potential for low cost assessment of movement and mobility in large scale clinical trials without reliance on specialist centers. Studies report good validity in some application areas. The ability to provide the level of accuracy needed in more rapid and finer movements requires more validation work.