Feasibility of a Home-Based Exergaming Intervention for Youth With Spinal Muscular Atrophy

Abstract

Introduction/Aims: Approaches to optimize physical activity in youth with spinal muscular atrophy (SMA) are rapidly evolving. The primary objective of this study was to assess the feasibility of a fit-for-purpose home-based exergaming intervention in children and youth with SMA and peer controls. Methods: We conducted a 4-week study at two Canadian sites to assess the feasibility of Tales from the Magic Keep, a home-based exergame specifically developed for youth with neuromuscular disorders that targets upper limb and trunk movements. Participants were asked to play the exergame for at least 20 min per session, 4 times a week for 4 weeks, and wear an accelerometer-based wearable device. Adherence, acceptability, and usability evaluations informed feasibility determinations. Adherence was quantified by gameplay frequency and duration. Acceptability and usability were assessed using study-specific questionnaires and the system usability scale (SUS). Results: We enrolled 12 participants, 8 of whom completed the study: 4 SMA (3 Type II, 1 Type III) and 4 controls. Among those 8, adherence was high, with an average of 4.5 and 3.5 sessions per week for the SMA and control groups respectively, and they found gameplay to be acceptable and enjoyable. The median score on the SUS was 68/100. The wearable device was generally well accepted; participants reported it as comfortable to wear and not interfering with daily activities. Discussion: The exergame was feasible and acceptable in two thirds of participants. Iterative feedback obtained during this study led to subsequent updates to the game interface to optimize gameplay.