Medical Video Games: Partners in Pediatrics

When most people hear the phrase video games, childhood memories of Pac-Man munching down pellets or Super Mario crashing into blocks usually come to mind.

But just as video games were created to entertain, there is an enduring interest in using them as a means to educate and train children in their health.

Because it’s not very difficult to convince young people to interact with video games, doctors are increasingly seeing them as a non-intrusive educational medium that not only teaches kids about their illness but can assist doctors in diagnosing as well.

Gaming’s History in Pediatrics
The use of video games in pediatrics isn’t necessarily a new concept. Dating back to the early 1980s and the original Atari gaming system, many studies have been conducted focusing on the benefits of video games in healthcare.

In a 1987 study, commercial video games were proven to be therapeutic for the side effects associated with chemotherapy and radiation treatments of cancer.

A group of pediatric oncology patients was given 10 minutes of Atari game time during chemo induction. These kids, aged 9-18, reported a significant decrease in levels of nausea, vomiting, anxiety, and pain compared to the control group, which was only allowed to play with non-digital books, toys, or board games.

The results suggested that there is something more engaging and distracting involved with video game play than with non-digital play objects.

In a similar study, doctors examined the use of commercial games as distractors to help young patients manage their anxiety in a hospital setting.

The study examined 112 children, aged 4-12, undergoing anesthesia for elective surgery.  A group of the kids was given access to a Nintendo Gameboy platform, while the rest were not.

The patients who did not have a Gameboy showed significant increases in anxiety from baseline to induction of anesthesia. But patients who played the video games showed no significant increase in anxiety.

These findings are important for pediatricians because the handheld devices represent a low-cost, easy-to-implement, portable, and effective method of anxiety management in a vulnerable age during a critical moment of care.

Games Designed to Heal
As the general popularity of video games grew, it became evident they could be used to engage in patient care, especially when it came to young people.

Many games have been created to specifically address issues in health care. Built on past research, these games differed from commercial games that were only used as a distraction for pain.

The goal of these games was to increase compliance to treatment instructions, including delivering health-related information to patients, modeling positive health behaviors, and providing opportunities for players to vicariously practice positive health behaviors through video game characters.

Packy and Marlon, originally designed for the Super Nintendo game console, aimed at helping kids manage their diabetes. The game’s main characters, two diabetic elephants, are tasked with keeping a gang of plundering rats from invading a summer camp. To win, players had to successfully manage their insulin levels and food intake while keeping their characters’ glucose levels within a healthy range.

After careful testing, patients who played Packy and Marlon showed greater perceived self-efficacy for diabetes self-management, increased communication with parents about diabetes, and improved daily diabetes self-management behaviors.

More impressive was that the treatment group had a 77% decrease in diabetes-related emergencies and urgent care visits compared with the control group.

In another example, the Re-Mission PC game was created by HopeLab specifically for adolescents and young adults with cancer. In Re-Mission, players pilot a nanobot named Roxxi as she travels through the bodies of fictional cancer patients destroying cancer cells, battling bacterial infections, and managing side effects associated with cancer and cancer treatment.

Research shows that patients who played Re-Mission stuck to their prescribed treatments more consistently, a key component of successful cancer treatment, and showed increases in cancer knowledge and self-efficacy.

Games like these go beyond the strengths of commercial games in their ability to increase specified knowledge about self-care and disease. They harness the power to focus, engage and motivate players in their treatment.

Even though video game reviewers may find these games lack the industry standards for graphics and gameplay, their intended users tend to give them high ratings of acceptability and find them engaging.

The No-Couch Potato
Although some studies have linked video game play with obesity, in recent years, gaming has incorporated movement and physical activity with the development of the Microsoft Kinnect and Nintendo Wii systems.

Best-selling games like Wii Fit and Dance Dance Revolution provide a significant increase in energy levels among players. Even though these games may not provide as much exercise as the real version of the sports simulated, e.g., boxing, tennis, bowling, etc., they provide alternative activities for individuals concerned about video games as a sedentary activity.

Now, researchers at the University of Minnesota are playing around with Microsoft’s Kinect sensors as part of finding ways to diagnose autism in children earlier.

The university was awarded two grants totaling more than $3 million from the National Science Foundation to create robotic devices and computer vision algorithms that diagnose disorders such as autism, attention deficit disorder, and obsessive compulsive disorder.

At the university’s Institute of Child Development in Minneapolis, five Kinect cameras capture the play of children ages 3 to 5 in groups of about 10. The cameras keep track of children based on their shape and the color of their clothes. The information is then fed to three computers, which analyze how each child moves each limb and whether he or she is hyperactive or unnaturally still– both red flags for autism. Doctors then intervene, if the system suggests a child might need to see a specialist.

So as you can see, video games aren’t just a way for you to safely duke it out with Mike Tyson or race down the busy streets of Manhattan. They can also be a means for better care of children and adolescents.

Have you used video games in your practice?  Let us know in the comment section. 

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