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Treasure in Video Gaming for Cognitive Rehabilitation

Treasure in Video Gaming for Cognitive Rehabilitation

This study was performed using the TREASURE OF BELL ISLAND game described here.

Abstract (ACRM format)

Title: Treasure in video gaming for cognitive rehabilitation

Authors: Bonnie L Kennedy, Nina Withrington, Meryl Paya, Sheryl Flynn

Objectives: Compare the effects of Video Game intervention to standard of care workbook intervention on processing efficiency in learning, memory, response speed and spatial perception for veterans with persistent post-concussion symptoms

Design: Randomized Controlled Counterbalanced Repeated Measures

Setting: Community living in a major west coast metropolitan area

Participants: Twenty veterans (95% men) reporting chronic post-concussion symptoms with a mean age of 31 (±SD 7.4) completed this study. All of the participants scored as “clearly below average” on at least one of four Automated Neuropsychological Assessment Metrics (ANAM) tests: Code Substitution-Learning phase, Code Substitution-Immediate Memory, Two Choice Reaction Time, or Spatial Processing Sequential.

Interventions: The effect of 2 weeks of playing Treasure of Bell Island (a new gamified cognitive skill activity) was compared to the effect of 2 weeks of standard care paper and pencil cognitive tasks commonly used in cognitive rehabilitation.

Main Outcome Measures: Throughput scores from the ANAM Code Substitution-Learning phase, Code Substitution-Immediate Memory, Two Choice Reaction Time and Spatial Processing- Sequential.

Results: Statistically significant improvements were observed in Code Substitution-Learning phase (t=1.956, p=.0355), Cohen’s d: 0.432 and Code Substitution-Immediate Memory (t=1.956, p=.0325), Cohen’s d: 0.438. A trend was observed for Spatial Processing- Sequential (t=1.350, p=.0965), Cohen’s d: 0.312. No statistically significant effect was found for Two Choice Reaction Time. Distribution of scores were not statistically significantly different from a normal distribution. Crossover effects were not statistically significant.

Conclusions: These findings indicate that the use of Treasure is more effective and more efficient at improving cognitive processing, than current standard care paper and pencil workbook pages for improving associative learning, memory and spatial processing. Throughput scores were tested because they represent both speed and accuracy of cognitive processing. The effect size of 43% of the standard deviation observed on the Code Substitution Throughput scores is 13% larger than commonly observed effect sizes for cognitive rehabilitation activities (Rohling, et al., 2011.) The effect size of 31% on Spatial Processing- Sequential is average for current practice in cognitive rehabilitation activities. However, it is important to note that while the mean duration of cognitive rehabilitation activities for acquired brain injury is 13 weeks (Rohling, et al., 2009); the robust effects of the Treasure gamified activity occurred after just 2 weeks of activity.