Playfulness and new technologies in hand therapy for children with cerebral palsy: A Scoping Review (Preprint)

BACKGROUND Innovative technologies such as game consoles and smart toys used with games or playful approaches have proven to be successful and attractive in providing effective and motivating hand therapy for children with Cerebral Palsy (CP). Thus, there is an increased interest in designing and implementing interventions that can improve the well-being of these children. However, there needs to be more understanding of the playful elements of technology-supported hand therapy. OBJECTIVE This scoping review aims to identify the playful elements and the innovative technologies currently used in hand therapy for children with CP. METHODS We included studies that design or evaluate interventions for children with CP that use innovative technologies with game or play strategies. Data were extracted and analyzed on the type of technology, description of the system and playful elements according to the Lenses of Play, a play design toolkit. Thirty-one studies were included in the analysis. RESULTS The results show high use of consumer technologies in hand therapy for children with CP. While several studies used a combination of consumer technologies with therapeutic-specific technologies, only a few studies focused on the exclusive use of therapeutic-specific technologies. To analyze the playfulness of these interventions that make use of innovative technologies, we focused our review on three Lenses of Play: Open-ended Play, where it was found that the characteristics of Ludus, such as a structured form of play and defined goals and rules, were the most common ones, while strategies that relate to Paidia were less common. The most used Forms of Play were physical or active form and games with rules. Finally, the most popular Playful experiences were control, challenge, and competition. CONCLUSIONS The inventory and analysis of innovative technology and playful elements we provide here can be a starting point for new developments of fun and engaging tools to assist hand therapy for children with CP.