Written by Emily Ashworth (Research Nurse)
Edited by Lucia M Li
Self-awareness, behaviour and social skills are important aspects of everyday life that inform the way we react and interact with what is going on around us. After traumatic brain injury (TBI), some of these skills can be impaired and has been reported in 45-97% of cases.
It has been shown previously that using feedback based skills can improve self-awareness through methods such as face to face with therapists, video tapes, and telephone conversations. It is thought that these motivational techniques are useful for patients to learn and understand the skills that may have been lost after a brain injury.
The researchers used a group video-game therapy session to investigate the impact it had on self-awareness and developing problem-solving and social interaction. Patients were recruited if had suffered a moderate to severe traumatic brain injury and experienced some memory loss immediately after the accident (known as post traumatic amnesia). They were assessed on their functional skills including activities of daily living (such as washing, dressing, eating etc.) prior to starting the therapy Behavioural scales and self-awareness assessments were also used.
Patients were grouped based upon their baseline tests into groups of 8. These groups were then divided into two teams of 4 who sat around a digital table that projected a video-game.
The objective of the game was for each team to climb to the top of the mountain by answering questions correctly. Questions included anatomical (biology) questions, role-playing questions, situational exercises, and jokes and riddles. People within the teams could work together to answer questions.
These game sessions lasted 1 hour, once a week, over a 6 month period. The aim of the study was to see whether these sessions could improve self-awareness, problem-solving skills and social interaction.
42 patients took part in the study, and the results showed that every patient benefited in some way from the video-game “therapy”. The biggest improvement was that patients were able to set realistic goals for the future and all had improvements in self-awareness.
But how reliable are these results? We would expect an improvement with time anyway in patients with TBI, so it would have been useful to have a comparable control group – for example, a group of patients who did not play the video games, to truly reflect the impact the video-games had. A group size of 42 patients is also relatively small in this kind of interventional study – it is difficult to know how representative they are of the many patients who have TBI. Finally, the demographic and clinical aspects of the study are linked to the local area and are therefore not globally represented. In order to use this kind of intervention in a broader area, the study would need to be rolled out in more than one geographical area.
In conclusion, this study suggests that using a video-game based therapy could improve self-awareness after TBI and therefore functional ability. This is a therapy that is easy to set-up and patients have motivation to attend. However, this study is very small and did not have a control group. Therefore, more research needs to be done to clarify just how much improvement can be made using these techniques.