1106 - Video Gaming as a Motivating Tool for Upper Extremity Motor Recovery in Incomplete Spinal Cord Injury: A Case-Based Approach

Case Diagnosis: Impaired hand function after spinal cord injury reduces quality of life. Intensive, repetitive training improves performance but can be demanding. Gaming-based virtual environments provide high-intensity, feedback-rich practice that enhances motor learning. We report a young adult with incomplete tetraplegia who used video gaming alongside rehabilitation, demonstrating potential benefits for hand and upper extremity function.

Case Description:

A 22-year-old right-handed male sustained an acute C3–C4 spinal cord injury from a diving accident and was admitted one month later with incomplete tetraplegia, motor deficits in all extremities, muscle strength 2/5–3/5, spasticity, and preserved passive range of motion. He was dependent on a power wheelchair for transfers, ambulation, and self-care, with limited hand function (grip: right 10 pounds, left 9 pounds; pinch: right 2 pounds, left 1.5 pounds) and restricted shoulder motion.

Daily 5–6 hour video gaming sessions provided repetitive, task-specific hand activity alongside conventional therapy. After four months, grip improved to right 50 pounds/left 40 pounds, pinch to right 8 pounds/left 6 pounds, and shoulder strength to right 4/5/left 3-/5. At eleven months, grip reached right 55 pounds/left 45 pounds, pinch right 17 pounds/left 19 pounds, with improved ambulation, reduced device dependence, and enhanced self-care scores.

Discussions: Intensive daily video gaming provided high-volume, repetitive practice essential for cortical reorganization after SCI. In incomplete SCI, repetitive upper extremity exercises improve hand function, and locomotor training enhances ambulation, requiring hundreds to thousands of repetitions. The patient’s engagement—5–6 hours daily during admission and ~4 hours post-discharge—far exceeded typical therapy durations. Game-based training with scoring, progressive challenges, and immediate feedback maintained motivation, supporting autonomy and competence. While physical evidence is limited, gaming enables high repetitions and complex movements, enhancing motor skill acquisition, adherence, and functional recovery beyond conventional rehabilitation.

Conclusions:

Intensive video gaming offers a motivating, high-repetition approach that may enhance motor recovery and complement conventional SCI rehabilitation.