Cancer treatment aims to eradicate disease from the body, but the chemotherapy-related effects can be challenging. The medical community focuses on recovering physical strength, flexibility, and endurance during and after the treatment. A team of researchers at University of Utah Health have developed EmpowerStars!, a mobile video game to help pediatric cancer patients as they progress through and complete cancer therapy. The results are published in the April issue of Frontiers in Pediatrics.
Previous studies have shown that digital technologies, such as mobile apps and games, offer an effective tool to improve a patient’s understanding of health, disease, and treatment. Today, FDA-approved mobile technologies are helping patients manage diabetes and recover from stroke and traumatic brain injury.
With this in mind, the team developed EmpowerStars!, a proof of concept prototype mobile video game aiming to improve physical and mental condition in children with cancer. The game is anchored in imaginative stories and graphics. After customizing an avatar, the child grasps the handles on the case enclosing the tablet. Using a series of actions, like balancing, stirring, sawing, and pumping, the player obtains the stars needed to power the first mission. In addition to this physical activity, the game aims to help children gain strength and confidence while overcoming the fear and anxiety associated with the cancer diagnosis and the subsequent treatments.
In this study, ten children, aged 7 to 14 who were undergoing chemotherapy, received the one-day video game treatment, which consisted of 20-minutes of physical activity during the 30-minute gaming session. One parent of each child also reviewed the game, along with 12 pediatric health care providers, including nurses, child life specialists, social workers, and physicians. All three groups responded positively to the prototype but stressed the need to improve the instructions and overall objective of the game.
“I really enjoyed being so involved in the clinical usability evaluation,” said Carol Bruggers, MD, professor of pediatrics at U of U Health, first author on the paper, and principal investigator on this study. “Being able to experience first-hand the excitement, laughter, and enjoyment of children who played the prototype game re-enforced that creating an exercise and educational empowerment-centered, mobile, cancer-related game was right on track.”
The game was developed in conjunction with Spy Hop, a Utah-based program aimed at empowering young people by developing their skills in the digital media arts. In addition to creating and coding the graphics, storylines, activities and music in the game, the high school students were challenged to link the tablet’s internal sensors to respond to the patient’s physical movements during each activity.
The current game prototype was designed as a mission to one planet with diverse challenges and exercise components, but the number of planets in this universe can be expanded to incorporate more teaching and exercise opportunities. The next version of the game will include a multi-day delivery of exercise and empowerment interventions to tackle chemotherapy-related fatigue. The long-term benefits of this prototype game remain unclear. Future work will need to evaluate the clinical benefits of the game in children during and after chemotherapy treatment.
“We are still at the beginning of this process,” said Grzegorz Bulaj, PhD, associate professor of medicinal chemistry and co-author on this paper. “Digital medicine technologies can improve therapy outcomes by modulating a patient’s behavior”.
The researchers believe that this concept can be expanded to deliver treatment for other chronic childhood diseases, including obesity, asthma, cystic fibrosis, diabetes, and juvenile idiopathic arthritis.