Digital hand tracker-based training improves functions and promotes hand-pinch strength in people with juvenile idiopathic arthritis, according to new clinical data.

The study with those results, “Leap Motion Controller-based training for upper extremity rehabilitation in children and adolescents with physical disabilities: A randomized controlled trial,” was published in the Journal of Hand Therapy.

Daily activities and routines that use upper extremities, such as feeding, personal care, and dressing, are often limited in children and adolescents with juvenile idiopathic (of unknown cause) arthritis due to swollen, stiff and painful joints.

However, hand and upper extremity rehabilitation is a prolonged, demanding and difficult pursuit to improve patients’ fine motor skills. Evidence indicates that in a rehabilitation scenario, virtual reality can improve motor skills and aid muscle recovery in a non-invasive, safe way.

Employment of digital technology has been gaining momentum among medical professionals in addressing those rehabilitation challenges.

“A novel commercially available device called Leap Motion Controller (LMC) is a low-cost and low-complexity optoelectronic system, which can track hand and finger movements with declared submillimeter accuracy,” researchers wrote.

A leap motion controller is a small USB device that plugs into the computer. Using LED lights and camera sensors, the technology scans the area between the subject and the computer and tracks both hands and all 10 fingers as they move through the open space.

Istanbul University scientists designed a randomized controlled study (NCT03078998) to investigate the potential effectiveness of an eight-week leap motion controller video game-based set as an upper extremity rehabilitation program. That was compared to a conventional rehabilitation program in children and adolescents with physical disabilities, including juvenile idiopathic arthritis, cerebral palsy and brachial plexus birth injury.

Juvenile idiopathic arthritis patients were randomized into two groups: leap motion controller-based training or conventional treatment. Participants had to complete the program in one-hour sessions three times a week for eight weeks.

For the leap motion controller-based training, subjects played two games: in the “Leapball” game, they had to grasp a virtual ball with all the fingers and throw it into the bucket of the same color; in the “CatchAPet” game, they were instructed to touch rabbits randomly coming out of the holes with repetitive wrist flexion/extension movements. Games were designed to improve joint range of motion, muscle strength, coordination, and fine motor functions of the hand and wrist; researchers made sure the games were played correctly.

Importantly, game hand movements reflected daily life activities for rehabilitation purposes, making this technology different from that of general public games.

Regarding the conventional approach, tasks included “grasp and release activities to improve the ability to flex and extend the hand and increase the joint range of motion of the wrist and digits. Progression within each movement was facilitated by increasing the number of repetitions, the weight of the item being handled, height at which tasks were done, and so on,” researchers explained.

Of the 92 people who completed the rehabilitation program, 43 had juvenile idiopathic arthritis (18 were assigned to the video-based game and 25 to the conventional treatment).

Patients’ abilities to perform activities in their daily environment, their hand, tip, lateral, and triple grip were improved in both the video-based game approach and the conventional treatment.

However, the results suggested there was a greater therapeutic effect from the video-based game in hand and pinch grips, fine motor skills during activities of daily living, and finger dexterity, compared to conventional treatment.

“This study has quantitatively shown that LMCBT [leap motion controller-based training] should be used as an effective alternative treatment option in children and adolescents with physical disabilities,” researchers concluded.