Predictors of Acceptance of Using Games for Cognitive Rehabilitation

Background:

Multiple Sclerosis (MS) is an auto-immune disease that affects central nervous system. Patients suffer from a wide range of symptoms including cognitive decline. Computer games are considered as potential means for ameliorating cognitive deficiencies. However, acceptance of using games by patients with MS for cognitive rehabilitation has not been studied systematically.

Objectives:

In this study, we assessed factors affecting acceptance of using games for cognitive rehabilitation by patients with MS.

Methods:

A total of 20 consecutive patients with MS were recruited from University of Maryland Center for Multiple Sclerosis. The participants were invited to the MS clinic and the research staff provided an introductory session on how to play the game. The gaming software ‘Brain Spa’ was used to evaluate the cognitive level and provide cognitive exercises. By helping the “townsfolk of Brainville” in a variety of mind-building challenges, the patients get to improve their skills in language, logic, memory and perception. Each patient completed a set of baseline surveys, played the game, and then provided feedback regarding the gaming software by competing an attitudinal survey. A regression model was used to identify factors predicting high acceptance score. The model included age, race, education, Expanded Disability Scale Score (EDSS) and frequency of computer use at home. Statistical analyses were performed using SAS version 9.0.      

Results:

The mean age was 41 years old, 90% were women. The average EDSS was 3.2 indicating mild disability in 3-4 functional system score range. On average, it took patients 2.8, 2.9, 3.5, and 1.6 minutes to complete language, logic, memory and perception sections; 70% reported that the rules of the games were not complicated at all; 100% responded that playing games may have a significant effect on their brain power; 80% thought it was very important to have their doctors to review the results from the brain training. During the semi-structured qualitative interview, patients mentioned: “I had a good experience with the games and I like that they could help me maintain my cognitive functions.”, and “I have noticed that I am not as sharp as I used to be and these games could help me improve my memory with repeated use.” From the linear regression model, education level, computer use at home, and being an African American were significant factors for gaming acceptance. Age and EDSS did not show statistically significance association with the acceptance score.

Conclusions:

The gaming software was well accepted by MS patients. Education level, computer use at home, and race were factors that influenced the acceptance score.