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Today's hospitals need innovative solutions to help patients transition from our care to self-management at home. The vast majority of the patients seen in Dodd Rehabilitation Hospital and associated clinics leave our care with persistent and life-altering challenges - behavioral, cognitive, emotional and/or physical. The period of time immediately following discharge is an under-addressed stage within the continuum of care. The investigators are researching solutions to help patients in this transition to self-care and believe that multiplayer gaming paradigms may be a promising innovation to facilitate this transition.
The investigators believe that Dr. Jane McGonigal's SuperBetter, and positive play games like it, are promising novel interventions that could make a positive difference in the ability of our patients to successfully transition to self care after discharge from therapeutic care.
Specifically, the investigators will evaluate feasibility of use of such a game by mild to moderate brain injured individuals and to record pilot data to help us plan a clinical effectiveness follow up study. Our goal is to finish this study with an intervention tailored for use within the clinical continuum of care and sufficient pilot data to prepare for a randomized clinical control trial of this intervention.
Today's hospitals need innovative solutions to help patients transition from our care to self-management at home. The vast majority of the patients seen in Dodd Rehabilitation Hospital and associated clinics leave our care with persistent and life-altering challenges - behavioral, cognitive, emotional and/or physical. The period of time immediately following discharge is an under-addressed stage within the continuum of care. The investigators are researching solutions to help patients in this transition to self-care and believe that multiplayer gaming paradigms may be a promising innovation to facilitate this transition for several reasons:
Despite the promise of games to facilitate transitions from hospital care to self care, no clinical studies have been done to establish best practices for applying gaming for rehabilitative purposes within the specific window of time in which discharge from standard care happens. While some commercially available games exist for those interested in health self-improvement, through companies such as That Game Company, Nintendo, Xbox, only the Nintendo Wii system has undergone clinical testing to demonstrate feasibility of use within the hospital-based model of patient care. Without more such evidence, the investigators are unable to confidently offer such novel interventions for our patients.
A new game, SuperBetter (SuperBetter, LLC, Sausilito, CA), has been developed to employ both social networking and alternate reality theory to achieve rehabilitative goals. SuperBetter is most similar to Facebook or Twitter in that users, or "gamers", create an account, invite others to be within their network, and post short status update messages. There are two major differences between SuperBetter and Twitter or Facebook, however. One difference is that this rehabilitation game will not offer a public option. The only people who can see a user's posts and status updates will have been specifically invited by that gamer; people outside the invited network will have no ability to "friend" a gamer, meaning there is no way to request to become part of a user's network - you must be invited by the account holder. The second difference is that SuperBetter assigns points to a gamer for attaining health goals such as: remembering to take medications each day; avoiding circumstances that exacerbate symptoms; checking in with someone within your trusted network (i.e. reaching out to your loved ones for support). Points are also assigned for "epic wins" which are defined by the patient and amount to things he or she cannot do today but want to be able to do tomorrow; this includes short term wins like hanging out with friends/loved ones or long term wins like getting back to playing sports.
The investigators believe that McGonigal's SuperBetter, and positive play games like it, are promising novel interventions that could make a positive difference in the ability of our patients to successfully transition to self care after discharge from therapeutic care. The investigators are conducting Phase I clinical testing (feasibility) to determine whether such a rehabilitation game is appropriate for use with: mild traumatic brain injured children and teens.
Specifically, the investigators will evaluate feasibility of use of such a game by mild traumatic brain injured individuals and to record pilot data to help us plan a clinical effectiveness follow up study. Our goal is to finish this study with an intervention tailored for use within the clinical continuum of care and sufficient pilot data to prepare for a randomized clinical control trial of this intervention.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| SuperBetter Play | Experimental | members of this group will play SuperBetter for 6 weeks (averaging 10 min per day of play for 6 week period) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| SuperBetter play | Behavioral | average 10 min of game play per day for 6 week period |
|
| Measure | Description | Time Frame |
|---|---|---|
| Participation | Number of Participants who used the app and returned for post testing | 8 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Satisfaction With App | Satisfaction rating on a 7 point Likert scale ranging from 1 (very satisfied) to 7 (very dissatisfied) among those who used the app and returned for post testing | 8 weeks |
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Inclusion Criteria:
Exclusion Criteria:
● history of substance abuse as self reported by patient or reported by support giver
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| Name | Affiliation | Role |
|---|---|---|
| Lise Worthen-Chaudhari, MFA,MS,CCRC | Ohio State University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Ohio State University Physical Medicine and Rehabilitation Department | Columbus | Ohio | 43210 | United States |
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| Label | URL |
|---|---|
| Sponsor website | View source |
| Game designer website | View source |
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Follow-up ended on 7 January 2015. Participants were excluded for premorbid learning disabilities, concurrent illness/injury at pre-test and complicated or atypical symptom presentation per treating clinician (e.g. symptoms incongruent with cognitive load).
Clinic patients (aged 13-18 years) with physician-diagnosed concussion and unresolved symptoms at 3 weeks to 12 months post injury between 13 August 2014 and 9 December 2014 were screened and recruited.
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| ID | Title | Description |
|---|---|---|
| FG000 | Gaming | Members of this group will play SuperBetter in addition to standard medical care for persistent concussion symptoms |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Gaming | Members of this group will play SuperBetter in addition to receiving standard medical care for persistent concussion symptoms |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Participation | Number of Participants who used the app and returned for post testing | Posted | Count of Participants | Participants | 8 weeks |
|
|
5 months (8/13/14 - 1/7/15)
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Gaming | Members of this group will play SuperBetter in addition to standard medical care for persistent concussion symptoms |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Lise Worthen-Chaudhari | The Ohio State University | 614-304-1421 | liseworthen@gmail.com |
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| ID | Term |
|---|---|
| D001924 | Brain Concussion |
| D001930 | Brain Injuries |
| ID | Term |
|---|---|
| D000070642 | Brain Injuries, Traumatic |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Number of participants with Sports Concussion Assessment Tool-3 (SCAT-3)Symptoms Score > 1 | The SCAT-3 is patient-reported outcome measure. Participants rate the severity level at which they are experiencing 22-items, that represent specific concussion symptoms. Severity per item ranges from 0 (none) to 6 (severe) at time of ecological momentary assessment. Scores are summed such that 0 corresponds to no symptoms, while 132 corresponds to severe incidence of all 22 items (i.e., worst presentation imaginable). Inclusion criteria for enrollment = a score of greater than 1. | Count of Participants | Participants |
|
|
| Secondary | Satisfaction With App | Satisfaction rating on a 7 point Likert scale ranging from 1 (very satisfied) to 7 (very dissatisfied) among those who used the app and returned for post testing | Posted | Median | Inter-Quartile Range | units on a scale | 8 weeks |
|
|
|
| 0 |
| 20 |
| 0 |
| 20 |
| 0 |
| 20 |
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| D006259 | Craniocerebral Trauma |
| D020196 | Trauma, Nervous System |
| D016489 | Head Injuries, Closed |
| D014947 | Wounds and Injuries |
| D014949 | Wounds, Nonpenetrating |