Authors :
Keerthana Murugan; Kishoremoy Das; Vignesh Shrinivasan; Pavithra Aravind; Iswarya Suresh; Pavithra Saravanan
Volume/Issue :
Volume 10 - 2025, Issue 9 - September
Google Scholar :
https://tinyurl.com/2rc8svcw
Scribd :
https://tinyurl.com/yttfacdb
DOI :
https://doi.org/10.38124/ijisrt/25sep577
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Abstract :
Postural instability and motor deficits are frequently observed in children with autism spectrum disorder largely
due to atypical sensory integration and poor motor planning. These difficulties usually make it difficult for them to perform
everyday duties endanger their independence and negatively affect their overall quality of life. Though they can sometimes
lack originality and may not sustain long-term interest traditional therapeutic approaches can enhance motor function and
balance. Conversely interactive and entertaining active video games (AVGs) such as those played with an Xbox Kinect
combine therapeutic effectiveness with enjoyment and active engagement.
Aim
To assess the feasibility and early effectiveness of Xbox Kinect based active video game interventions in enhancing
balance among children with autism spectrum disorder.
Materials and Methods
This pilot RCT involved 30 children with ASD (6–12 years), randomized to an intervention group (Xbox Kinect +
physiotherapy, n = 15) or control group (physiotherapy alone n = 15). Training was delivered thrice weekly for 8 weeks.
Feasibility was assessed through adherence safety and acceptability while preliminary outcomes included the Paediatric
Balance Scale (PBS) and Timed Up and Go (TUG) test.
Results
Recruitment and retention were excellent with all participants completing the study (100%). No adverse events
occurred supporting the intervention’s feasibility. Compared with the control group, the intervention group demonstrated
significant gains in PBS (p < 0.001) and TUG (p < 0.001).
Conclusion
This pilot trial suggests Xbox Kinect–based training is safe, feasible and acceptable for children with ASD with
preliminary evidence of balance benefits larger RCTs are needed to confirm efficacy and long-term outcomes.
Keywords :
Autism Spectrum Disorder, Balance, Xbox Kinect, Pediatric Physiotherapy, Pilot Study.
References :
- Wang L, Wang B, Wu C, Wang J, Sun M. Autism spectrum disorder: neurodevelopmental risk factors, biological mechanism, and precision therapy. Int J Mol Sci. 2023;24(3):1819.
- Stins JF, Emck C. Balance performance in autism: A brief overview. Front Psychol. 2018;9:901.
- da Silva SH, Felippin MR, de Oliveira Medeiros L, Hedin-Pereira C, Nogueira-Campos AA. A scoping review of the motor impairments in autism spectrum disorder. Neurosci Biobehav Rev. 2025;106002.
- Thirumalai J, Sekar M, Ramalingam V, Bhuvaneshwar S, Gajendran K, Jeslin GN. Culturally Adapted Play-based Behavioral Intervention among Children with Autism Spectrum Disorder in Semi-rural Tamil Nadu: A Randomized Controlled Trial. Journal of Mental Health and Human Behaviour. 2025;10–4103.
- Autism [Internet]. World Health Organization. 2023 [cited 2024 May 4]. Available from: https://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders
- Aronoff E, Hillyer R, Leon M. Environmental Enrichment Therapy for Autism: Outcomes with Increased Access. Neural Plast. 2016;2016:2734915.
- Dissanaykae C. Long term stability of individual difference in the emotional responsiveness of children with autism’’. Journal of child psychology and psychiatry. 37:461–7.
- Mahajan R, Sagar R. Adequate management of autism spectrum disorder in children in India. Indian J Pediatr. 2023;90(4):387–92.
- Dey I, Chakrabarty S, Nandi R, Shekhar R, Singhi S, Nayar S, Ram JR, Mukerji S, Chakrabarti B. Autism community priorities in diverse low-resource settings: A country-wide scoping exercise in India. Autism. 2024 Jan;28(1):187–98.
- Dijkstra-de Neijs L, Tisseur C, Kluwen LA, van Berckelaer-Onnes IA, Swaab H, Ester WA. Effectivity of Play-Based Interventions in Children with Autism Spectrum Disorder and Their Parents: A Systematic Review. J Autism Dev Disord. 2023 Apr;53(4):1588–617.
- Barghi F, Safarzadeh S, Marashian FS, Bakhtiarpour S. Effectiveness of DIR/Floor Time Play Therapy in Social Skills and Emotion Regulation of Children with Autism Spectrum Disorder. Middle East Journal of Rehabilitation and Health Studies. 2023;(In Press).
- Yang CM, Hsieh JSC, Chen YC, Yang SY, Lin HCK. Effects of Kinect exergames on balance training among community older adults: A randomized controlled trial. Medicine. 2020;99(28):e21228.
- Page ZE, Barrington S, Edwards J, Barnett LM. Do active video games benefit the motor skill development of non-typically developing children and adolescents: A systematic review. J Sci Med Sport. 2017;20(12):1087–100.
- Zayeni D, Raynaud JP, Revet A. Therapeutic and preventive use of video games in child and adolescent psychiatry: a systematic review. Front Psychiatry. 2020;11:36.
- Zayeni D, Raynaud JP, Revet A. Therapeutic and preventive use of video games in child and adolescent psychiatry: a systematic review. Front Psychiatry. 2020;11:36.
- da Silva SH, Felippin MR, de Oliveira Medeiros L, Hedin-Pereira C, Nogueira-Campos AA. A scoping review of the motor impairments in autism spectrum disorder. Neurosci Biobehav Rev. 2025;106002.
- Soniyasri S, Alagesan J. Impact of Xbox Gaming on Object control skills and Balance for children with autism spectrum disorder-A Pilot study. Indian J Physiother Occup Ther. 2024;18.
- Edwards J, Jeffrey S, May T, Rinehart NJ, Barnett LM. Does playing a sports active video game improve object control skills of children with autism spectrum disorder? J Sport Health Sci. 2017;6(1):17–24.
- Golden D, Liang LY, Getchell N. The effects of Xbox Kinect active video gaming on executive function, inhibition, in children with and without autism spectrum disorder: A pilot study. J Behav Brain Sci. 2022;12(6):287–301.
- Jeevarathinam T, Vinodhkumar R. Utilizing Technological Intervention for Behavior Problems in Children with Cerebral Palsy within a Tertiary Care Setting. Indian Journal of Community Medicine [Internet]. 9900; Available from: https://journals.lww.com/ijcm/fulltext/9900/utilizing_technological_intervention_for_behavior.179.aspx
- Dubey I, Bishain R, Dasgupta J, Bhavnani S, Belmonte MK, Gliga T, Mukherjee D, Lockwood Estrin G, Johnson MH, Chandran S, Patel V, Gulati S, Divan G, Chakrabarti B. Using mobile health technology to assess childhood autism in low-resource community settings in India: An innovation to address the detection gap. Autism. 2024 Mar;28(3):755–69.
- Shumway-Cook A, Woollacott MH. Motor control: translating research into clinical practice. Lippincott Williams & Wilkins; 2007.
- Franjoine MR, Gunther JS, Taylor MJ. Pediatric balance scale: a modified version of the berg balance scale for the school-age child with mild to moderate motor impairment. Pediatric physical therapy. 2003;15(2):114–28.
- Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP. Investigation of the timed ‘up & go’test in children. Dev Med Child Neurol. 2005;47(8):518–24.
- Shogren KA, Scott LA, Dean EE, Linnenkamp B. Handbook of research-based practices for educating students with intellectual disability. Routledge; 2024.
- Thirumalai J, Aravind P, Ramalingam V, Abathsagayam K, Alagesan J, Suganthirababu P. Analyzing the Efficacy of Anti-Gravity Treadmill in Enhancing Gait and Balance among Patients with Spastic Cerebral Palsy–A Critical Review. INTI Journal. 2024;2024.
- Jelsma D, Geuze RH, Mombarg R, Smits-Engelsman BCM. The impact of Wii Fit intervention on dynamic balance control in children with probable Developmental Coordination Disorder and balance problems. Hum Mov Sci. 2014;33:404–18.
- Anderson-Hanley C, Tureck K, Schneiderman RL. Autism and exergaming: effects on repetitive behaviors and cognition. Psychol Res Behav Manag. 2011;129–37.
- Gatica-Rojas V, Cartes-Velásquez R, Guzmán-Munoz E, Méndez-Rebolledo G, Soto-Poblete A, Pacheco-Espinoza AC, Amigo-Mendoza C, Albornoz-Verdugo ME, Elgueta-Cancino E. Effectiveness of a Nintendo Wii balance board exercise programme on standing balance of children with cerebral palsy: A randomised clinical trial protocol. Contemp Clin Trials Commun. 2017;6:17–21.
Postural instability and motor deficits are frequently observed in children with autism spectrum disorder largely
due to atypical sensory integration and poor motor planning. These difficulties usually make it difficult for them to perform
everyday duties endanger their independence and negatively affect their overall quality of life. Though they can sometimes
lack originality and may not sustain long-term interest traditional therapeutic approaches can enhance motor function and
balance. Conversely interactive and entertaining active video games (AVGs) such as those played with an Xbox Kinect
combine therapeutic effectiveness with enjoyment and active engagement.
Aim
To assess the feasibility and early effectiveness of Xbox Kinect based active video game interventions in enhancing
balance among children with autism spectrum disorder.
Materials and Methods
This pilot RCT involved 30 children with ASD (6–12 years), randomized to an intervention group (Xbox Kinect +
physiotherapy, n = 15) or control group (physiotherapy alone n = 15). Training was delivered thrice weekly for 8 weeks.
Feasibility was assessed through adherence safety and acceptability while preliminary outcomes included the Paediatric
Balance Scale (PBS) and Timed Up and Go (TUG) test.
Results
Recruitment and retention were excellent with all participants completing the study (100%). No adverse events
occurred supporting the intervention’s feasibility. Compared with the control group, the intervention group demonstrated
significant gains in PBS (p < 0.001) and TUG (p < 0.001).
Conclusion
This pilot trial suggests Xbox Kinect–based training is safe, feasible and acceptable for children with ASD with
preliminary evidence of balance benefits larger RCTs are needed to confirm efficacy and long-term outcomes.
Keywords :
Autism Spectrum Disorder, Balance, Xbox Kinect, Pediatric Physiotherapy, Pilot Study.