Hippotherapy positively affects gross motor function and balance in children with CP of various functional levels.

This study was performed to examine the convergent and discriminant validity of the Pediatric Balance Scale (PBS), a modified version of the Berg Balance Scale (BBS), in children with spastic cerebral palsy (CP). A total of 38 children (age, 4 to 10 years) with spastic CP who could ambulate participated in this study. PBS, equilibrium scores of Sensory Organization Test derived from computerized dynamic posturography, Gross Motor Function Measure (GMFM), and Pediatric Evaluation of Disability Inventory (PEDI) mobility skills were evaluated. With regard to convergent validity, PBS total score was moderately correlated with equilibrium score under the condition with eyes open, fixed foot support and condition with eyes closed, fixed foot support (rs = 0.579, eye open; rs = 0.448, eye closed; p < 0.05). PBS total score was highly correlated with GMFM scores (dimensions D and E; total GMFM-88; and GMFM-66) and capability, of the PEDI mobility domain, and moderately correlated with performance of the PEDI mobility domain. Discriminant validity indicated that PBS total score can distinguish between different Gross Motor Function Classification Scale levels in children with CP. PBS can be considered a simple, valid scale for examining functional balance capacity in children with spastic CP. Furthermore, it can better predict motor capacity and capability than equilibrium score and motor performance.

Aim To investigate the efficacy of a virtual reality rehabilitation system of wearable multi‐inertial sensors to improve upper‐limb function in children with brain injury. Method Eighty children (39 males, 41 females) with brain injury including cerebral palsy aged 3 to 16 years (mean age 5y 8mo, SD 2y 10mo) were assessed as part of a multicentre, single‐blind, randomized controlled trial. The intervention group received a 30‐minute virtual reality intervention and a 30‐minute session of conventional occupational therapy while the control group received 60 minutes of conventional occupational therapy per session, with 20 sessions over 4 weeks. The virtual reality rehabilitation system consisted of games promoting wrist and forearm articular movements using wearable inertial sensors. The Melbourne Assessment of Unilateral Upper Limb Function‐2 (MA‐2), Upper Limb Physician’s Rating Scale, Pediatric Evaluation of Disability Inventory Computer Adaptive Test, and computerized three‐dimensional motion analysis were performed. Results Both groups (virtual reality, n=40; control, n=38) significantly improved after treatment compared to baseline; however, the virtual reality group showed more significant improvements in upper‐limb dexterity functions (MA‐2, virtual reality group: Δ=10.09±10.50; control: Δ=3.65±6.92), performance of activities of daily living, and forearm supination by kinematic analysis (p<0.05). In the virtual reality group, children with more severe motor impairment showed significant improvements compared to those with less severe impairment. Interpretation The virtual reality rehabilitation system used in this study, which consists of wearable inertial sensors and offers intensive, interactive, and repetitive motor training, is effective in children with brain injury. What this paper adds Both virtual reality rehabilitation and conventional occupational therapy were effective for upper‐limb training. Virtual reality training was superior in improving dexterity, performance of activities of daily living, and active forearm supination motion. The effect of virtual reality training was significant in children with more severe motor impairments.