Augmented Effects of Sensory Integration Therapy and Virtual Reality on Movement and Balance Issues in Cerebral Palsy: A Pilot Study

Abstract

Background: Cerebral Palsy (CP) causes many sensory and motor deficits in children which may lead to deterioration of their functional activities and daily life. Effective interventions are required to be worked on, which can improve the movement status of such subjects. Objective: To determine the effects of sensory integration therapy (SIT) in addition with virtual reality (VR) and Conventional Physical Therapy in subjects with cerebral palsy. Methods: A Pilot randomized control trial (RCT) was conducted at Pakistan Railway Hospital Rawalpindi from July to December 2019. The n=26 subjects were recruited after fulfilment of inclusion criteria; male and female diagnosed spastic CP subjectswith age 5-12 years, gross motor function classification system (GMFC) level I-II, can independently walk ≥ 5 meters, spasticity of lower limb <3 on Modified Ashworth Scale (MAS), able to understand commands and play gamesThe subjects were randomly divided into group A, receiving sensory integration therapy (SIT) in addition to virtual reality (VR) and conventional physical therapy CPT), while group B received only virtual reality (VR) and conventional physical therapy CPT). The interventions were given for 6 weeks with assessments at baseline, 3rd and 6th weeks. The outcome measures were gross motor function measurement (GMFM) for assessment of gross motor functions, pediatric balance scale (PBS) for assessment of balance in children and 2-minute walk test (2MWT) for mobility. The analysis was done via SPSS 21 and ANOVA test was applied. Results: The mean age of the study participants was 7.52±2.25 years. The balance Scale and 2-minute walk test showed significant interaction (p<0.001) between intervention and time. Between group analyses done by one way ANOVA, the assessment at 3rd and 6 weeks has shown significant difference (p<0.001) for GMFM standing, walking/running and total along with PBS and 2 MWT. Conclusion: Augmentation of sensory integration therapy with virtual reality has significant effects on improving gross motor functions, balance and mobility in cerebral palsy as compared to virtual reality. Keywords: Balance, cerebral palsy, gross motor functions, virtual reality, sensory integration therapy

A Case Study on the Fundamentals of Sensory Problems in Cerebral Palsy

“…Children with CP frequently experience sensory and motor deficiencies, which may adversely affect their everyday lives and functional activities. (13) Food fussiness has been related to increased sensory sensitivity in both normal and CP child. Sensory issues and dietary fussiness are described as important issues for concern in children with neurological disorders (14) .…”

Effectiveness of Neurodevelopmental Treatment and Sensory Integration Therapy on Gross Motor Function, Balance and Gait Parameters in Children With Spastic Diplegia

“…Batool et al investigated in a pilot study whether cerebral palsy patients would benefit from sensory integration treatment (SIT) combined with virtual reality (VR) and traditional physical therapy. They came to the conclusion that, in comparison to virtual reality, adding virtual reality to sensory integration therapy had significant impacts on improving cerebral palsy patients' gross motor skills, balance, and mobility [ 32 ].…”