Randomised trial of virtual reality gaming and physiotherapy on balance, gross motor performance and daily functions among children with bilateral spastic cerebral palsy

Jha, Krishna Kumari; Karunanithi, Gandhi Balaji; Sahana, A; Karthikbabu, Suruliraj

doi:10.1080/08990220.2021.1876016

Cited by 32 publications

(47 citation statements)

References 40 publications

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“…All studies measured balance using at least one instrument, and five studies used two or more instruments to assess patients' balance ( 9 , 53 – 56 ). Eight studies used the PBS assessment tool ( 41 , 43 , 51 – 53 , 55 , 57 , 59 ), five studies used the CoP Kinematics system (balance force plate) ( 19 , 41 , 48 , 50 , 53 ), three studies used the TUG ( 54 – 56 ), two studies used the BOTMP ( 9 , 49 ), and one study used the MABC-2 ( 58 ), FRT ( 56 ), MFRT ( 60 ), PRT ( 42 ) and DBT ( 54 ).…”

Section: Resultsmentioning

confidence: 99%

“…Although previous review studies showed improvements in gross motor skills and upper limb skills in children with CP, the evidence for their assessment was limited by studies including randomized controlled trials ( 39 , 40 ). Recent studies by Sajan et al, Pin et al, and Jha et al did not support the hypothesis that VR therapy is more effective than physical therapy for balance in children with CP ( 41 – 43 ). To date, there is no strong evidence from studies showing the effectiveness of VR therapy on balance in children with CP.…”

Section: Introductionmentioning

confidence: 95%

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Effect of Virtual Reality on Balance Function in Children With Cerebral Palsy: A Systematic Review and Meta-analysis

Liu

Hu²,

et al. 2022

Front. Public Health

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Virtual Reality (VR) therapy is popular in treating children with Cerebral Palsy (CP) as a new technology for rehabilitation. Nevertheless, no substantial evidence supporting VR therapy promotion has been developed to date. This study aimed to investigate the effects of VR therapy on balance in children with CP. We conducted a systematic search in PubMed and Web of Science (updated to December 30, 2021). The systematic review and meta-analysis included all randomized controlled trials that included children with CP. A total of 18 RCT studies were eligible for inclusion in the systematic review, and meta-analysis was performed on 16 of them. Results showed that the VR intervention was beneficial for balance (SMD 0.47 [95% CI, SD 0.28, 0.66]). We concluded that VR therapy interventions for children with CP have positive effects. However, cautious implementation is needed in clinical applications.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

Effect of Virtual Reality on Balance Function in Children With Cerebral Palsy: A Systematic Review and Meta-analysis

Liu

Hu²,

et al. 2022

Front. Public Health

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“…Virtual environments and wearable haptic devices can be viable alternatives to conventional therapy for improving upper extremity function in children with neuromotor impairments [30][31][32]. Although numerous studies investigated the use of VR technology (audio-visual feedback) [14,15,[18][19][20], studies on the use of haptic feedback (tactile/force feedback) along with VR for children with CP remain scarce, and the research is still in the nascent stage.…”

Section: Vr As Interventionmentioning

confidence: 99%

“…In 2021, Jha et al reported that VR gaming coupled with physiotherapy improved balance (as measured using the Pediatric Balance Scale and Kids-Mini-Balance Evaluation Systems Test) in bilateral CP, but they did not find VR gaming with physiotherapy significantly superior to physiotherapy alone in improving gross motor function (as measured using the Gross Motor Function Measure-88) and routine functioning (as measured using the Wee-Functional Independence Measure). In Jha et al's study, each exercise session lasted for 60 minutes, and a single session was conducted every day for four days a week over a period of six weeks [ 18 ]. In another recently published study, Avcil et al conducted a study incorporating 60 minutes of VR intervention for three days per week over a period of eight weeks and concluded that V-based gaming has a superior effect on manual dexterity (as measured using the Minnesota Manual Dexterity Test) in children with CP compared with physiotherapy based on neurodevelopmental treatment.…”

Section: Reviewmentioning

confidence: 99%

Virtual Reality-Based Intervention for Enhancing Upper Extremity Function in Children With Hemiplegic Cerebral Palsy: A Literature Review

Goyal¹,

Vardhan²,

Naqvi³

2022

Cureus

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Cerebral palsy (CP) is the most common cause of motor disability in the pediatric population, with hemiplegia as one of the most widely seen subtypes of spastic CP. Although most of the children with hemiplegic CP are independent ambulators, deficits in hand function of the affected side remain a major concern of caregivers and children themselves. Children use the unaffected upper extremity to compensate for the weakness in the affected one, which consequently leads to the disuse of the hemiparetic upper extremity. Interactive virtual environments can enhance the activation of brain areas during training by providing feedback that can catalyze neuroplastic changes for improved function. Although numerous studies have been conducted on the impact of virtual reality (VR)-based rehabilitation in adults with stroke, studies on its use in the pediatric population are scarce. The three broad categories of VR systems based on the type of human-computer interactions are feedback-focused, gesture-based, and haptic-based. Preliminary studies have shown promising results of VR intervention in improving motor function, including upper extremity function, in children with hemiplegic CP. It is an engaging and entertaining intervention that adds an advantage of high compliance due to motivation. The current literature consists of studies with highly heterogeneous groups of participants and small sample sizes. Further investigation on children with a specific type of CP with advanced VR systems technology is warranted.

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“…Game-based rehabilitation approaches have the potential to improve clinical outcomes and enhance the active participation of children with neuromotor deficits [ 12 , 23 , 24 ]. However, there are only a small number of exercise games available for either commercial gaming systems or custom exergaming systems.…”

Section: Introductionmentioning

confidence: 99%

Game-Based Dual-Task Exercise Program for Children with Cerebral Palsy: Blending Balance, Visuomotor and Cognitive Training: Feasibility Randomized Control Trial

Szturm

Sanjay²,

Mehta

et al. 2022

Sensors

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The objective of this exploratory randomized controlled trial (RCT) was to provide evidence for the feasibility and therapeutic value of a novel game-based dual-task balance exercise program in children with cerebral palsy (CP). Twenty children with CP were recruited and randomized into two groups: (a) the conventional balance training group (CG) and (b) the experimental group (XG), which received a game-based dual-task (DT) balance exercise program. Both groups received their respective therapy programs for 12 weeks at a frequency of three sessions per week. Semi-structured interviews with the parents and children and qualitative analysis were conducted to evaluate the children’s experiences with the game-based exercise program. The quantitative analysis included (a) the Pediatric Balance Scale (PBS), (b) Gross Motor Function Measure-88 (GMFM-88), and (c) computerized measures of standing balance performance during various dual-task conditions. Compliance was 100% for all 20 participants. Four themes captured the range of each participant’s experiences and opinions: (a) reasons for participation, (b) likes and dislikes with the technologies, (c) positive effects of the program, and (d) future expectations. Children in the XG demonstrated greater improvements in PBS, GMFM, and DT balance measures as compared to children in the CG. The findings demonstrate feasible trial procedures and acceptable DT-oriented training with a high compliance rate and positive outcomes. These findings support further research and development and progression to the next phase of a full-scale RCT to evaluate the clinical effectiveness of the game-based DT balance exercise program for children with CP.

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Randomised trial of virtual reality gaming and physiotherapy on balance, gross motor performance and daily functions among children with bilateral spastic cerebral palsy

Cited by 32 publications

References 40 publications

Effect of Virtual Reality on Balance Function in Children With Cerebral Palsy: A Systematic Review and Meta-analysis

Effect of Virtual Reality on Balance Function in Children With Cerebral Palsy: A Systematic Review and Meta-analysis

Virtual Reality-Based Intervention for Enhancing Upper Extremity Function in Children With Hemiplegic Cerebral Palsy: A Literature Review

Game-Based Dual-Task Exercise Program for Children with Cerebral Palsy: Blending Balance, Visuomotor and Cognitive Training: Feasibility Randomized Control Trial

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