Effects of a Multi-component Virtual Reality Program on Motor Skills and Functional Postural Control in Children with Hemiplegic Cerebral Palsy

Overview

Journal Heliyon

Specialty Social Sciences

Date 2023 Oct 9

PMID 37809784

Authors

Meysam Roostaei

Marzieh Babaee

Seyedmostafa Alavian

Narjes Jafari

Seyed Mansoor Rayegani

Saeed Behzadipour

Affiliations

Soon will be listed here.

Abstract

Background: Pediatric neurorehabilitation has recently employed virtual reality (VR) technologies as a platform to design and implement novel modalities.

Aims: To evaluate the feasibility of a multi-component VR-based program on motor skills and functional postural control for children with hemiplegic cerebral palsy (HCP).

Methods: A single-case-experimental design was conducted on eight children with HCP (12.33 ± 4.71 years and GMFCS= II, I). The VR-based program consisted of 3 sessions per week for four weeks. Timed Up and Go (TUG) test, Functional Reach Test (FRT), Pediatric Balance Scale (PBS), Activities Scale for Kids (ASK), ABILHAND-Kids, and Box and Block Test (BBT) were used to evaluate functional changes.

Outcomes And Results: Statistical analysis showed that improvements in functional postural control were significant on at least one balance measure for seven out of eight participants during the intervention phase. For all participants, a significant increase was observed in the BBT scores. Before-after intervention analysis revealed statistically significant improvements in PBS ( = -2.52, ≤ 0.01), ABILHAND-Kids ( = -2.25, ≤ 0.01), and ASK ( = -2.38, ≤ 0.01).

Conclusions And Implications: This study provided early evidence of the effectiveness of the multi-component VR-based program in children with HCP. However, future studies with randomized controlled trial design are needed to evaluate the long-term effects and compare them with conventional rehabilitation practice.

Citing Articles

Exploring the perspectives of health care professionals on digital health technologies in pediatric care and rehabilitation.

Roy I, Salles J, Neveu E, Lariviere-Bastien D, Blondin A, Levac D J Neuroeng Rehabil. 2024; 21(1):156.

PMID: 39261920 PMC: 11391714. DOI: 10.1186/s12984-024-01431-9.

References

Pourazar M, Bagherzadeh F, Mirakhori F . Virtual reality training improves dynamic balance in children with cerebral palsy. Int J Dev Disabil. 2021; 67(6):429-434. PMC: 8676581. DOI: 10.1080/20473869.2019.1679471. View

Jonsson U, Eek M, Sunnerhagen K, Himmelmann K . Cerebral palsy prevalence, subtypes, and associated impairments: a population-based comparison study of adults and children. Dev Med Child Neurol. 2019; 61(10):1162-1167. DOI: 10.1111/dmcn.14229. View

ALIMIl E, Kalantari M, Nazeri A, Baghban A . Test-retest & Inter-rater Reliability of Persian Version of Pediatric Balance Scale in Children with Spastic Cerebral Palsy. Iran J Child Neurol. 2019; 13(4):163-171. PMC: 6789081. View

Rathinam C, Mohan V, Peirson J, Skinner J, Nethaji K, Kuhn I . Effectiveness of virtual reality in the treatment of hand function in children with cerebral palsy: A systematic review. J Hand Ther. 2018; 32(4):426-434.e1. DOI: 10.1016/j.jht.2018.01.006. View

Chen C, Shen I, Chen C, Wu C, Liu W, Chung C . Validity, responsiveness, minimal detectable change, and minimal clinically important change of Pediatric Balance Scale in children with cerebral palsy. Res Dev Disabil. 2013; 34(3):916-22. DOI: 10.1016/j.ridd.2012.11.006. View

Elnaggar R, Mahmoud W, Alsubaie S, Abd El-Nabie W . Effectiveness of a Multi-Modal Exercise Program Incorporating Plyometric and Balance Training in Children With Hemiplegic Cerebral Palsy: A Three-Armed Randomized Clinical Trial. Phys Occup Ther Pediatr. 2021; 42(2):113-129. DOI: 10.1080/01942638.2021.1964674. View

Burn M, Gogola G . Dexterity of the Less Affected Hand in Children With Hemiplegic Cerebral Palsy. Hand (N Y). 2021; 17(6):1114-1121. PMC: 9608304. DOI: 10.1177/1558944721990803. View

Adamovich S, Fluet G, Tunik E, Merians A . Sensorimotor training in virtual reality: a review. NeuroRehabilitation. 2009; 25(1):29-44. PMC: 2819065. DOI: 10.3233/NRE-2009-0497. View

Hashemi Y, Taghizadeh G, Azad A, Behzadipour S . The effects of supervised and non-supervised upper limb virtual reality exercises on upper limb sensory-motor functions in patients with idiopathic Parkinson's disease. Hum Mov Sci. 2022; 85:102977. DOI: 10.1016/j.humov.2022.102977. View

10.

Hassani S, Krzak J, Johnson B, Flanagan A, Gorton 3rd G, Bagley A . One-Minute Walk and modified Timed Up and Go tests in children with cerebral palsy: performance and minimum clinically important differences. Dev Med Child Neurol. 2014; 56(5):482-9. DOI: 10.1111/dmcn.12325. View

11.

Roostaei M, Raji P, Khademi Kalantari K, Faghihzadeh E, Fragala-Pinkham M . Effect of upper extremity constraints on functional and dynamic postural control in children with hemiplegic cerebral palsy. Dev Neurorehabil. 2021; 25(4):281-288. DOI: 10.1080/17518423.2021.2020351. View

12.

Pavao S, Visicato L, da Costa C, de Campos A, Rocha N . Effect of the severity of manual impairment and hand dominance on anticipatory and compensatory postural adjustments during manual reaching in children with cerebral palsy. Res Dev Disabil. 2018; 83:47-56. DOI: 10.1016/j.ridd.2018.08.007. View

13.

Demers M, Fung K, Subramanian S, Lemay M, Robert M . Integration of Motor Learning Principles Into Virtual Reality Interventions for Individuals With Cerebral Palsy: Systematic Review. JMIR Serious Games. 2021; 9(2):e23822. PMC: 8060861. DOI: 10.2196/23822. View

14.

Gan S, Tung L, Tang Y, Wang C . Psychometric properties of functional balance assessment in children with cerebral palsy. Neurorehabil Neural Repair. 2008; 22(6):745-53. DOI: 10.1177/1545968308316474. View

15.

Johnson C, Hallemans A, Goetschalckx M, Meyns P, Rameckers E, Klingels K . Psychometric properties of functional postural control tests in children: A systematic review. Ann Phys Rehabil Med. 2023; 66(4):101729. DOI: 10.1016/j.rehab.2022.101729. View

16.

Mohammadkhani-Pordanjani E, Arnould C, Raji P, Nakhostin Ansari N, Hasson S . Validity and reliability of the Persian ABILHAND-Kids in a sample of Iranian children with cerebral palsy. Disabil Rehabil. 2019; 42(12):1744-1752. DOI: 10.1080/09638288.2018.1530307. View

17.

Metzler M, OGrady K, Fay L, Herrero M, Dunbar M, Fehlings D . Feasibility of High Repetition Upper Extremity Rehabilitation for Children with Unilateral Cerebral Palsy. Phys Occup Ther Pediatr. 2021; 42(3):242-258. DOI: 10.1080/01942638.2021.2010857. View

18.

Krasny-Pacini A, Evans J . Single-case experimental designs to assess intervention effectiveness in rehabilitation: A practical guide. Ann Phys Rehabil Med. 2017; 61(3):164-179. DOI: 10.1016/j.rehab.2017.12.002. View

19.

Rich T, Menk J, Rudser K, Feyma T, Gillick B . Less-Affected Hand Function in Children With Hemiparetic Unilateral Cerebral Palsy: A Comparison Study With Typically Developing Peers. Neurorehabil Neural Repair. 2017; 31(10-11):965-976. PMC: 5729110. DOI: 10.1177/1545968317739997. View

20.

Dinomais M, Veaux F, Yamaguchi T, Richard P, Richard I, Nguyen S . A new virtual reality tool for unilateral cerebral palsy rehabilitation: two single-case studies. Dev Neurorehabil. 2013; 16(6):418-22. DOI: 10.3109/17518423.2013.778347. View