Effectiveness of virtual reality in children and young adults with cerebral palsy: a systematic review of randomized controlled trial

Fandim, Junior Vitorino; Saragiotto, Bruno Tirotti; Porfírio, Gustavo José Martiniano; Santana, Renato Figueiredo

doi:10.1016/j.bjpt.2020.11.003

Cited by 31 publications

(22 citation statements)

References 78 publications

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“…Larger clinical trials have been recommended to establish the efficacy of intervention using VR approaches in specific homogenous target populations and to formulate VR training parameters that would allow optimal transfer of skills to improve function in the daily routine of patients [ 33 ]. According to a study published in 2021 by Fandim et al [ 34 ], evidence of the benefit of VR use in CP is limited. However, future investigations may improve this.…”

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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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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“…Beside robotic rehabilitation, gait training can take advantage of virtual reality (VR) [18,19]. VR is defined as an artificial environment, where patients are able to experience live interactions with a gaming environment through sensory stimuli and/or motor feedback.…”

Section: Introductionmentioning

confidence: 99%

“…A recent meta-analysis has shown the effectiveness of VR for gait rehabilitation in patients with CP, specifically in terms of speed, stride length and gross motor function [18]. Conversely, Fandim and co-authors in their systematic review suggest that there is no benefit of adding VR to conventional rehabilitation of children and young adults with CP, even if the quality of the evidence is low [19].…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Robot- vs. Virtual Reality-Based Gait Rehabilitation: A Propensity Score Matched Cohort

Biffi

Beretta

Storm

et al. 2021

Life

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Robot assisted gait training (RAGT) and virtual reality plus treadmill training (VRTT) are two technologies that can support locomotion rehabilitation in children and adolescents affected by acquired brain injury (ABI). The literature provides evidence of their effectiveness in this population. However, a comparison between these methods is not available. This study aims at comparing the effectiveness of RAGT and VRTT for the gait rehabilitation of children and adolescents suffering from ABI. This is a prospective cohort study with propensity score matching. Between October 2016 and September 2018, all patients undergoing an intensive gait rehabilitation treatment based on RAGT or VRTT were prospectively observed. To minimize selection bias associated with the study design, patients who underwent RAGT or VRTT were retrospectively matched for age, gender, time elapsed from injury, level of impairment, and motor impairment using propensity score in a matching ratio of 1:1. Outcome measures were Gross Motor Function Mesure-88 (GMFM-88), six-min walking test (6MWT), Gillette Functional Assessment Questionnaire (FAQ), and three-dimensional gait analysis (GA). The FAQ and the GMFM-88 had a statistically significant increase in both groups while the 6MWT improved in the RAGT group only. GA highlighted changes at the proximal level in the RAGT group, and at the distal district in the VRTT group. Although preliminary, this work suggests that RAGT and VRTT protocols foster different motor improvements, thus recommending to couple the two therapies in the paediatric population with ABI.

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“…Therefore, novel treatments, especially targeting pain behaviors and improvement of the current therapeutic options for adults are warranted. Several promising trials investigating children with CP have included Mirror Visual Feedback (MVF) [3][4][5] and virtual reality (VR)-mediated physical and occupational therapy [6] in their approach.…”

Section: Introductionmentioning

confidence: 99%

“…While more than 23 randomized controlled trials of fair-to-good methodological quality have investigated the use of VR for children with CP, no reports of its use in adults were found. These studies have been summarized in a systematic review [6], which concluded that VR may demonstrate short-term benefits to limb function, postural control, and balance in pediatric CP. Investigators hypothesize that the possible mechanisms for VR effects may include increases in cognitive engagement paired with a motor task, the ability to increase external cues, and a dosage effect mediated by increased motivation and repetitions from gamified designs.…”

Section: Introductionmentioning

confidence: 99%

Embodied Virtual Reality Mirror Visual Feedback for an Adult with Cerebral Palsy

Bullock¹,

Won²,

Bailenson³

et al. 2021

AJPN

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Virtual reality-assisted physical therapy and mirror visual feedback (MVF) are promising treatments for children with cerebral palsy (CP). However, thus far, neither interventions' use has been reported in adults with CP. The following case report examines the safety and feasibility of using customized virtual reality (VR) interventions to deliver MVF to an adult with hemiplegic CP and right sided pain, weakness, and dystonias. A weekly intervention was delivered in an ambulatory care setting over one year. Self-reported pain, motor function, anxiety, disability, quality of life and depression were monitored weekly. The treatment was acceptable and well tolerated with no instances of cybersickness. The intervention showed immediate and consistent pain relief during treatment, similar to those reported in other studies, with the percentage of pain relief during sessions ranging from 6.25% to 38.5%. Motor function, including range of motion, control, and dexterity, were improved per patient report. However, the duration of pain relief lasted only 2-4 days between sessions. The authors believe that the present findings may inspire others treating adults and children with CP to explore the use of MVF and VR to enhance rehabilitation with an emphasis on adapting technologies for home use. Further implications of these findings for the future are discussed.

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Effectiveness of virtual reality in children and young adults with cerebral palsy: a systematic review of randomized controlled trial

Cited by 31 publications

References 78 publications

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

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

The Effectiveness of Robot- vs. Virtual Reality-Based Gait Rehabilitation: A Propensity Score Matched Cohort

Embodied Virtual Reality Mirror Visual Feedback for an Adult with Cerebral Palsy

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