The effect of interactive computer play on balance and functional abilities in children with moderate cerebral palsy: a pilot randomized study

Abstract

Objectives: To investigate the feasibility and potential efficacy of a six-week interactive computer play training on balance and gross motor function in children with moderate cerebral palsy. Design: A pilot single-blinded matched randomized controlled study. Setting: Community. Participants: In total, 18 children with moderate cerebral palsy were recruited, paired according to age and severity of cerebral palsy and randomized into intervention group or control group. Intervention: The intervention group received additional trunk control training using the interactive computer play in sitting four times per week, 20 minutes per session for six weeks. All study children continued their usual physiotherapy programme. Measurements: All study children were assessed at baseline, week 3, week 6 (completion of intervention) and week 12 using the Pediatric Reach Test, Gross Motor Function Measure–66-Item Set and 2-Minute Walk Test. Results: All intervention children completed and enjoyed the training with no reported adverse event. All children were assessed at all time points. No significant difference was found between the two groups in all assessments. In both groups of children, significant improvements were found in the Gross Motor Function Measure–66-Item Set between week 3 (intervention group: mean 53.41, SD 5.34; control group: mean 52.86, SD 8.33) and week 6 (intervention group: mean 55.00, SD 6.32; control group: mean 54.20, SD 8.35). Conclusion: The intervention protocol of a six-week interactive computer play training was feasible and safe for children with moderate cerebral palsy in special school settings. Future studies with larger sample sizes or using single-subject designs are recommended.

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

“…The age range of participants was 4–18 years. The participants in one study included only Gross Motor Function Classification System (GMFCS) Level I ( 48 ), four studies included GMFCS Levels I-II ( 19 , 49 – 51 ), eight studies included GMFCS Levels I-III ( 52 – 57 ), one study included GMFCS Levels I-IV ( 41 ), and four studies included GMFCS Levels III ( 58 ) or III-IV ( 42 , 62 , 63 ). All studies measured balance using at least one instrument, and five studies used two or more instruments to assess patients' balance ( 9 , 53 – 56 ).…”

“…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 ).…”

“…The applied VR interventions could be categorized into two groups ( Figure 3 ). One group of 11 studies used the intervention with a game component ( 19 , 41 , 42 , 50 , 52 , 54 , 56 – 60 ), and the other seven used real-time feedback or interactive exercise in the virtual world ( 9 , 43 , 48 , 49 , 51 , 53 , 55 ). The interventions in all these studies were as follows: the total amount of treatment (160–1,680 min), duration of treatment (20–60 min), and intervention period (2–12 weeks).…”

The Effect of Virtual Reality Games on the Gross Motor Skills of Children with Cerebral Palsy: A Meta-Analysis of Randomized Controlled Trials

“…Besides the commonly used platform Nintendo, the Eloton SimCycle Virtual Cycling System, Mitii, Q4 situational interactive training system, the somatosensory games on Microsoft Xbox Kinect platform, TYROMOTION GmbH, and limb A2 feedback system were also included. Four papers did not state the VRG types that children involved [31,[34][35][36]. Furthermore, seven of nine papers had one outcome indicator while three papers had two (D and E in the GMFM test) [32][33][34].…”

“…There are many empirical studies on the intervention effect of VRGs on children's physical health, mainly covering physical activities as well as psychological and motor development [40][41][42][43][44][45][46]. On top of that, VRGs are increasingly applied in the field of sports rehabilitation, and the intervention of VRGs in special children is centered on the mobility, balance and motor development of children with autism [46][47][48][49][50][51][52][53], CP [34,36,39,54,55]and developmental coordination disorder [18,26,56,57], without many studies focusing on relevant meta-analysis. This research mainly aims to comprehensively assess the effect of VRGs and traditional therapy on the gross motor skills of children with CP.…”