Effect of Augmented Reality Intervention on the Range of Motion, Muscle Strength, Function of Upper Extremity and Balance in Children With Spastic Hemiplegic Cerebral Palsy: A Randomized Clinical Trial
Condition: Spastic Hemiplegic Cerebral Palsy
MeSH terms: Muscle Spasticity; Paralysis; Cerebral Palsy
Study type: Interventional

Summary: 
      Cerebral Palsy (CP) is a disorder of the development of movement and posture, causing
      activity limitations attributed to nonprogressive disturbances of the fetal or infant brain
      that may also affect sensation, perception, cognition, communication, and behavior. Motor
      control during reaching, grasping, and walking are disturbed by spasticity, dyskinesia,
      hyperreflexia, excessive coactivation of antagonist muscles, retained developmental
      reactions, and secondary musculoskeletal malformations, together with paresis and defective
      programing. Weakness and hypoextensibility of the muscles are due not only to inadequate
      recruitment of motor units, but also to changes in mechanical stresses and hormonal factors.
      As it affects the children, therefore it should be emphasized. Effect of Augmented Reality
      (AR) based therapeutic games on the range of motion, muscle strength,function of upper limb
      and balance of spastic hemiplegic cerebral palsy children would be assessed through
      goniometer, manual muscle testing (MMT), disability of Arms, Shoulders, and Hand (DASH)
      questionnaire, and Pediatric Berg Balance Scale, respectively.
    

Detailed description: 
      A total of 30 children with spastic hemiplegic cerebral palsy would be recruited and randomly
      divided into three groups, 10 in each group. The demo-graphical data would be collected
      through a general demographic questionnaire. Outcome measures would include Goniometer to
      determine the Range of Motion (ROM), Manual Muscle Testing (MMT) to determine the upper limb
      muscle power/strength, disability of Arms, Shoulders, and Hand (DASH) questionnaire to assess
      the function of upper extremity, and Pediatric Balance Scale to determine the body balance.
    

Intervention name(s): Balance It; Bubble Pop; Scoop'd
Intervention type(s): Other; Other; Other
Intervention description(s): Each patient in group 1 i.e. Balance It group would be given a 15 minutes long session. Each session would start in standing position and the patient would play the game while they would be instructed to balance the objects falling from above on the imaginary bar (and an actual bar at later stages) held with their both hands, and not let those objects fall by opening their arms wide open and by staying or moving according to the target spot for the set time. This session would be repeated three times a week for two months (total 12 sessions/month).; Each patient in group II i.e. Bubble Pop group would be given a 15 minutes long session. Each session would start in standing position and the patient would play the game while they would be instructed to reach for the balloons coming from random directions and pop them by moving their upper limbs and even their whole body if required. They would also be instructed to avoid a specific object that would result in deduction of their overall game score. This session would be repeated three times a week for two months (total 12 sessions/month).; Each patient in group III i.e. Scoop'd group would be given a 15 minutes long session. Each session would start in standing position and the patient would play the game while they would be instructed to hold an imaginary ice cream cone (and an actual basket designed similar to an ice cream cone in later stages) with their both hands and move to catch the ice cream scoops falling at random spots from above, one spot at a time. They would also be instructed to avoid a specific object that would result in deduction of their overall game score. This session would be repeated three times a week for two months (total 12 sessions/month).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Spastic; Hemiplegia; Cerebral palsy; Child; Upper Extremity; Range of Motion; Muscle Strength; Function; Balance; Augmented Reality; Intervention