The Effect of Video-based Game Therapy on Treatment Intensity in Children With Cerebral Palsy
Condition: Cerebral Palsy
MeSH terms: Paralysis; Cerebral Palsy
Study type: Observational

Summary: 
      In a recent review by Kolobe et al., It was reported that there was no study investigating
      the effects of treatment intensity on upper or lower extremity function in children with
      traumatic brain injury and cerebral palsy. In other words, any study in this review reported
      no studies on the amount of effort or the number of repetitions at high or low intensity.

      This indicates a clear gap in the literature related to density, which is a dosage variable
      for cerebral palsy.

      It is difficult to determine and increase density without having strong, practical methods to
      measure density during rehabilitation.

      Therefore, there is a clear need for alternative measurements to measure density.

      As the alternative measurements, the number of repetitions, the duration of active time
      during the sessions are used.

      Energy consumption seen as a useful tool for evaluating functional capacity may also reflect
      activity intensity by measuring the intensity of activity during the session.

      Because the ability to perform an activity when interpreted; It is considered as an indicator
      of fatigue and endurance.

      Children with cerebral palsy have decreased selective muscle control, abnormal muscle tone,
      imbalance between agonist and antagonist muscles, and abnormalities in balance due to
      inadequate balance reactions.

      Due to all these reasons, cerebral palsy in children has been shown to have higher energy
      consumption during physical activities such as walking compared to healthy children.

      Children with cerebral palsy usually have difficulty in regular participation in treatment
      and adaptation to traditional home exercise programs. Active video games are recommended for
      use in addition to neurodevelopmental therapy and, in particular, for home use, because of
      the potential for increasing treatment dosage.

      Researchers focus on evidence in terms of exercise games, Some games on the market (Wii
      Sports tennis and boxing and Dance Dance Revolution) have achieved that the physical activity
      measured by the metabolic equivalent, which is necessary to perform the tasks in individuals
      with cerebral palsy, is associated with the level of moderate severity.

      In this study, it is aimed to compare the treatment intensity, performance and balance
      parameters of the patients with cerebral palsy in a planned neurodevelopmental treatment
      session and active video games.

      In this study, the effects of clinical type, age and functional level on treatment intensity,
      performance and balance parameters during these sessions will be investigated.

      Hypothesis of the study In line with the needs of children with cerebral palsy, there is a
      difference in terms of treatment intensity, performance and balance parameters between a
      planned neurodevelopmental treatment session and active video games.
    


Intervention name(s): Active Video Games Therapy
Intervention type(s): Other
Intervention description(s): Interventions were completed in 1-week periods, after 3 clinical visits. All individuals underwent both neurodevelopmental therapy and active video games therapy. Demographic data of individuals were recorded and muscle tone and gross motor functions were evaluated at the first visit. The games determined by the physiotherapist were explained and experienced by individuals. During the second visit, individuals played 4 games that were previously determined and experienced for about 45 minutes. On the last visit, individuals underwent neurodevelopmental therapy. During both treatment sessions, the accelerometer was fitted on a flexible belt by attaching it to the dominant wrist. Individuals were instructed not to remove the device during both treatment sessions.
One session individuals treated with exercises which weight transfer and postural reactions were facilitated.
Other session they played Nintendo Wii games in accordance with their current level and skills.
Other intervention name(s): Neurodevelopmental therapy
Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Individuals with a diagnosis of Cerebral Palsy who had been undergoing physiotherapy for 2
        days a week between the ages of 6 and 18 were included in the study.
      
Keywords: cerebral palsy; neurodevelopmental therapy; active video games; treatment intensity; energy consumption