Virtual Reality in Children With Cerebral Palsy
Condition: Cerebral Palsy
MeSH terms: Paralysis; Cerebral Palsy
Study type: Interventional

Summary: 
      OBJECTIVE: To investigate whether VR videogames plus conventional therapy improves motor
      control compared with conventional therapy in children with cerebral palsy (CP).

      METHODS: Thirty participants with CP were included. A baseline (A0), a post-conventional
      intervention (A1), a post-experimental treatment (A2) and a two-month follow-up (A3)
      assessment were performed. Experimental intervention was based on videogames treatment
      (Kinect-Kbox360TM) added to their conventional physiotherapy. Motor and the process skills
      were evaluated by the Assessment of Motor and Process Skills (AMPS); balance by the Pediatric
      Reach test (PRT); gait speed by the 10-meters walk test (10MW); and running and jumping
      capacity by the Gross Motor Function Measure (GMFM).
    

Detailed description: 
      Thirty participants were recruited, seventeen were boys and thirteen were girls, with a mean
      age of 8.41 years (SD 2.55).

      The inclusion and exclusion criteria Children were recruited from Public Schools of Madrid
      (Spain) and they were classified according to their Gross Motor Function Classification
      System (GMFCS) level.

      The inclusion criteria were a diagnostic of mild-moderate hemiplegic and diplegic CP, age
      between four to eleven years and receive physiotherapy treatment in the public school related
      with this project. The exclusion criteria were not have visual impairments, severe cognitive
      disability, surgical intervention in the year before study onset, botulinum injections in the
      six months before study onset and non-controlled epilepsy. Six participants were classified
      as GMFCS level I and twenty-four was level II, all with spastic involvement.

      All were receiving physiotherapy at the time of enrollment by the same therapist. All
      children were enrolled in age-appropriate classes in regular public schools; 100% did receive
      some extra help for mild learning issues.

      Statistical Analyses:

      We used a repeated measures analysis of variance (ANOVA) to assess differences among the four
      assessments in each of the variables, using paired t-test with Bonferroni correction when a
      significant effect was detected. We performed all the analysis by The Statistical Package for
      Social Sciences (SPSS 19.0 Version).The statistical analysis was conducted at a 95%
      confidence level. A p value <0.05 was considered statistically significant.
    

Intervention name(s): Device: Kinect-Xbox 360TM; Conventional therapy
Intervention type(s): Other; Other
Intervention description(s): Based around a webcam-style add-on peripheral for the Xbox 360 console, it enables users to control and interact with the Xbox 360 without the need to touch a game controller, through a natural user interface using gestures and spoken commands. Participants were asked to practice 30 minutes per day, 2 days per week for 2 months, added to their conventional treatment. The games used were Kinect Sports ITM, Kinect Joy RideTM and Kinect Disneyland AdventuresTM and involved balance and trunk movements, general and visual-manual coordination and limb tasks. Each subject followed instructions on the screen with the help of his physiotherapist, with points awarded based on degree and speed of movement and level of difficulty.
Allocation: Non-Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Cerebral palsy; child; rehabilitation; video games; virtual reality.