Motor Learning in People With Cerebral Palsy by Using Virtual Reality.
Condition: Cerebral Palsy
MeSH terms: Cerebral Palsy
Study type: Interventional

Summary: 
      Cerebral Palsy (CP) is a group of permanent disorders that affect movement and posture due to
      a non-progressive lesion in the immature brain occurring in fetal brain development or in
      infancy. These disorders are often associated with changes in sensation, learning, body
      perception, communication and behavior. People with CP present variable difficulties in
      muscle action. With increasing access to computer-aided accessibility, rehabilitation
      programs have increasingly used virtual reality (VR) environments to provide functional
      tasks. Virtual reality research in individuals with cerebral palsy has demonstrated
      improvements in gross motor functions and functional disabilities in mobility, and is a good
      device for rehabilitation. The present research is a cross-sectional study. For this study 40
      individuals aged over six years (with task comprehension) of both gender who have a clinical
      diagnosis of spastic hemiparetic Cerebral Palsy will be evaluated. Thus, the present study
      aims to compare the motor function of the committed and uncommitted body side by performing
      tasks in virtual reality.
    

Detailed description: 
      METHOD The present research is a cross-sectional study. The study will be carried out at the
      School of Special Education Don Bosco, Rio Branco, Acre.

      PARTICIPANTS (CASE) For this study 40 individuals aged over six years (with task
      comprehension) of both gender who have a clinical diagnosis of spastic hemiparetic Cerebral
      Palsy will be evaluated.

      STUDY DESIGN The individuals selected will be divided according to the affected body side,
      forming a first group categorized by RH (Right Hemiparetic) and a second LH (Left
      Hemiparetic), and for the accomplishment of the activity in the RH group half will start the
      task with the affected side and than with the unaffected side and the same will be reproduced
      in the LH group. Before performing the matching Timing task, individuals will perform a
      simple reaction time (RT) task, with 14 repetitions in each task.

      Next, they will perform 20 attempts of the Timing task in the acquisition phase (0.5 second
      speed between the firings of each sphere - level 4), after 10 minutes without contact with
      the task the subjects will carry out 5 attempts for the Retention phase at the same speed as
      the acquisition phase. Then the subjects will perform 5 more attempts for the transfer phase
      with change in the speed of the task (0.25 seconds between the firings of each sphere - level
      5). After the task is finished, the TR will be applied again.

      INSTRUMENTS Timing Software Coincident For the data collection will be used a software of
      games created in partnership with the group of Information Systems of the School of Arts,
      Sciences and Humanities, EACH-USP. The game proposes a Coincident Timing task, which displays
      on the computer screen 10 spheres that light up (red light) in sequence until reaching the
      last ball that is considered the target (Green light). The participant can have immediate
      feedback of correctness or error of the task through different sounds (Auditory Interaction)
      and through visual images (Visual Interaction) that change color previously demonstrated to
      them.

      Software TRT_S (Simple Reaction Time) Other software used was TRT_S2012. Which was
      constructed and validated by Crocetta et al. The software proposes a simple TRT test
      consisting of the appearance of a yellow square (parameterizable) in the center of the
      monitor at predefined time intervals (ranging from 1.5 to 6.5 ms - these intervals were
      identical in both Software) and, when the stimulus is applied, the participant should react
      as quickly as possible by pressing the spacebar on the computer keyboard.

      Procedure and design Participants will perform the task individually in a quiet room, with
      only the experimenter, who will provide the instructions. The computer monitor will be
      positioned on a desk. Participants will remain seated in the chair with height adjusted
      according to the needs of each. In addition, a footrest will be available if needed. The
      functional assessment scales will be performed at the beginning of the research, the
      experimenter will explain the task verbally and perform a demonstration of the game's
      functioning and interfaces (Kinect for Windows®, touch the computer key or touchscreen).
    

Intervention name(s): Right hemiparesis, right upper limb.; Right hemiparesis, left upper limb; Left hemiparesis, left upper limb; Left hemiparesis, right upper limb
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral
Intervention description(s): Individuals with right hemiparesis Cerebral Palsy that will perform the tasks with the affected upper limb.; Individuals with right hemiparesis Cerebral Palsy that will perform the tasks with the non-affected upper limb.; Individuals with left hemiparesis Cerebral Palsy that will perform the tasks with the affected upper limb.; Individuals with left hemiparesis Cerebral Palsy that will perform the tasks with the non-affected upper limb.
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Other