Training With Virtual Reality in Upper Arm Reaching of Children With Cerebral Palsy
Condition: Cerebral Palsy
MeSH terms: Paralysis; Cerebral Palsy
Study type: Interventional

Summary: 
      The objective of this study was to evaluate the effects of training with Virtual Reality in
      the movement range of children with Cerebral Palsy spastic hemiparetic.The study protocol
      consisted of two days of training and 1 revaluation. The training A (Nintendo Wii®) and B
      (standard protocol) were randomized the children in AB and BA sequences, with one week
      interval. Immediately kinematics pre and post-training was held and after a week no
      significant changes were observed for the angular variables and space-time between groups.
      The Virtual Reality used for intervention to improve upper arm function in children with
      Cerebral Palsy is still a relatively new method.
    

Detailed description: 
      Introduction: The disability of upper limb function (MS) of children with Cerebral Palsy (CP)
      spastic hemiparetic restricts their participation in social activities. Virtual reality (VR)
      has shown promising results in functional recovery of this population, however, few studies
      have evaluated its effectiveness in the reaching of motion of these children. Objective: To
      assess the effects of training with VR in the movement range of children with CP spastic
      hemiparetic. Materials and Methods: We conducted a randomized crossover trial, where the
      sample consisted of 12 children diagnosed with CP hemiparetic, both genders, with a mean age
      of 9.63 ± 2.3 years. The sample description was performed by assessing muscle tone, range of
      motion, grip strength, functional performance and disability. Kinematic analysis of the upper
      limb was performed by Qualisys Motion Capture System®. The study protocol consisted of two
      days of training and 1 revaluation. The training A (Nintendo Wii®) and B (standard protocol)
      were randomized the children in AB and BA sequences, with one week interval. Immediately
      kinematics pre and post-training was held and after a week. Data were analyzed using SPSS
      20.0 (Statistical Package for Social Science) assigning a 5% significance level. The
      kinematic variables were analyzed by two-way ANOVA for repeated measures.
    

Intervention name(s): Training with Virtual Reality; Conventional Training
Intervention type(s): Other; Other
Intervention description(s): Computed virtual reality therapy was performed using the Nintendo Wii® console equipment. This system allows interaction with the player by means of a movement detection system and the representation of his avatar graphical representation of a user in virtual reality. It has a remote control with a wireless system, responsible for capturing the speed, direction , acceleration and deceleration of movement. The movements performed by the player are captured and reproduced on a screen via an infrared light sensor, positioned above the TV. The feedback given by the TV provides the movement itself observing opportunity in real time, generating positive reinforcement and facilitating training and improved task. The software used in this study was the Nintendo Wii Sports.; It was done five types of exercises following to the protocol:
Exercise 1 (shoulder abduction); Exercise 2 (external rotation of the shoulder); Exercise 3 (elbow extension); Exercise 4 (weight transfer in upper limbs: a sitting position); Exercise 5 (function: task-oriented training).
Other intervention name(s): Training A; Training B
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Cerebral Palsy; Rehabilitation; Physiotherapy; Virtual Reality