Virtual Reality versusTask-oriented for Gait in CP

Study Overview
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Brief Summary
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The children with hemiplegic cerebral palsy had a longer gait cycle, slower walking speed, and longer support phase than did the healthy children. The support phase was longer than the swing phase in the children with hemiplegic cerebral palsy

Detailed Description
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This research aims to evaluate the effect of virtual reality (VR) games on balance recovery of children with cerebral palsy (CP) by quantitatively synthesizing the existing literature, and to further determine the impact of VR game intervention (the duration of each intervention, intervention frequency, intervention cycle, and total intervention time) on the balance recovery of children with CP. A high-intensity task-oriented training programme designed to improve hemiplegic gait and physical fitness was feasible in the present study and the effectiveness exceeds a low intensity physiotherapy-programme in terms of gait speed and walking capacity in hemiplegic cp. In a future study, seems appropriate to additionally use measures to evaluate physical fitness and energy expenditure while walking.

Official Title
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Wii Sport Games Versus Task-oriented Training on Gait in Children With Unilateral Cerebral Palsy

Conditions
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Cerebral Palsy

Intervention / Treatment
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* Other: selected physical therapy program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Their age will ranging from 7 to 9 years. Children participated in this study will from both sexes. Their degree of spasticity will ranged from mild to moderate according to Modified Ashworth Scale. All children will able to walk supported or unsupported by the therapist. Children will able to follow the instructions during testing and training. All children had no fixed contractures or deformities at the lower limb. Exclusion Criteria: Children with visual or auditory problems. Children with history of epilepsy. Children with structural joints deformities of the lower limbs. Children with history of surgical interference in lower limbs less than one year. Children with convulsions and fixed contractures. Uncooperative children.

Ages Eligible for Study
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Minimum Age: 7 Years
Maximum Age: 9 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: G 1 (control) received traditional physical therapy program for 60 min. G 2 (study) received traditional physical therapy program for 30 min. and virtual reality for 30 min. G 3 (study) received traditional physical therapy program for 30 min. and task oriented training for 30 min. all groups treated for four successive months.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: the control group<br>Group 1 the control group received selected physical therapy program which contain strengthening exercises for upper limb and lower limb muscles, stretching exercises for elbow extensors, hand supinator, wrist extensors, knee extensors and ankle dorsiflexors, balancing exercises, coordination exercises and gait training exercises in open environment. | Other: selected physical therapy program<br>* strengthening muscles of upper and lower limbs, balancing exercise, gait training in open environment, stretching for elbow flexors and forearm pronators,lower limb hip flexors and knee extensor and ankle dorsiflexors<br>|
| Experimental: virtual reality<br>Group 2 the study group received the same physical therapy program 30 min. plus virtual reality for 30 min. | Other: selected physical therapy program<br>* strengthening muscles of upper and lower limbs, balancing exercise, gait training in open environment, stretching for elbow flexors and forearm pronators,lower limb hip flexors and knee extensor and ankle dorsiflexors<br>|
| Experimental: Task oriented<br>Group 3 the study group received the same physical therapy program 30 min. plus task oriented training for 30 min. | Other: selected physical therapy program<br>* strengthening muscles of upper and lower limbs, balancing exercise, gait training in open environment, stretching for elbow flexors and forearm pronators,lower limb hip flexors and knee extensor and ankle dorsiflexors<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| cadence (number) | number of steps in each min. | cadence assessed at day 0. | 
| cadence (number) | number of steps in each min. | cadence assessed at day 90. | 
| step length of affected side (cm) | distance between the point of initial contact of one foot and the point of initial contact of the opposite foot (cm) | step length assessed at day 0. | 
| step length of affected side (cm) | distance between the point of initial contact of one foot and the point of initial contact of the opposite foot (cm) | step length assessed at day 90. | 
| stride length of affected side(cm) | the distance from the toe of right foot (starting position) to the toe of right foot (ending position), or the heel of right foot (starting position) to the heel of right foot (ending position). (cm) | stride length assessed at day 0. | 
| stride length of affected side(cm) | the distance from the toe of right foot (starting position) to the toe of right foot (ending position), or the heel of right foot (starting position) to the heel of right foot (ending position). (cm) | stride length assessed at day 90. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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wii sport, task oriented training, hemiplegic cerebral palsy