Video-game Based Therapy in Cerebral Palsy

Study Overview
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Brief Summary
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The video-based therapy applications; will be applied in a non-three-dimensional (with desktop screen) way. In this application, there are different types of exercise programs that will work the upper extremity movements. The video-based therapy applications will be applied to individuals with Cerebral Palsy (CP) who will be included in the study with the Xbox Kinect 3600 (Microsoft, Washington, USA) device. This study was planned to examine the effect of video-based therapy on upper extremity selective motor control and proprioception in individuals with Cerebral Palsy.

Detailed Description
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Spastic CP will be participate the study between the ages of 4 and 18 years. Children's classified with GMFCS and MACS. The eligible participants will be allocated two groups, including video-game based therapy group and conventional physiotherapy control group. All the assessments will be performed before and after the therapy in the 8-week therapy groups.The control group individuals will be given a conventional physiotherapy two days per week for a total of 8 weeks (conventional physiotherapy session will last 45 minutes). The video-game based therapy group will receive a conventional physiotherapy and video-game based therapy, two days a week for a total of 8 weeks (15 minutes conventional physiotherapy session+30 minutes video-game based therapy). All sessions will be performed in the clinic with the specialist physiotherapist.

Official Title
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Effects of Video-game Based Therapy on Upper Extremity Selective Motor Control and Proprioception in Cerebral Palsy

Conditions
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Cerebral Palsy

Intervention / Treatment
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* Other: Video-game based therapy
* Other: Conventional physiotherapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of Cerebral Palsy voluntary participation, Age between 4-18 years GMFCS Level I-II-III MACS Level I-II-III Exclusion Criteria: Not voluntary to participate in the research, Botox in the last 6 months, Upper limb or spine surgeries in the last 6 months

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 18 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
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Video-game based therapy group<br>The video-game based therapy group will receive a conventional physiotherapy and video-game based therapy, two days a week for a total of 8 weeks (15 minutes conventional physiotherapy session+30 minutes video-game based therapy). | Other: Video-game based therapy<br>* Video-game based therapy will be designed for the individual basis for the upper extremity.<br>Other: Conventional physiotherapy<br>* Conventional physiotherapy within a specific program<br>|
| Active Comparator: Conventional physiotherapy group<br>The conventional physiotherapy group individuals will be given a conventional physiotherapy two days per week for a total of 8 weeks (conventional physiotherapy session will last 45 minutes). | Other: Conventional physiotherapy<br>* Conventional physiotherapy within a specific program<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Gross Motor Function Classification System (GMFCS) | Assessing functional level and motor function. Gross motor functions of children with CP are classified in five levels with GMFCS. This is a classification system based on the child's self-initiated movements with emphasis on sitting, displacement and mobility. | At Baseline | 
| Manuel ability classification system (MACS) | This is a classification system based on the grasping and releasing objects in daily life, and how they use their hands while holding objects. It is classify the hand skills of children with CP between the ages of 4-18.Children with CP are classified in five levels with MACS. The higher level indicates worse hand function | At Baseline | 
| Change from Baseline ABILHAND-Kids at 8 weeks | Abilhand Kids evaluates manual ability in children with upper extremity disorders. It consists of 21 items and confirmed in CP. The lowest score that can be obtained from the scale is 21 and the highest score is 63. It can be stated that higher scores correspond to more difficulty in activities. | Change from Baseline at 8 weeks | 
| Change from Baseline Selective Control of the Upper Extremity Scale (SCUES) at 8 weeks | It is a practical and useful assessment tool developed to evaluate upper extremity selective motor control. The administration of the SCUES required patients to perform specific isolated movement patterns at various levels including: shoulder (abduction/adduction); elbow (flexion/extension); forearm (supination/pronation); wrist (flexion/extension); and fingers/thumb (grasp/release). The total score of the SCUES ranges between 0 and 15 and higher scores indicate better selective motor control. | Change from Baseline at 8 weeks | 
| Change from Baseline Clinometer at 8 weeks | Caliper clinometer (App Development) is a phone application used to measure angle changes in the relevant region. In the evaluation of shoulder and elbow proprioception change will be evaluated. | Change from Baseline at 8 weeks | 
| Change from Baseline Entertainment Scale at 8 weeks | The entertainment level of sessions and therapy training for individuals will be evaluated with a 0-10 point numerical rating scale (entertainment scale). There are numbers from 0 to 10 on the horizontal line of 10 cm. 0 Not fun on the line in the scale; 10 represents a lot of fun. Entertainment rating will be recorded numerically from 0 to 10. | Change from Baseline at 8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cerebral palsy, Virtual reality, Video games, Upper extremity, Rehabilitation