Abstract
Objective
To establish the feasibility and effectiveness of a rehabilitation programme using low-cost virtual reality aimed at improving postural control in children with cerebral palsy—spastic hemiplegia. It also aims to compare the effectiveness of this programme under two delivery modalities, telerehabilitation (TR) and face-to-face (FtF).
Methods
This is a registered randomized controlled clinical trial protocol (ACTRN12621000117819). Eighteen sessions of low-cost virtual reality therapy will be provided through both, FtF and TR modalities using a Nintendo Wii balance board. Each programme will last for 6 weeks and will consist of 3 sessions per week of 25 minutes each. Twenty patients diagnosed with cerebral palsy—spastic hemiplegia will be recruited for each group: FtF or TR (n = 40). Participants will be assessed at baseline, by the end of weeks 2, 4, and 6, and at weeks 8 and 10 (post-intervention follow-ups). The primary outcome will be the Center of Pressure sway area (CoParea); secondary outcomes will be standard deviation and velocity of the CoP in the mediolateral and anterior-posterior directions; tertiary outcomes will include the Modified-Modified Ashworth Scale for lower limbs, Modified Ashworth Scale for upper limbs, timed up-and-go tests, the timed one-leg standing and 6-minute walk test.
Results
This study provides an assessment of the feasibility and effectiveness of an affordable rehabilitation programme using low-cost virtual reality aimed at improving postural control in children with cerebral palsy.
Conclusion
The designed rehabilitation programme using low-cost virtual reality may improve postural control in children with cerebral palsy—spastic hemiplegia. The TR modality is likely to be as effective as the FtF modality. The TR programme has been designed to overcome access barriers to physiotherapy services for children with cerebral palsy in low-resource settings, remote areas, and in restricted mobility contexts.
Funder
Ministerio de Educación, Gobierno de Chile
Publisher
Public Library of Science (PLoS)
Reference57 articles.
1. Effectiveness of exercise interventions for children with cerebral palsy: A systematic review and meta-analysis of randomized controlled trials;L Xianrong;J Rehabil Med,2021
2. An update on the prevalence of cerebral palsy: a systematic review and meta-analysis;M Oskoui;Dev. Med. Child Neurol,2013
3. Increasing prevalence of cerebral palsy among children and adolescents in China 1988–2020: A systematic review and meta-analysis;Y Shengyi;J Rehabil Med,2021
4. Analysis of postural stability in children with cerebral palsy and children with typical development: an observational study;S Saxena;Pediatr. Phys. Ther,2014
5. Differences in standing balance between patients with diplegic and hemiplegic cerebral palsy;VG Rojas;Neural Regen. Res,2013