Effect of virtual reality games on motor performance level in children with spastic cerebral palsy
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Department of Physical Therapy for Pediatrics and Women Health, Faculty of Physical Therapy, Ahram Canadian University, Giza, Egypt
Department of Pediatrics, Faculty of Medicine, October 6 University, Giza, Egypt
Physical Therapy Department, College of Medical Rehabilitation, Qassim University, Buraydah, Saudi Arabia
Submission date: 2021-02-03
Acceptance date: 2021-07-12
Publication date: 2022-05-31
Physiother Quart. 2022;30(2):15-19
The study aim was to examine the effects of virtual reality games on motor performance level in children with spastic cerebral palsy.

The study involved 30 children (boys and girls) aged 7–10 years with spastic diplegic cerebral palsy. They were randomly divided into the control group, who received a conventional selected exercise program, and the study group, who received the same conventional selected exercise accompanied by virtual reality games, 3 times per week for 3 successive months. Motor performance level was evaluated with the Gross Motor Function Measure scale (GMFM) and Gross Motor Function Classification System (GMFCS). The Wilcoxon test was applied for within-group comparison and the Mann-Whitney test for between-group comparison.

The within-group comparison revealed significant improvements of GMFM and GMFCS scores in the study group, while in the control group, there was no statistically significant difference. Between-group comparisons showed a significant improvement of GMFM in the study group.

Virtual reality games have positive effects on the motor performance level in patients with spastic diplegic cerebral palsy.

Surveillance of Cerebral Palsy in Europe (SCPE). Prevalence and characteristics of children with cerebral palsy in Europe. Dev Med Child Neurol. 2002;44(9):633–640; doi: 10.1111/j.1469-8749.2002.tb00848.x.
Kim D-A, Lee J-A, Hwang P-W, Lee M-J, Kim H-K, Park J-J, et al. The effect of comprehensive hand repetitive intensive strength training (CHRIST) using motion analysis in children with cerebral palsy. Ann Rehabil Med. 2012;36(1):39–46; doi: 10.5535/arm.2012.36.1.39.
Weightman A, Preston N, Levesley M, Holt R, Mon-Williams M, Clarke M, et al. Home-based computer-assisted upper limb exercise for young children with cerebral palsy: a feasibility study investigating impact on motor and functional outcome. J Rehabil Med. 2011; 43(4):359–363; doi: 10.2340/16501977-0679.
Novak I, McIntyre S, Morgan C, Campbell L, Dark L, Morton N, et al. A systematic review of interventions for children with cerebral palsy: state of the evidence. Dev Med Child Neurol. 2013;55(10):885–910; doi: 10.1111/dmcn.12246.
Burke JW, McNeill MDJ, Charles DK, Morrow PJ, Crosbie JH, McDonough SM. Optimising engagement for stroke rehabilitation using serious games. Vis Comput. 2009;25:1085–1099; doi: 10.1007/s00371-009-0387-4.
Huber M, Rabin B, Docan C, Burdea GC, AbdelBaky M, Golomb MR. Feasibility of modified remotely monitored in-home gaming technology for improving hand function in adolescents with cerebral palsy. IEEE Trans Inf Technol Biomed. 2010;14(2):526–534; doi: 10.1109/TITB.2009.2038995.
Levac DE, Sveistrup H. Motor learning and virtual reality. In: Weiss PL, Keshner EA, Levin MF (eds.), Virtual reality for physical and motor rehabilitation. New York: Springer; 2014; 25–46.
Bilde PE, Kliim-Due M, Rasmussen B, Petersen LZ, Petersen TH, Nielsen JB. Individualized, home-based interactive training of cerebral palsy children delivered through the Internet. BMC Neurol. 2011;11:32; doi: 10.1186/1471-2377-11-32.
Levac D, Rivard L, Missiuna C. Defining the active ingredients of interactive computer play interventions for children with neuromotor impairments: a scoping review. Res Dev Disabil. 2012;33(1):214–223; doi: 10.1016/j.ridd.2011.09.007.
Weiss PL, Kizony R, Feintuch U, Rand D, Katz N. Virtual reality applications in neurorehabilitation. In: Selzer ME, Clarke S, Cohen LG, Kwakkel G, Miller RH (eds.), Textbook of neural repair and neurorehabilitation, vol. 2. Cambridge: Cambridge University Press; 2014; 198–218.
Ko J, Kim M. Reliability and responsiveness of the gross motor function measure-88 in children with cerebral palsy. Phys Ther. 2013;93(3):393–400; doi: 10.2522/ptj.20110374.
Alotaibi M, Long T, Kennedy E, Bavishi S. The efficacy of GMFM-88 and GMFM-66 to detect changes in gross motor function in children with cerebral palsy (CP): a lite­rature review. Disabil Rehabil. 2014;36(8):617–627; doi: 10.3109/09638288.2013.805820.
Palisano RJ, Rosenbaum P, Bartlett D, Livingston MH. Content validity of the expanded and revised Gross Motor Function Classification System. Dev Med Child Neurol. 2008;50(10):744–750; doi: 10.1111/j.1469-8749.2008.03089.x.
Öhrvall A-M, Eliasson A-C, Löwing K, Ödman P, Krumlinde-Sundholm L. Self-care and mobility skills in children with cerebral palsy, related to their manual ability and gross motor function classifications. Dev Med Child Neurol. 2010;52(11):1048–1055; doi: 10.1111/j.1469-8749.2010.03764.x.
Rosenbaum PL, Palisano RJ, Bartlett DJ, Galuppi BE, Russell DJ. Development of the Gross Motor Function Classification System for cerebral palsy. Dev Med Child Neurol. 2008;50(4):249–253; doi: 10.1111/j.1469-8749.2008.02045.x.
Pavone V, Testa G. Classifications of cerebral palsy. In: Canavese F, Deslandes J (eds.), Orthopedic management of children with cerebral palsy. A comprehensive approach. New York: Nova Biomedical Books; 2015; 75–98.
Bryanton C, Bossé J, Brien M, McLean J, McCormick A, Sveistrup H. Feasibility, motivation, and selective motor control: virtual reality compared to conventional home exercise in children with cerebral palsy. Cyberpsychol Behav. 2006;9(2):123–128; doi: 10.1089/cpb.2006.9.123.
Sandlund M, Waterworth EL, Häger C. Using motion interactive games to promote physical activity and enlace motor performance in children with cerebral palsy. Dev Neurorehabil. 2011;14(1):15–21; doi: 10.3109/17518423.2010.533329.
Adamovich SV, Fluet GG, Tunik E, Merians AS. Sensorimotor training in virtual reality: a review. NeuroRehabilitation. 2009;25(1):29–44; doi: 10.3233/NRE-2009-0497.
Reid D. The influence of virtual reality on playfulness in children with cerebral palsy: a pilot study. Occup Ther Int. 2004;11(3):131–144; doi: 10.1002/oti.202.
Snider L, Majnemer A, Darsaklis V. Virtual reality as a therapeutic modality for children with cerebral palsy. Dev Neurorehabil. 2010;13(2):120–128; doi: 10.3109/17518420903357753.
Harris K, Reid D. The influence of virtual reality play on children’s motivation. Can J Occup Ther. 2005;72(1):21–29; doi: 10.1177/000841740507200107.
Chen Y-P, Lee S-Y, Howard AM. Effect of virtual reality on upper extremity function in children with cerebral palsy: a meta-analysis. Pediatr Phys Ther. 2014;26(3):289–300; doi: 10.1097/PEP.0000000000000046.
Beaman J, Kalisperis FR, Miller-Skomorucha K. The infant and child with cerebral palsy. In: Tecklin JS (ed.), Pediatric physical therapy, 5th ed. Baltimore: Lippincott Williams and Wilkins; 2015; 187–246.
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