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Volume 16, Issue 4 (December 2018)
Iranian Rehabilitation Journal 2018, 16(4): 413-422 |
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Boroumand S, Hassani Mehraban A. The Effect of Virtual Reality Practice on Postural Control and Balance in Children With Cerebral Palsy: A Single-Subject Study. Iranian Rehabilitation Journal 2018; 16 (4) :413-422
URL: http://irj.uswr.ac.ir/article-1-849-en.html
URL: http://irj.uswr.ac.ir/article-1-849-en.html
1- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
Abstract: (7337 Views)
Objectives: Virtual reality is a new technology that has been recently used for different purposes in the rehabilitation of children. This study aimed to investigate the effectiveness of this method in balance rehabilitation of children with Cerebral Palsy (CP).
Methods: This was an A-B-A design single subject study in which 3 children with hemiplegic CP participated. The baseline phase and intervention phase, lasted 2 and 4 weeks, respectively. Then, the secondary evaluation phase was held at an evaluation session. Intervention sessions as the baseline phase were repeated 3 times a week. In each session, children performed different computer games with displacement of the center of pressure in frontal and sagittal planes (for 21 min). The secondary evaluation phase of this study was held 2 to 3 months after the completion of the intervention phase. The changes made in this study were evaluated by assessment tools of Pediatric Reach Test (PRT), Single Limb Stance (SLS), Plate sensitive to pressure of Biometrics Ltd E-LINK force plate, and Activity Scale for Kids (ASK). Finally, the results were evaluated by C static and the visual analysis method.
Results: Comparison of the results of PRT, ASK and the evaluation of planes sensitive to pressure of Biometrics Ltd E-LINK in all 3 phases revealed the significant improvement of dynamic balance and the enhancement of the independence performance of children in daily living activities and the sustainability of the recovery in the secondary evaluation phase. Although, the SLS test results and data of force Plate indicated no significant improvements in the static balance of patients.
Discussion: The study results suggest that weight shift exercises with the use of virtual reality can effectively improve the dynamic balance of children with CP. However, it fails to make a significant change in the static balance of these children.
Methods: This was an A-B-A design single subject study in which 3 children with hemiplegic CP participated. The baseline phase and intervention phase, lasted 2 and 4 weeks, respectively. Then, the secondary evaluation phase was held at an evaluation session. Intervention sessions as the baseline phase were repeated 3 times a week. In each session, children performed different computer games with displacement of the center of pressure in frontal and sagittal planes (for 21 min). The secondary evaluation phase of this study was held 2 to 3 months after the completion of the intervention phase. The changes made in this study were evaluated by assessment tools of Pediatric Reach Test (PRT), Single Limb Stance (SLS), Plate sensitive to pressure of Biometrics Ltd E-LINK force plate, and Activity Scale for Kids (ASK). Finally, the results were evaluated by C static and the visual analysis method.
Results: Comparison of the results of PRT, ASK and the evaluation of planes sensitive to pressure of Biometrics Ltd E-LINK in all 3 phases revealed the significant improvement of dynamic balance and the enhancement of the independence performance of children in daily living activities and the sustainability of the recovery in the secondary evaluation phase. Although, the SLS test results and data of force Plate indicated no significant improvements in the static balance of patients.
Discussion: The study results suggest that weight shift exercises with the use of virtual reality can effectively improve the dynamic balance of children with CP. However, it fails to make a significant change in the static balance of these children.
Article type: Case Reports |
Subject:
Occupational therapy
Received: 2018/01/26 | Accepted: 2018/09/15 | Published: 2019/01/21
Received: 2018/01/26 | Accepted: 2018/09/15 | Published: 2019/01/21
References
1. Krägeloh Mann I, Cans C. Cerebral palsy update. Brain and Development. 2009; 31(7):537-44. [DOI:10.1016/j.braindev.2009.03.009] [PMID] [DOI:10.1016/j.braindev.2009.03.009]
2. Kulak W, Sobaniec W. Comparisons of right and left hemiparetic cerebral palsy. Pediatric Neurology. 2004; 31(2):101-8. [DOI:10.1016/j.pediatrneurol.2004.01.009] [PMID] [DOI:10.1016/j.pediatrneurol.2004.01.009]
3. Cimolin V, Galli M, Tenore N, Albertini G, Crivellini M. Gait strategy of uninvolved limb in children with spastic hemiplegia. Europa Medicophysica. 2007; 43(3):303-10. [PMID] [PMID]
4. Jelsma J, Pronk M, Ferguson G, Jelsma Smit D. The effect of the Nintendo Wii Fit on balance control and gross motor function of children with spastic hemiplegic cerebral palsy. Developmental Neurorehabilitation. 2013; 16(1):27-37. [DOI:10.3109/17518423.2012.711781] [PMID] [DOI:10.3109/17518423.2012.711781]
5. Domagalska ME, Szopa AJ, Lembert DT. A descriptive analysis of abnormal postural patterns in children with hemiplegic cerebral palsy. Medical Science Monitor. 2011; 17(2):CR110-CR6. [DOI:10.12659/MSM.881396] [PMID] [PMCID] [DOI:10.12659/MSM.881396]
6. Böhm H, Döderlein L. Gait asymmetries in children with cerebral palsy: Do they deteriorate with running? Gait & Posture. 2012; 35(2):322-7. [DOI:10.1016/j.gaitpost.2011.10.003] [PMID] [DOI:10.1016/j.gaitpost.2011.10.003]
7. Radtka S, Hone R, Brown C, Mastick J, Melnick ME, Dowling GA. Feasibilityof computer-based videogame therapy for children with cerebral palsy. Games For Health. 2013; 2(4):222-8. [DOI:10.1089/g4h.2012.0071] [PMID] [PMCID] [DOI:10.1089/g4h.2012.0071]
8. Ledebt A, Becher J, Kapper J, Rozendaal RM, Bakker R, Leenders IC, et al. Balance training withvisual feedback in children with hemiplegic cerebral palsy: Effect on stance and gait. Motor Control. 2005; 9(4):459-68. [DOI:10.1123/mcj.9.4.459] [PMID] [DOI:10.1123/mcj.9.4.459]
9. Brumels KA, Blasius T, Cortright T, Oumedian D, Solberg B. Comparison of efficacy between traditional and video game based balance programs. Clinical Kinesiology. 2008; 62(4):26-32.
10. Shumway Cook A, Woollacott MH. Motor control: Translating research into clinical practice. Philadelphia: Lippincott Williams & Wilkins; 2007. [PMCID] [PMCID]
11. Howcroft J, Klejman S, Fehlings D, Wright V, Zabjek K, Andrysek J, et al. Active video game play in children with cerebral palsy: Potential for physical activity promotion and rehabilitation therapies. Archives of Physical Medicine and Rehabilitation. 2012; 93(8):1448-56. [DOI:10.1016/j.apmr.2012.02.033] [PMID] [DOI:10.1016/j.apmr.2012.02.033]
12. Weiss PL, Rand D, Katz N, Kizony R. Video capture virtual reality as a flexible and effective rehabilitation tool. Journal of Neuroengineering and Rehabilitation. 2004; 1(1):12. [DOI:10.1186/1743-0003-1-12] [PMID] [PMCID] [DOI:10.1186/1743-0003-1-12]
13. Rahman SA. Efficacy of virtual reality-based therapy on balance in children with Down syndrome. World Applied Sciences Journal. 2010; 10(3):254-61.
14. Deutsch JE, Borbely M, Filler J, Huhn K, Guarrera Bowlby P. Use of a low-cost, commercially available gaming console (Wii) for rehabilitation of an adolescent with cerebral palsy. Physical Therapy. 2008; 88(10):1196-207. [DOI:10.2522/ptj.20080062] [PMID] [DOI:10.2522/ptj.20080062]
15. Salem Y, Gropack SJ, Coffin D, Godwin EM. Effectiveness of a low-cost virtual reality system for children with developmental delay: A preliminary randomised single-blind controlled trial. Physiotherapy. 2012; 98(3):189-95. [DOI:10.1016/j.physio.2012.06.003] [PMID] [DOI:10.1016/j.physio.2012.06.003]
16. Corbetta D, Imeri F, Gatti R. Rehabilitation that incorporates virtual reality is more effective than standard rehabilitation for improving walking speed, balance and mobility after stroke: A systematic review. Journal of Physiotherapy. 2015; 61(3):117-24. [DOI:10.1016/j.jphys.2015.05.017] [PMID] [DOI:10.1016/j.jphys.2015.05.017]
17. Barry G, Galna B, Rochester L. The role of exergaming in Parkinson's disease rehabilitation: A systematic review of the evidence. Journal of Neuroengineering and Rehabilitation. 2014; 11(1):33 [DOI:10.1186/1743-0003-11-33] [PMID] [PMCID] [DOI:10.1186/1743-0003-11-33]
18. Monfared NRS, Mehraban AH, Boroumand S. Effectiveness of videogames on balance and fear of falling in chronic stroke patient. Iranian Rehabilitation Journal. 2015; 13(1):68-74.
19. Reid D. Changes in seated postural control in children with cerebral palsy following a virtual play environment intervention: A pilot study. The Israel Journal of Occupational Therapy. 2002; 11(3):E75-E95.
20. Tatla SK, Radomski A, Cheung J, Maron M, Jarus T. Wii-habilitation as balance therapy forchildren with acquired brain injury. Developmental Neuro Rehabilitation. 2014; 17(1):1-15. [DOI:10.3109/17518423.2012.740508] [PMID] [DOI:10.3109/17518423.2012.740508]
21. Silva RRD, Iwabe-Marchese C. [Using virtual reality for motor rehabilitation in a child with ataxic cerebral palsy: Case report (Portuguese)]. Physiotherapy and Research. 2015; 22(1):97-102. [DOI:10.590/1809-2950/13375322012015]
22. Cho C, Hwang W, Hwang S, Chung Y. [Treadmill training with virtual reality improves gait, balance, and muscle strength in children with cerebral palsy (Japanese)]. The Tohoku Journal of Experimental Medicine. 2016; 238(3):213-8. [DOI:10.1620/tjem.238.213] [PMID] [DOI:10.1620/tjem.238.213]
23. Ottenbacher KJ. Evaluating clinical change: Strategies for occupational and physical therapists. Philadelphia: Williams & Wilkins; 1986.
24. Bartlett D, Birmingham T. Validity and reliability of a pediatric reach test. Pediatric Physical Therapy. 2003; 15(2):84-92. [DOI:10.1097/01.PEP.0000067885.63909.5C] [PMID] [DOI:10.1097/01.PEP.0000067885.63909.5C]
25. Seale J. Valid and reliable instruments for the clinical assessment of the effect of an ankle-foot orthoses on balance. Journal of Prosthetics and Orthotics. 2010; 22(10):P38-45. [DOI:10.1097/JPO.0b013e3181f301ab]
26. Siconolfi Morris GC. Use of a video game based balancetraining intervention on the balance and function of children with developmental disabilities [PhD. dissertation]. Lexington: University of Kentucky; 2012.
27. Dehghan SK, Rassafiani M, Fahimi NA, Farahbod M, Saleh M. [Validity and reliability of Activities Scale for Kids (ASK) in children with cerebral palsy (Persian)]. Journal of Research in Rehabilitation Sciences. 2011; 7(3):267-77. [DOI: 10.22122/jrrs.v7i3.182]
28. Extron Electronics. Operating manual E-LINK evaluation and exercise systems version 12 series software (user guide). Anaheim, California: Extron Electronics; 2012.
29. Umphred DA, Lazaro RT, Roller M, Burton G. Neurological rehabilitation. Amsterdam: Elsevier Health Sciences; 2007. [PMID]
30. Satake E, Jagaroo V, Maxwell DL. Handbook of statistical methods: Single subject design. San Diego: Plural Publishing; 2008.
31. Brien M, Sveistrup H. An intensive virtual reality program improves functional balance and mobility of adolescents with cerebral palsy. Pediatric Physical Therapy. 2011; 23(3):258-66. [DOI:10.1097/PEP.0b013e318227ca0f] [PMID] [DOI:10.1097/PEP.0b013e318227ca0f]
32. Luna Oliva L, Ortiz Gutiérrez RM, Cano de la Cuerda R, Piédrola RM, Alguacil Diego IM, Sánchez Camarero C, et al. Kinect Xbox 360 as a therapeutic modality for children with cerebral palsy in a school environment: A preliminary study. Neurorehabilitation. 2013; 33(4):513-21. [PMID] [PMID]
33. Tarakci D, Ozdincler AR, Tarakci E, Tutuncuoglu F, Ozmen M. Wii-based balance therapy to improve balance function of children with cerebral palsy: A pilot study. Journal of Physical Therapy Science. 2013; 25(9):1123-7. [DOI:10.1589/jpts.25.1123] [PMID] [PMCID] [DOI:10.1589/jpts.25.1123]
34. Tarakci D, Ersoz Huseyinsinoglu B, Tarakci E, Razak Ozdincler A. Effects of nintendo Wii‐Fit® video games on balance in children with mild cerebral palsy. Pediatrics International. 2016; 58(10):1042-50. [DOI:10.1111/ped.12942] [PMID] [DOI:10.1111/ped.12942]
35. Ramstrand N, Lygnegård F. Can balance in children with cerebral palsy improve through use of an activity promoting computer game? Technology and Health Care. 2012; 20(6):531-40.
36. Gatica Rojas V, Méndez Rebolledo G, Guzman Mu oz E, Soto Poblete A, Cartes Velásquez R, Elgueta Cancino E, et al. Does Nintendo Wii balance board improve standing balance? A randomized controlled trial in children with cerebral palsy. European Journal of Physical and Rehabilitation Medicine. 2017; 53(4):535-44. [PMID]
37. Tsaklis PV, Grooten WJ, Franzén E. Effects of weight-shift training on balance control and weight distribution in chronic stroke: A pilot study. Topics in Stroke Rehabilitation. 2012; 19(1):23-31. [DOI:10.1310/tsr1901-23] [PMID] [DOI:10.1310/tsr1901-23]
38. Atasavun Uysal S, Baltaci G. Effects of Nintendo Wii™ training on occupational performance, balance, and daily living activities in children with spastic hemiplegic cerebral palsy: A single-blind and randomized trial. Games for Health Journal. 2016; 5(5):311-7. [DOI:10.1089/g4h.2015.0102] [PMID] [DOI:10.1089/g4h.2015.0102]
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