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Gözaçan Karabulut D, Maden Ç, Karabulut Y, Aslan M. Effects of Video-Based Exercises and Conventional Physiotherapy on Upper Extremity Functionality, Selective Motor Control, and Proprioception in Unilateral Cerebral Palsy: A Randomized Controlled Trial. Games Health J 2024. [PMID: 39069879 DOI: 10.1089/g4h.2024.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024] Open
Abstract
Objective: The present study was conducted to evaluate the effects of video-based exercises added to conventional physiotherapy (CPT) on upper extremity functionality, selective motor control, and proprioception in individuals with unilateral cerebral palsy (UCP). Materials and Methods: Thirty patients with UCP were randomized into two groups: the intervention group (15 individuals with a mean age of 9.2 ± 3.8 years) and the control group (15 individuals with a mean age of 8.3 ± 4.1 years). The intervention group received 8 weeks of video-based exercises, and the control group received 8 weeks of conventional physiotherapy. Upper extremity functional abilities, upper extremity selective motor control, proprioception, and entertainment levels were evaluated before and after the intervention for all groups. Results: While a significant change was observed in the mean scores of the ABILHAND-Kids, Selective Control of the Upper Extremity Scale right-left scores, shoulder flexion, shoulder abduction, and elbow flexion proprioception angles after the video-based exercises in the intervention group (P < 0.05), a significant change was observed only in the 60-degree flexion angle in the control group (P = 0.001). In the comparison between the groups, there were significant differences in post-intervention value only in shoulder flexion and abduction angles, whereas there was no difference between the groups in elbow flexion angles (P > 0.05). Conclusion: Incorporating video-based exercises into the upper extremity rehabilitation processes of individuals with UCP is beneficial in terms of upper extremity functionality, selective motor control, and proprioception.
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Affiliation(s)
- Demet Gözaçan Karabulut
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gaziantep Islam Science and Technology University, Gaziantep, Turkey
| | - Çağtay Maden
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gaziantep Islam Science and Technology University, Gaziantep, Turkey
| | - Yalçın Karabulut
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Mehmet Aslan
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
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Abd-Elmonem AM, Ali HA, Saad-Eldien SS, El-Nabie WAA. Efficacy of plyometric exercises on upper extremity function, selective motor control and hand grip strength in children with unilateral cerebral palsy: A randomized controlled study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2024; 29:e2061. [PMID: 37922449 DOI: 10.1002/pri.2061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/17/2023] [Accepted: 10/23/2023] [Indexed: 11/05/2023]
Abstract
BACKGROUND Impairment in unimanual upper limb function is frequent among children with unilateral cerebral palsy (UCP), which affects their ability to perform functional activities. AIM To assess the efficacy of plyometric exercises on the function of upper extremity, selective motor control (SMC) and hand grip strength (HGS) in children with UCP. DESIGN This was a double-masked, randomized, controlled clinical trial. SETTING Outpatient Clinics of Faculty of Physical Therapy, Cairo University and Center for Physical Medicine, Rehabilitation and Rheumatology, Al-Agouza Hospital, Giza, Egypt. POPULATION Forty children with UCP, ranging in age from 8 to 12 years, were randomly allocated to two groups equal in numbers. METHOD Children were allocated to receive conventional therapy (CONV-group; n = 20) or plyometric exercises (PLYO-group; n = 20) for 45 min. In addition, children of both groups received selected physical and occupational therapy programs (each lasted for 30 min) twice a week over 3-month. The intervention was delivered on non-consecutive days. Upper extremity function, SMC and HGS were assessed by using quality of upper extremity skills test (QUEST), Test of arm selective control and pneumatic squeeze bulb dynamometer, respectively. RESULTS Overall, 35 children (18 in the CONV-group, 17 in the PLYO-group) completed data collection and treatment. With-in group comparison showed significant improvement in the study groups while post-treatment comparisons revealed a significant difference from mean difference in upper extremity function is 9.55 (8.71:10.39), SMC is 2.12 (1.51:2.72) and HGS is 2.91 (2.13:3.68) (p < 0.05; 95% Confidence interval) in favor of the PLYO-group. CONCLUSIONS Plyometric exercises have the capability to enhance upper extremity function and strength in children with UCP.
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Affiliation(s)
- Amira M Abd-Elmonem
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Hazem A Ali
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Sara S Saad-Eldien
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
- Center for Physical Medicine, Rehabilitation and Rheumatology, Al-Agouza Hospital, Giza, Egypt
| | - Walaa A Abd El-Nabie
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Burin-Chu S, Baillet H, Leconte P, Lejeune L, Thouvarecq R, Benguigui N. Effectiveness of virtual reality interventions of the upper limb in children and young adults with cerebral palsy: A systematic review with meta-analysis. Clin Rehabil 2024; 38:15-33. [PMID: 37499213 DOI: 10.1177/02692155231187858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
OBJECTIVE To examine the characteristics and the effectiveness of virtual reality systems on upper limb impairments in children and young adults with cerebral palsy. DATA SOURCES An electronic search was conducted on PubMed, PEDro, Web of Science, Central, and EMBASE. METHODS The protocol of this review was prospectively registered in the PROSPERO database (CRD42022302271). Randomized controlled trials that tested the effects of virtual reality-based interventions on the upper limb of participants with cerebral palsy were included. The methodological quality of the studies was measured by the PEDro scale. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation. The data of the studies were analyzed in meta-analysis and presented in forest plots and narrative synthesis. RESULTS Twenty-two studies involving 746 participants were included. Ten different virtual reality systems were used in the interventions, of which six were designed specifically for rehabilitation and four commercial video games. We found an effect in favor of virtual reality when it was used in combination with conventional therapy for upper limb activity (SMD = 0.65; 95% CI (0.19 to 1.11)). However, the certainty of the evidence of the comparisons ranged from very low to low. CONCLUSION Virtual reality seems to be an effective tool for upper limb activity in children and young adults with cerebral palsy. Nevertheless, future studies should present a better methodological quality, a larger sample size, and well-defined rehabilitation programs to reduce the inconsistency of the evidence in this domain.
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Affiliation(s)
| | - Héloïse Baillet
- Normandie Univ, UNICAEN, ENSICAEN, CNRS, GREYC, Caen, France
| | | | - Laure Lejeune
- Normandie Univ, UNICAEN, ENSICAEN, CNRS, GREYC, Caen, France
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Wang N, Liu N, Liu S, Gao Y. Effects of Nonimmersive Virtual Reality Intervention on Children With Spastic Cerebral Palsy: A Meta-analysis and Systematic Review. Am J Phys Med Rehabil 2023; 102:1130-1138. [PMID: 37535642 DOI: 10.1097/phm.0000000000002321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
ABSTRACT This review aimed to assess the effectiveness of nonimmersive virtual reality intervention compared with traditional rehabilitation in improving the functions of the upper and lower limbs, balance, and social participation among children with spastic cerebral palsy. We used librarian-designed searches of 10 databases to identify research articles on randomized controlled trials that assessed the effectiveness of nonimmersive virtual reality in intervening spastic cerebral palsy patients up to April 15, 2023. Independent evaluation was conducted by two trained investigators using the evaluation criteria of randomized controlled trial quality indicated in the Cochrane Manual of Assessment "risk-of-bias tool." The Physical Therapy Evidence Database scale was used to evaluate the method and quality of the literature. Twenty-one research articles involving 779 patients with spastic cerebral palsy were included. Significant differences between the nonimmersive virtual reality rehabilitation and traditional rehabilitation groups were observed in all indicators, except for the Jebsen-Taylor Hand Function Test. Nonimmersive virtual reality intervention is effective in improving the function of the lower extremity, balance, and social participation in children with spastic cerebral palsy, but its effect on upper limb function is still controversial.
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Affiliation(s)
- Nan Wang
- From the Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, China (NW, SL, YG); and Department of Nephrology, Shengjing Hospital of China Medical University, Shenyang, China (NL)
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Tobaiqi MA, Albadawi EA, Fadlalmola HA, Albadrani MS. Application of Virtual Reality-Assisted Exergaming on the Rehabilitation of Children with Cerebral Palsy: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:7091. [PMID: 38002703 PMCID: PMC10672287 DOI: 10.3390/jcm12227091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/15/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Rehabilitation programs for children with cerebral palsy (CP) aim to improve their motor and cognitive skills through repeated and progressively challenging exercises. However, these exercises can be tedious and demotivating, which can affect the effectiveness and feasibility of the programs. To overcome this problem, virtual reality VR-assisted exergaming has emerged as a novel modality of physiotherapy that combines fun and motivation with physical activity. VR exergaming allows children with CP to perform complex movements in a secure and immersive environment, where they can interact with virtual objects and scenarios. This enhances their active engagement and learning, as well as their self-confidence and enjoyment. We aim to provide a comprehensive overview of the current state of research on VR exergaming for CP rehabilitation. The specific objectives are: To identify and describe the existing studies that have investigated the effects of VR exergaming on motor function and participation outcomes in children with CP. In addition, we aim to identify and discuss the main gaps, challenges, and limitations in the current research on VR exergaming for CP rehabilitation. Finally, we aim to provide recommendations and suggestions for future research and practice in this field. METHODS In June 2023, we conducted a systematic search on Scopus, Web of Science, PubMed, Cochrane, and Embase for randomized trials and cohort studies that applied VR-assisted exergaming to rehabilitating patients with CP. The inclusion criteria encompassed the following: (1) Randomized controlled trials (RCTs) and cohort studies involving the rehabilitation of children with CP; (2) the application of VR-based exergaming on the rehabilitation; (3) in comparison with conventional rehabilitation/usual care. The quality of the selected RCTs was evaluated using Cochrane's tool for risk of bias assessment bias includes. Whereas the quality of cohort studies was assessed using the National Institutes of Health (NIH) tool. RESULTS The systematic search of databases retrieved a total of 2576 studies. After removing 863 duplicates, 1713 studies underwent title and abstract screening, and 68 studies were then selected as eligible for full-text screening. Finally, 45 studies were involved in this review (n = 1580), and 24 of those were included in the quantitative analysis. The majority of the included RCTs had a low risk of bias regarding study reporting, participants' attrition, and generating a random sequence. Nearly half of the RCTs ensured good blinding of outcomes assessors. However, almost all the RCTs were unclear regarding the blinding of the participants and the study personnel. The 2020 retrospective cohort study conducted at Samsung Changwon Hospital, investigating the effects of virtual reality-based rehabilitation on upper extremity function in children with cerebral palsy, demonstrated fair quality in its methodology and findings. VR-assisted exergaming was more effective than conventional physiotherapy in improving the Gross Motor Function Measurement (GMFM)-88 score (MD = 0.81; 95% CI [0.15, 1.47], p-value = 0.02) and the GMFM walking and standing dimensions (MD = 1.45; 95% CI [0.48, 2.24], p-value = 0.003 and MD = 3.15; 95% CI [0.87, 5.42], p-value = 0.007), respectively. The mobility and cognitive domains of the Pediatric Evaluation of Disability Inventory score (MD = 1.32; 95% CI [1.11, 1.52], p-value < 0.001) and (MD = 0.81; 95% CI [0.50, 1.13], p-value < 0.0001) were also improved. The Canadian Occupational Performance Measure performance domain (MD = 1.30; 95% CI [1.04, 1.56], p-value < 0.001), the WeeFunctional Independence Measure total score (MD = 6.67; 95% CI [6.36, 6.99], p-value < 0.0001), and the Melbourne Assessment of Unilateral Upper Limb Function-2 score (p-value < 0.001) improved as well. This new intervention is similarly beneficial as conventional therapy in improving other efficacy measures. CONCLUSIONS Our findings suggest that VR-assisted exergaming may have some advantages over conventional rehabilitation in improving CP children's functioning and performance in daily life activities, upper and lower limb mobility, and cognition. VR-assisted exergaming seems to be as effective as conventional physiotherapy in the other studied function measures. With its potential efficacy, better feasibility, no reported side effects, and entertaining experience, VR-assisted exergaming may be a viable complementary approach to conventional physiotherapy in rehabilitating children with CP.
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Affiliation(s)
- Muhammad Abubaker Tobaiqi
- Department of Family and Community Medicine, College of Medicine, Taibah University, Al-Madinah Al-Munawara 42353, Saudi Arabia
| | - Emad Ali Albadawi
- Department of Anatomy, College of Medicine, Taibah University, Al-Madinah Al-Munawara 42353, Saudi Arabia;
| | - Hammad Ali Fadlalmola
- Department of Community Health Nursing, Nursing College, Taibah University, Al-Madinah Al-Munawara 42353, Saudi Arabia;
| | - Muayad Saud Albadrani
- Department of Family and Community Medicine, College of Medicine, Taibah University, Al-Madinah Al-Munawara 42353, Saudi Arabia
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Pinos Cisneros TV, Brons A, Kröse B, Schouten B, Ludden G. Playfulness and New Technologies in Hand Therapy for Children With Cerebral Palsy: Scoping Review. JMIR Serious Games 2023; 11:e44904. [PMID: 37843886 PMCID: PMC10616756 DOI: 10.2196/44904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 05/23/2023] [Accepted: 07/21/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND Innovative technologies such as game consoles and smart toys used with games or playful approaches have proven to be successful and attractive in providing effective and motivating hand therapy for children with cerebral palsy (CP). Thus, there is an increased interest in designing and implementing interventions that can improve the well-being of these children. However, to understand how and why these interventions are motivating children, we need a better understanding of the playful elements of technology-supported hand therapy. OBJECTIVE This scoping review aims to identify the playful elements and the innovative technologies currently used in hand therapy for children with CP. METHODS We included studies that design or evaluate interventions for children with CP that use innovative technologies with game or play strategies. Data were extracted and analyzed based on the type of technology, description of the system, and playful elements according to the Lenses of Play, a play design toolkit. A total of 31 studies were included in the analysis. RESULTS Overall, 54 papers were included in the analysis. The results showed high use of consumer technologies in hand therapy for children with CP. Although several studies have used a combination of consumer technologies with therapeutic-specific technologies, only a few studies focused on the exclusive use of therapeutic-specific technologies. To analyze the playfulness of these interventions that make use of innovative technologies, we focused our review on 3 lenses of play: Open-ended Play, where it was found that the characteristics of ludus, such as a structured form of play and defined goals and rules, were the most common, whereas strategies that relate to paidia were less common. The most commonly used Forms of Play were physical or active form and games with rules. Finally, the most popular Playful experiences were control, challenge, and competition. CONCLUSIONS The inventory and analysis of innovative technology and playful elements provided in this study can be a starting point for new developments of fun and engaging tools to assist hand therapy for children with CP.
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Affiliation(s)
- Tamara Veronica Pinos Cisneros
- Digital Life Centre, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
- Interaction Design, University of Twente, Enschede, Netherlands
| | - Annette Brons
- Digital Life Centre, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Ben Kröse
- Digital Life Centre, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Ben Schouten
- Play and Civic Media, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Geke Ludden
- Interaction Design, University of Twente, Enschede, Netherlands
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Alrashidi M, Wadey CA, Tomlinson RJ, Buckingham G, Williams CA. The efficacy of virtual reality interventions compared with conventional physiotherapy in improving the upper limb motor function of children with cerebral palsy: a systematic review of randomised controlled trials. Disabil Rehabil 2023; 45:1773-1783. [PMID: 35575755 DOI: 10.1080/09638288.2022.2071484] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/06/2022] [Accepted: 04/24/2022] [Indexed: 01/16/2023]
Abstract
PURPOSE Cerebral palsy (CP) is the commonest motor disability affecting children. This study reviewed the evidence for virtual reality (VR) intervention compared with conventional physiotherapy in upper limb function of children with CP. METHODS Searches were undertaken in MEDLINE, EMBASE, PEDro, CENTRAL, Web of Science, CINAHL, ERIC, ICTRP, EU-CTR, ClinicalTrials.gov and EThOS databases. Only randomised-controlled trials (RCTs) were included. Two reviewers independently screened the search results, assessed full-text articles, extracted data and appraised the methodological quality by using the Cochrane collaboration's risk of bias (RoB2) tool. Albatross plots were used to synthesise the data. RESULTS Seven RCTs, examining motor function in a total of 202 children with CP, included. Four trials used the Quality of Upper Extremity Skills Test (QUEST) as an outcome measure, and three trials used grip strength. These outcome measures were utilised to develop two Albatross plots. Data from the plots showed contradictory findings of the included studies. CONCLUSIONS The effect of VR in the upper limb rehabilitation of children with CP remains unclear. All included studies used commercial non-immersive VR games. Future high-quality clinical research is needed to explore the extent to which non-immersive and immersive VR is feasible and effective with children and adolescents.IMPLICATIONS FOR REHABILITATIONThe current evidence supporting the use of VR as a rehabilitative tool is weak and uncertain.The current use of VR relies only on commercial non-immersive VR (off-shelf) games, which are not adjustable to meet the demands and goals of therapy programmes.Future research is needed to study the therapeutic feasibility of immersive VR with children and adolescents.
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Affiliation(s)
- Mohammed Alrashidi
- Children's Health and Exercise Research Centre, Sport & Health Sciences, University of Exeter, Exeter, UK
- Sport and Health Sciences, University of Exeter, Exeter, UK
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, Taibah University, Madina, KSA
| | - Curtis A Wadey
- Children's Health and Exercise Research Centre, Sport & Health Sciences, University of Exeter, Exeter, UK
| | | | | | - Craig A Williams
- Children's Health and Exercise Research Centre, Sport & Health Sciences, University of Exeter, Exeter, UK
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Crebbin K, Grisbrook T, Elliott C, Thornton A. The Use of Serious Gaming to Improve Sensorimotor Function and Motivation in People with Cerebral Palsy: A Systematic Review. Games Health J 2023; 12:169-197. [PMID: 36161972 DOI: 10.1089/g4h.2022.0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of this systematic review was to review the evidence for serious gaming interventions in improving sensorimotor function in children and adults with cerebral palsy (CP). Seven databases were searched with terms related to serious gaming and CP. Articles were evaluated according to the Downs and Black rating scale and important principles of serious gaming defined by Whyte et al. Extracted data included the population, intervention, serious gaming elements, outcomes, and authors' conclusions. Fifty-seven articles were identified for inclusion. Participants' ages ranged from 3 to 57 years. Interventions tested included commercial videogames as well as specially designed games. Most interventions had themed content, short-term goals, rewards, feedback, and multiple games. Outcome measures and study designs were inconsistent between studies. Sensorimotor function results of noncomparative studies were positive or neutral overall, but results of comparative studies were more mixed. We concluded that serious gaming interventions may be a useful adjunct to treatment as they are noninvasive, were not associated with deterioration in most cases, and may improve compliance. More comparative studies need to be completed to assess compliance and treatment outcomes. Future games should also aim to adhere more closely to the principles of serious gaming.
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Affiliation(s)
- Kayley Crebbin
- UWA Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Tiffany Grisbrook
- UWA Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Perth Children's Hospital, Perth, Western Australia, Australia
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Catherine Elliott
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Ashleigh Thornton
- UWA Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Perth Children's Hospital, Perth, Western Australia, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
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Montoro-Cárdenas D, Cortés-Pérez I, Ibancos-Losada MDR, Zagalaz-Anula N, Obrero-Gaitán E, Osuna-Pérez MC. Nintendo ® Wii Therapy Improves Upper Extremity Motor Function in Children with Cerebral Palsy: A Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12343. [PMID: 36231643 PMCID: PMC9566093 DOI: 10.3390/ijerph191912343] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/22/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Nintendo® Wii-based therapy (NWT) is a non-immersive virtual reality therapy used to recover upper extremity (UE) motor function in children with cerebral palsy (CP). We aimed primarily to elucidate the effectiveness of NWT in improving UE motor and functional impaired abilities in children with CP, compared to conventional therapy or no intervention. The secondary aim was to assess if NWT is more effective when used alone or combined with conventional therapy. METHODS A systematic review with meta-analysis was conducted from a bibliographic search in PubMed, Scopus, PEDro, Web of Science, and CINHAL, ending in October 2021, in accordance with PRISMA guidelines. We included randomized controlled trials that compared NWT vs. conventional therapy or no intervention in terms of their impact on different UE impaired abilities (grip strength, tip grip strength, UE dissociated movements, functional capacity in daily living activities, gross and fine motor dexterity, and grasping ability) in children with CP. Effect size was calculated with standardized mean difference (SMD) and its 95% confidence interval (95% CI). RESULTS Nine studies (276 participants) were included. NWT is more effective than conventional therapy at improving grip strength (SMD = 0.5, 95% CI 0.08, 0.91), tip grip strength (SMD = 0.95, 95% CI 0.3, 1.61), and grasping ability (SMD = 0.72, 95%CI 0.14, 1.3). NWT is more effective than conventional therapy at improving functional capacity in daily living activities (SMD = 0.83, 95% CI 0.07, 1.56). For fine manual dexterity, NWT was better than no intervention (SMD = 3.12, 95% CI 1.5, 4.7). CONCLUSIONS Our results indicate that NWT is effective at improving various UE impaired motor skills in children with CP.
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McCall JV, Ludovice MC, Elliott C, Kamper DG. Hand function development of children with hemiplegic cerebral palsy: A scoping review. J Pediatr Rehabil Med 2022; 15:211-228. [PMID: 34864699 DOI: 10.3233/prm-200714] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Hemiplegic cerebral palsy (hCP) typically impacts sensorimotor control of the hand, but comprehensive assessments of the hands of children with hCP are relatively rare. This scoping review summarizes the development of hand function for children with hCP. METHODS This scoping review focused on the development of hand function in children with hCP. Electronic databases (PubMed, PEDro, Web of Science, CINAHL, and SpringerLink) were searched to identify studies assessing hand function in children with hCP. The search was performed using keywords (e.g., "hemiplegia"). An iterative approach verified by two authors was used to select the studies. Articles which reported quantitative data for children with hCP on any items of a specified set of hand evaluations were included. Measures were sorted into three categories: quantitative neuromechanics, clinical assessments, and clinical functional evaluations. RESULTS Initial searches returned 1536 articles, 131 of which were included in the final review. Trends between assessment scores and age were examined for both hands. CONCLUSION While several studies have evaluated hand function in children with hCP, the majority relied on clinical scales, assessments, or qualitative descriptions. Further assessments of kinematics, kinetics, and muscle activation patterns are needed to identify the underlying impairment mechanisms that should be targeted for treatment.
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Affiliation(s)
- James V McCall
- Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC, USA.,University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Miranda C Ludovice
- Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC, USA.,University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Catherine Elliott
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia.,Child and Adolescent Health Services, Perth Children's Hospital, Perth, Australia
| | - Derek G Kamper
- Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC, USA.,University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Zhang Y, Li R, Miao X, Cheng LJ, Lau Y. Virtual motor training to improve the activities of daily living, hand grip, and gross motor function among children with cerebral palsy: Meta-regression analysis. Gait Posture 2022; 91:297-305. [PMID: 34798421 DOI: 10.1016/j.gaitpost.2021.10.046] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Given that cerebral palsy is a lifelong condition, continuous motor training is necessary to correct abnormal posture and patterns to improve functional performance. OBJECTIVE To explore the essential features of virtual motor training and identify its effects on the activities of daily living, hand grip function, and gross motor function among children with cerebral palsy. METHODS Ten databases were systematically searched for randomized controlled trials from inception until October 15, 2019. Studies with a randomized controlled trials design, children with cerebral palsy, comparisons of virtual motor training with other interventions, and activities of daily living, hand grip, and gross motor function outcomes were included. Subgroup analyses and meta-regression were performed. The effect size was assessed using random-effects meta-analysis and evaluated by using Hedges' g. Random effects univariate meta-regression model was used to examine the association of covariates with intervention effectiveness. RESULTS Seventeen randomized controlled trials with 853 participants were included. Meta-analysis indicated that the virtual motor training had significant positive effects on activities of daily living (g = 0.31, 95% confidence interval, CI = 0.10, 0.51), grip (g = 0.40, 95% CI = 0.08, 0.71), and gross motor (g = 0.71, 95% CI = 0.43, 0.99) function. Univariate random-effects meta-regression analysis indicated an increase in activities of daily living scores for motion capture systems that used depth imaging compared with those that used digital imaging. SIGNIFICANCE Our systematic review indicated that virtual motor function may significantly improve ADLs, hand grip, and gross motor functions among children with cerebral palsy.
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Affiliation(s)
- Yanran Zhang
- The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
| | - Runze Li
- The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
| | - Xiuxin Miao
- Associate Professor and Director, School of Nursing, Department of Medicine, Qingdao University, Qingdao, Shandong, China.
| | - Ling Jie Cheng
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Fandim JV, Saragiotto BT, Porfírio GJM, Santana RF. Effectiveness of virtual reality in children and young adults with cerebral palsy: a systematic review of randomized controlled trial. Braz J Phys Ther 2021; 25:369-386. [PMID: 33358737 PMCID: PMC8353293 DOI: 10.1016/j.bjpt.2020.11.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 07/06/2020] [Accepted: 11/17/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Cerebral palsy (CP) is one of the main causes of disability in childhood. Virtual reality (VR) has been used as a treatment option in this population, however its effectiveness is unclear. OBJECTIVE To evaluate the effectiveness of VR in patients with CP. METHODS We conducted electronic searches in EMBASE, MEDLINE, Cochrane library, PEDro, AMED, PsycoINFO, and LILACS databases and trial site registries such as ClinicalTrials.gov and ICTRP. We included randomized controlled trials that tested the use of VR alone or in combination with other interventions compared to more conventional rehabilitation or usual care in individuals with CP. The primary outcomes were upper and lower limb function, postural control, and balance. The secondary outcomes included global motor function, perception, cognition and spatial functions, motivation, motor learning, and adverse events. Two independent reviewers extracted and assessed included articles for risk of bias using the Cochrane risk of bias tool. We use a meta-analysis with random effect model whenever possible. We analyzed the quality of evidence using theGRADE approach. RESULTS We included 38 trials (pooled n = 1233 participants) in this review. There is very low quality of evidence that VR plus conventional rehabilitation is better than conventional rehabilitation for upper limb function. There is also very low quality evidence that VR alone is no better than conventional rehabilitation for upper and lower limb function. No adverse events were observed among the 10 trials that provided information on this outcome. CONCLUSION At present we have very limited to limited confidence in effect estimation for utilization of VR in this population. Future studies may change our confidence in results and effect estimates. PROTOCOL REGISTRATION PROSPERO CRD 42018102759.
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Affiliation(s)
- Junior Vitorino Fandim
- Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil.
| | - Bruno Tirotti Saragiotto
- Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
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Viana RB, de Oliveira VN, Dankel SJ, Loenneke JP, Abe T, da Silva WF, Morais NS, Vancini RL, Andrade MS, de Lira CAB. The effects of exergames on muscle strength: A systematic review and meta-analysis. Scand J Med Sci Sports 2021; 31:1592-1611. [PMID: 33797115 DOI: 10.1111/sms.13964] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 12/17/2022]
Abstract
This systematic review and meta-analysis examined studies on the chronic effects of exergames on muscle strength in humans. PubMed, Scopus, CENTRAL, Web of Science, SciELO, Biblioteca Virtual em Saúde, and Google Scholar were searched, and manual searches of the reference lists of included studies and hand-searches on Physiotherapy Evidence Database and ResearchGate were conducted from inception to August 10, 2020. Randomized and non-randomized exergame intervention studies with or without a non-exercise group and/or a "usual care intervention group" (any other intervention that did not incorporate exergames), which evaluated muscle strength through direct measurements, were included. Forty-seven and 25 studies were included in the qualitative review and meta-analysis, respectively. The between-groups meta-analyses showed no significant differences between exergames and non-exercise control groups for handgrip strength in heathy/unhealthy middle-aged/older adults or knee extension maximum voluntary isometric contraction (MVIC) in healthy older adults. However, exergames provided a greater increase in handgrip strength, knee flexion MVIC, and elbow extension MVIC, but not knee extension MVIC or elbow flexion MVIC, in individuals with different health statuses when compared to usual care interventions. Also, there was a greater increase in handgrip strength in children with hemiplegic cerebral palsy favouring usual care plus exergames compared to usual care interventions. These results suggest that exergames may improve upper and lower limb muscle strength in individuals with different heath statuses compared to usual care interventions, but not muscle strength in middle age/older adults after accounting for random error. Also, exergames appear to be a useful tool for improving handgrip strength in children with hemiplegic cerebral palsy when added to usual care. However, as the exergame interventions were applied in different populations and there currently are many different approaches to perform exergames, future randomized controlled trials with high methodological quality and large sample sizes are needed to provide more compelling evidence in favour of a specific exergame protocol, or to elucidate exergame protocol design principles that appear to strongly influence outcomes.
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Affiliation(s)
- Ricardo Borges Viana
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | | | - Scott J Dankel
- Department of Health and Exercise Science, Rowan University, Glassboro, NJ, USA
| | - Jeremy P Loenneke
- Kevser Ermin Applied Physiology Laboratory, University of Mississippi, University, MS, USA
| | - Takashi Abe
- Kevser Ermin Applied Physiology Laboratory, University of Mississippi, University, MS, USA
| | | | - Naiane Silva Morais
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | - Rodrigo Luiz Vancini
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória, Brazil
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Suárez-Iglesias D, Ayán Perez C, Mendoza-Laiz N, Villa-Vicente JG. Boccia as a Rehabilitation Intervention for Adults With Severe Mobility Limitations Due to Neuromuscular and Other Neurological Disorders: Feasibility and Effects on Upper Limb Impairments. Front Psychol 2020; 11:581. [PMID: 32292381 PMCID: PMC7133800 DOI: 10.3389/fpsyg.2020.00581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 03/11/2020] [Indexed: 11/13/2022] Open
Abstract
Purpose Scant research exists regarding the effects of playing Boccia as a rehabilitation strategy for people with severe mobility limitations due to neuromuscular and other neurological disorders. This study is aimed at identifying the feasibility and effects of playing Boccia on the upper limb impairments of people with severe mobility limitations due to neuromuscular and other neurological disorders. Materials and Methods Seven people played Boccia three times per week for 20 weeks as part of the rehabilitation process, while other seven kept up with their usual rehabilitation schedule. Attrition, adherence, adverse effects, participation and completion rate were registered to assess feasibility. The effects of the program on grip, pinch strength and upper-limb active range of motion were assessed by means of a dynamometer and a goniometer. Results and Conclusions The program was feasible, although no effects were observed after its completion on variables assessed, except for hand flexion and ulnar deviation active range of motion. In a group of people with severe disability due to neuromuscular and other neurological disorders, playing Boccia as part of a multidisciplinary rehabilitation program was shown to be a feasible therapy. However, practicing this game did not lead to significant improvements in upper limb impairments, except for wrist flexion and ulnar deviation active range of motion.
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Affiliation(s)
- David Suárez-Iglesias
- Department of Physical Education and Sport, VALFIS Research Group, Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Carlos Ayán Perez
- Well-Move Research Group, Faculty of Education and Sport Science, Department of Special Didactics, University of Vigo, Vigo, Spain
| | - Nuria Mendoza-Laiz
- Department of Sport Science, University of Francisco de Vitoria, Madrid, Spain
| | - José Gerardo Villa-Vicente
- Department of Physical Education and Sport, VALFIS Research Group, Institute of Biomedicine (IBIOMED), University of León, León, Spain
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