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Lai CC, Hsieh HC, Lee WK, Lin CH, Lin HY. Application of remodeled glove puppetry for children with developmental disabilities: A randomized controlled trial. Assist Technol 2024; 36:256-263. [PMID: 37796439 DOI: 10.1080/10400435.2023.2267626] [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: 05/03/2023] [Accepted: 10/01/2023] [Indexed: 10/06/2023] Open
Abstract
This study aimed to improve hand performance and play behavior in children with developmental disabilities (DD) using a remodeled glove puppetry approach. Overall, 62 children with DD were randomly assigned to experimental and control groups (n = 31 each). The experimental group underwent a 12-week rehabilitation program by playing with the remodeled glove puppetry, while the children in the control group played with non-remodeled glove puppetry. The Chinese puppet was remodeled using a Lego EV3® robot. Hand kinematics were analyzed through the Siliconcoach® Pro 7 software, which measured the force produced by the baseline ® hydraulic pinch gauge. Play behavior was measured using the Knox Preschool Play Scale-revised (KPPS-r). The experimental group exhibited significant improvements compared to the control group in hand kinematics (wrist range of motion [ROM], p < .05; metacarpophalangeal ROM, p < .05; proximal interphalangeal ROM, p < .05) and KPPS-r scores (space management, p < .05; material management, p < .05; pretense-symbolic, p < .05; participation, p < .05). After the 12-week rehabilitation with the remodeled glove puppetry, the experimental group exhibited significant improvement in kinematics and KPPS-r scores.
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Affiliation(s)
- Chia Ching Lai
- Department of Child Care and Education, Ling Tung University, Taichung, Taiwan
| | - Hsieh-Chun Hsieh
- Department of Special Education, National Tsing Hua University, Hsinchu, Taiwan
| | - Wai-Keung Lee
- Ministry of Health and Welfare, Taoyuan General Hospital, Taoyuan, Taiwan
| | - Chien-Heng Lin
- Department of Psychiatry, National Taiwan University Hospital Chu-Tung Branch, Hsinchu, Taiwan
| | - Hung-Yu Lin
- Department of Occupational Therapy, Asia University, Taichung, Taiwan
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Romeo DM, D’Amario G, Brunozzi G, Napoli V, Villa M, Arpaia C, Velli C, Sini F, Brogna C. Sports Activities in Children with Cerebral Palsy: A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:457. [PMID: 38541183 PMCID: PMC10972358 DOI: 10.3390/medicina60030457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/03/2024] [Accepted: 03/06/2024] [Indexed: 07/23/2024]
Abstract
Physical exercise is known to have beneficial effects on psychosocial well-being and cognitive performance. Children with cerebral palsy (CP) showed lower levels of physical activity (PA) than healthy children; this fact, in addition to the basic clinical condition, increased the sedentary habit with a psychological impact and motor impairment of these children. Furthermore, children and adolescents with CP are less committed to sports activities than typically developing children of the same age. The aim of the present narrative review was to increase the amount of knowledge regarding the effectiveness and importance of specific and individualized sports in children with CP. A comprehensive search of MED-LINE and EMBASE databases was performed, including specific search terms such as "cerebral palsy" combined with "sport", "physical activity", and the names of different sports. No publication date limits were set. We included studies with an age range of 0-18 years. The main results pointed out that most of the sports improved motor function, quality of life, and coordination in children and adolescents with CP. Physicians, therapists, and parents should become aware of the benefits of sports activities for this population of patients. Specific sports activities could be included as a usual indication in clinical practice in addition to rehabilitation treatment.
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Affiliation(s)
- Domenico M. Romeo
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (G.D.); (V.N.); (M.V.); (C.A.); (C.V.); (F.S.); (C.B.)
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Giulia D’Amario
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (G.D.); (V.N.); (M.V.); (C.A.); (C.V.); (F.S.); (C.B.)
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Giulia Brunozzi
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Valentina Napoli
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (G.D.); (V.N.); (M.V.); (C.A.); (C.V.); (F.S.); (C.B.)
| | - Marianna Villa
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (G.D.); (V.N.); (M.V.); (C.A.); (C.V.); (F.S.); (C.B.)
| | - Chiara Arpaia
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (G.D.); (V.N.); (M.V.); (C.A.); (C.V.); (F.S.); (C.B.)
| | - Chiara Velli
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (G.D.); (V.N.); (M.V.); (C.A.); (C.V.); (F.S.); (C.B.)
| | - Francesca Sini
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (G.D.); (V.N.); (M.V.); (C.A.); (C.V.); (F.S.); (C.B.)
| | - Claudia Brogna
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (G.D.); (V.N.); (M.V.); (C.A.); (C.V.); (F.S.); (C.B.)
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Komariah M, Amirah S, Abdurrahman MF, Handimulya MFS, Platini H, Maulana S, Nugrahani AD, Mulyana AM, Qadous SG, Mediani HS, Mago A. Effectivity of Virtual Reality to Improve Balance, Motor Function, Activities of Daily Living, and Upper Limb Function in Children with Cerebral Palsy: A Systematic Review and Meta-Analysis. Ther Clin Risk Manag 2024; 20:95-109. [PMID: 38375076 PMCID: PMC10875340 DOI: 10.2147/tcrm.s432249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/03/2024] [Indexed: 02/21/2024] Open
Abstract
Background Cerebral palsy (CP) is the most common motor disorder in childhood. CP limits movement, which can interfere with children's daily activities. As a technology that provides intensive mass practice to children, virtual reality (VR) can create an interactive and motivating environment. With the intensity set by the therapist and feedback that can be used to produce individualized therapy, VR has great potential to improve CP patients' quality of life, especially in a safe, enjoyable, and playful environment. Purpose This systematic review and meta-analysis sought to determine the effectiveness of VR for children with CP. Methods We conducted a comprehensive literature search based on the PRISMA guidelines through PubMed, Scopus, Embase, Wiley, and ProQuest to assess the efficacy of VR in managing children with CP up to 15 September 2022. Risk assessment of bias was performed using Cochrane RoB 2. Results Nineteen randomized controlled trials with 467 and 427 patients with CP were included in the intervention and control groups in qualitative and quantitative analyses. Participants consisted of cerebral palsy with hemiplegia (n=7), diplegia (n=2), a combination of both (n=4), and undefined (n=13). From all studies conducted, VR showed significant results where VR could improve balance (MD: 2.71[1.95, 3.48]; p < 0.00001), motor function (MD: 3.73 [1.67, 5.79]; p = 0.0004), and activity daily living (MD: 10.05 [2.89, 17.22]. However, VR showed not effective in improving upper limb function. Conclusion With its advantages and excellent effectiveness, VR may improve functional mobility and the quality of life of children with CP.
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Affiliation(s)
- Maria Komariah
- Department of Fundamental Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 45363, Indonesia
| | - Shakira Amirah
- Faculty of Medicine, Universitas Indonesia, Depok, West Java, 16424Indonesia
| | | | | | - Hesti Platini
- Department of Medical-Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 45363, Indonesia
| | - Sidik Maulana
- Master of Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Annisa Dewi Nugrahani
- Maternal Fetal Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
| | - Aep Maulid Mulyana
- Master of Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Shurouq Ghalib Qadous
- Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Henny Suzana Mediani
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 45363, Indonesia
| | - Arpit Mago
- Department of Clinical Medicine, Jawaharlal Nehru Medical College, Belagavi, Karnataka, 590010, India
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Pimentel-Ponce M, Romero-Galisteo RP, Palomo-Carrión R, Pinero-Pinto E, Antonio Merchán-Baeza J, Ruiz-Muñoz M, Oliver-Pece J, González-Sánchez M. Gamification and neurological motor rehabilitation in children and adolescents: a systematic review. Neurologia 2024; 39:63-83. [PMID: 38065433 DOI: 10.1016/j.nrleng.2023.12.006] [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: 09/04/2020] [Accepted: 02/07/2021] [Indexed: 12/25/2023] Open
Abstract
INTRODUCTION Gamification consists of the use of games in non-playful contexts. It is widely employed in the motor rehabilitation of neurological diseases, but mainly in adult patients. The objective of this review was to describe the use of gamification in the rehabilitation of children and adolescents with neuromotor impairment. METHODS We performed a systematic review of clinical trials published to date on the MEDLINE (PubMed), Scielo, SCOPUS, Dialnet, CINAHL, and PEDro databases, following the PRISMA protocol. The methodological quality of the studies identified was assessed using the PEDro scale. RESULTS From a total of 469 studies, 11 clinical trials met the inclusion criteria. We analysed the gamification systems used as part of the rehabilitation treatment of different neuromotor conditions in children and adolescents. Cerebral palsy was the most frequently studied condition (6 studies), followed by developmental coordination disorder (3), neurological gait disorders (1), and neurological impairment of balance and coordination (1). CONCLUSION The use of gamification in rehabilitation is helpful in the conventional treatment of neuromotor disorders in children and adolescents, with increased motivation and therapeutic adherence being the benefits with the greatest consensus among authors. While strength, balance, functional status, and coordination also appear to improve, future research should aim to determine an optimal dosage.
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Affiliation(s)
| | - R P Romero-Galisteo
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.
| | - R Palomo-Carrión
- Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, Facultad de Fisioterapia, Universidad de Castilla la Mancha, Toledo, Spain
| | - E Pinero-Pinto
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
| | - J Antonio Merchán-Baeza
- Grupo de investigación Methodology, Methods, Models and Outcomes of Health and Social Sciences (M30), Facultad de Cienciasde la Salud y Bienestar, Universidad de Vic-Universidad Central de Cataluña (UVIC-UCC), Vic, Barcelona, Spain
| | - M Ruiz-Muñoz
- Departamento de Enfermería y Podología, Facultad de Ciencias de la Salud, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - J Oliver-Pece
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad de Málaga, Málaga, Spain
| | - M González-Sánchez
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga. Instituto de Investigación Biomédica deMálaga (IBIMA), Málaga, Spain
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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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Meneses Castaño C, Penagos P, Yamile Jaramillo B. [Effectiveness of robotic technology and virtual reality for the rehabilitation of motor function in cerebral palsy. Systematic review]. Rehabilitacion (Madr) 2022:S0048-7120(22)00079-2. [PMID: 36344300 DOI: 10.1016/j.rh.2022.07.001] [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: 05/17/2021] [Revised: 07/06/2022] [Accepted: 07/10/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Cerebral palsy (CP) is a health condition secondary to non-progressive damage that occurs during brain development in the fetal or infant stage. To evaluate the effectiveness of robotic technology and virtual reality on motor function in patients with CP compared to conventional rehabilitation strategies such as physical therapy, occupational therapy, neurodevelopmental intervention, and transcranial stimulation. A review of randomized controlled trials of the last 5 years was carried out. For the evaluation of the methodological quality of the included studies, the PEDro scale was used, with evaluation of the level of evidence and degree of recommendation according to the Oxford classification. RESULTS Seventeen articles met the eligibility criteria. Robotic technology and virtual reality proved to be effective in improving motor function, manual skills, and visual-perceptual skills in patients with CP, compared to the use of conventional rehabilitation strategies.
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Affiliation(s)
- C Meneses Castaño
- Escuela Colombiana de Rehabilitación, Bogotá, Cundinamarca, Colombia.
| | - P Penagos
- Escuela Colombiana de Rehabilitación, Bogotá, Cundinamarca, Colombia
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Arnoni JLB, Lima CRG, Verdério BN, Kleiner AFR, de Campos AC, Rocha NACF. Active Videogame Training Combined with Conventional Therapy Alters Body Oscillation in Children with Cerebral Palsy: A Randomized Controlled Trial. Games Health J 2022; 11:252-261. [PMID: 35687479 DOI: 10.1089/g4h.2021.0158] [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: 12/29/2022] Open
Abstract
Objective: Assess the effect of nonimmersive virtual reality (VR) training as complementary rehabilitation on body oscillation in children with cerebral palsy (CP) while standing on different bases of support and surfaces. Materials and Methods: Twenty-three children with unilateral CP randomly allocated to an intervention group (IG, n = 12) or control group (CG, n = 11). The IG underwent two weekly 50-minute sessions of VR training over 8 weeks, associated with conventional therapy, while the CG was submitted to two 45-minute sessions of conventional neurodevelopmental-based physiotherapy a week over the same time period. Participants were evaluated on a force platform under control conditions (CCs) (rigid surface, feet parallel); semitandem stance; flexible surface (FS) with feet parallel; and flexible surface in a semitandem (FSST) stance. The effect of the group and time factors on the center of pressure oscillation variables was analyzed by repeated-measures analysis of variance (ANOVA), with significance set at 0.05. Results: The main effect observed was for time on the FS, with a decline in the amplitude of mediolateral (ML Amp) (P = 0.01) and mediolateral root mean square (P = 0.01) after intervention. In the IG, ML Amp also declined after intervention under CCs (P = 0.02) and total velocity increased for FSST (P = 0.04). The percentage change was significant only in the IG. Conclusion: VR training as complementary rehabilitation can help improve body oscillation in children with CP and mild functional impairment. Nonimmersive VR can be considered a complementary tool for the physical rehabilitation of children with CP. This study was registered with the Brazilian Clinical Trials Registry (RBR-3zty4w).
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Affiliation(s)
- Joice Luiza Bruno Arnoni
- Neuropediatrics Section, Department of Physiotherapy, Federal University of Sao Carlos, Sao Carlos, Brazil
| | | | - Bruna Nayara Verdério
- Neuropediatrics Section, Department of Physiotherapy, Federal University of Sao Carlos, Sao Carlos, Brazil
| | | | - Ana Carolina de Campos
- Neuropediatrics Section, Department of Physiotherapy, Federal University of Sao Carlos, Sao Carlos, Brazil
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Selph SS, Skelly AC, Wasson N, Dettori JR, Brodt ED, Ensrud E, Elliot D, Dissinger KM, McDonagh M. Physical Activity and the Health of Wheelchair Users: A Systematic Review in Multiple Sclerosis, Cerebral Palsy, and Spinal Cord Injury. Arch Phys Med Rehabil 2021; 102:2464-2481.e33. [PMID: 34653376 DOI: 10.1016/j.apmr.2021.10.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/10/2021] [Accepted: 10/02/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To understand the benefits and harms of physical activity in people who may require a wheelchair with a focus on people with multiple sclerosis (MS), cerebral palsy (CP), and spinal cord injury (SCI). DATA SOURCES Searches were conducted in MEDLINE, Cumulative Index to Nursing and Allied Health, PsycINFO, Cochrane CENTRAL, and Embase (January 2008 through November 2020). STUDY SELECTION Randomized controlled trials, nonrandomized trials, and cohort studies of observed physical activity (at least 10 sessions on 10 days) in participants with MS, CP, and SCI. DATA EXTRACTION We conducted dual data abstraction, quality assessment, and strength of evidence. Measures of physical functioning are reported individually where sufficient data exist and grouped as "function" where data are scant. DATA SYNTHESIS No studies provided evidence for prevention of cardiovascular conditions, development of diabetes, or obesity. Among 168 included studies, 44% enrolled participants with MS (38% CP, 18% SCI). Studies in MS found walking ability may be improved with treadmill training and multimodal exercises; function may be improved with treadmill, balance exercises, and motion gaming; balance is likely improved with balance exercises and may be improved with aquatic exercises, robot-assisted gait training (RAGT), motion gaming, and multimodal exercises; activities of daily living (ADL), female sexual function, and spasticity may be improved with aquatic therapy; sleep may be improved with aerobic exercises and aerobic fitness with multimodal exercises. In CP, balance may be improved with hippotherapy and motion gaming; function may be improved with cycling, treadmill, and hippotherapy. In SCI, ADL may be improved with RAGT. CONCLUSIONS Depending on population and type of exercise, physical activity was associated with improvements in walking, function, balance, depression, sleep, ADL, spasticity, female sexual function, and aerobic capacity. Few harms of physical activity were reported in studies. Future studies are needed to address evidence gaps and to confirm findings.
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Affiliation(s)
- Shelley S Selph
- Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon.
| | | | - Ngoc Wasson
- Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon
| | | | | | - Erik Ensrud
- Department of Medicine, Oregon Health and Science University, Portland, Oregon
| | - Diane Elliot
- Department of Medicine, Oregon Health and Science University, Portland, Oregon
| | - Kristin M Dissinger
- Department of Medicine, Oregon Health and Science University, Portland, Oregon
| | - Marian McDonagh
- Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon
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Wan G, Hsieh HC, Lin CH, Lin HY, Lin CY, Chiu WH. An Accessible Training Device for Children With Cerebral Palsy. IEEE Trans Neural Syst Rehabil Eng 2021; 29:1252-1258. [PMID: 34166195 DOI: 10.1109/tnsre.2021.3092199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Walking and balance capabilities can be improved upon using repetitive ankle dorsiflexion exercises. Here we developed two types of pedal switches incorporated with training devices to improve their walking and balance performance of children with cerebral palsy. The first type of pedal switch can be used to operate a home appliance, while the second type of pedal switch can connect them to web games. Pedal switches can be used for home rehabilitation. This randomized controlled trial included patients in the intervention (n = 24) and control (n = 24) groups who completed 15 weeks of ankle training. The experimental group performed ankle dorsiflexion using a pressure-activated pedal switch connected to the web games. The control group performed ankle dorsiflexion exercises using a pedal switch that operated a home appliance (a fan). Standing balance and walking performance were estimated using the Zebris FDM system, a pressure force platform, the Pediatric Balance Scale score, and the 1-minute walk test. The pre- and posttest data were analyzed using analysis of variance and analysis of covariance, which revealed that the intervention group had more significant improvements in sway patterns and balance and walking. The developed facility of a modified pedal switch integrated with web games can achieve better exercise adherence to promote balance and walking performance than that with home appliances. Maintaining motivation in children with cerebral palsy plays a very important role in the rehabilitation process.
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Pimentel-Ponce M, Romero-Galisteo RP, Palomo-Carrión R, Pinero-Pinto E, Merchán-Baeza JA, Ruiz-Muñoz M, Oliver-Pece J, González-Sánchez M. Gamification and neurological motor rehabilitation in children and adolescents: A systematic review. Neurologia 2021; 39:S0213-4853(21)00049-9. [PMID: 33867183 DOI: 10.1016/j.nrl.2021.02.011] [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: 09/04/2020] [Revised: 12/30/2020] [Accepted: 02/07/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Gamification consists of the use of games in non-playful contexts. It is widely employed in the motor rehabilitation of neurological diseases, but mainly in adult patients. The objective of this review was to describe the use of gamification in the rehabilitation of children and adolescents with neuromotor impairment. METHODS We performed a systematic review of clinical trials published to date on the MEDLINE (PubMed), Scielo, SCOPUS, Dialnet, CINAHL, and PEDro databases, following the PRISMA protocol. The methodological quality of the studies identified was assessed using the PEDro scale. RESULTS From a total of 469 studies, 10 clinical trials met the inclusion criteria. We analysed the gamification systems used as part of the rehabilitation treatment of different neuromotor conditions in children and adolescents. Cerebral palsy was the most frequently studied condition (6studies), followed by developmental coordination disorder (3), and neurological impairment of balance and coordination (1). CONCLUSION The use of gamification in rehabilitation is helpful in the conventional treatment of neuromotor disorders in children and adolescents, with increased motivation and therapeutic adherence being the benefits with the greatest consensus among authors. While strength, balance, functional status, and coordination also appear to improve, future research should aim to determine an optimal dosage.
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Affiliation(s)
| | - R P Romero-Galisteo
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España.
| | - R Palomo-Carrión
- Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, Facultad de Fisioterapia, Universidad de Castilla la Mancha, Toledo, España
| | - E Pinero-Pinto
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, España
| | - J A Merchán-Baeza
- Grupo de investigación Methodlogy, Methods, Models and Outcomes of Health and Social Sciences (M30), Facultad de Ciencias de la Salud y Bienestar, Universidad de Vic-Universidad Central de Cataluña (UVIC-UCC), Vic, Barcelona, España
| | - M Ruiz-Muñoz
- Departamento de Enfermería y Podología, Facultad de Ciencias de la Salud, Universidad de Málaga. Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España
| | - J Oliver-Pece
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad de Málaga, Málaga, España
| | - M González-Sánchez
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga. Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España
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Warnier N, Lambregts S, Port IVD. Effect of Virtual Reality Therapy on Balance and Walking in Children with Cerebral Palsy: A Systematic Review. Dev Neurorehabil 2020; 23:502-518. [PMID: 31674852 DOI: 10.1080/17518423.2019.1683907] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Aim: To investigate the effect of Virtual Reality Therapy (VRT) on balance and walking in children with cerebral palsy (CP). Method: A systematic search in Pubmed and Embase was performed until the 9th of July 2019. Articles were included if the population consisted of children with CP and data on balance and/or walking were reported. Results were pooled in two meta-analyses. Results: 26 articles were included. For 'balance' 5 and for 'walking' 4 were used for the meta-analyses. The meta-analyses showed a significant result in favor of VRT for balance, SMD 0.89 [95% CI, SD 0.14, 1.63] and for walking, SMD 3.10 [95% Cl, SD 0.78, 5.35]. Interpretation: VRT seems a promising intervention for rehabilitation in children with CP. The meta-analysis confirmed this positive effect. These results must be interpreted with caution due to differences in the interventions used, the lack of randomized-controlled trials, and the relatively small groups.
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Affiliation(s)
- Nadieh Warnier
- Rijndam Revalidatie centrum , Rotterdam, LJ, Netherlands
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The Rehabilitative Effects of Virtual Reality Games on Balance Performance among Children with Cerebral Palsy: A Meta-Analysis of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214161. [PMID: 31661938 PMCID: PMC6861947 DOI: 10.3390/ijerph16214161] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/22/2019] [Accepted: 10/25/2019] [Indexed: 02/02/2023]
Abstract
This research aims to evaluate the effect of virtual reality (VR) games on balance recovery of children with cerebral palsy (CP) by quantitatively synthesizing the existing literature, and to further determine the impact of VR game intervention (the duration of each intervention, intervention frequency, intervention cycle, and total intervention time) on the balance recovery of children with CP. To this end, relevant literature up until 3 August 2019 was retrieved from Chinese databases (CNKI and Wanfang Data) and the databases in other languages (Web of Science, Pubmed, EBSCOhost, Informit, Scopus, Science Direct, and ProQuest), and bias analysis was conducted with the PEDro scale in this research. Randomized controlled trials (RCTs) were selected and underwent meta-analysis, and combined effect size was calculated with a random effects model. The results showed that VR games may improve the balance of children with CP (Hedge’s g = 0.29; 95% CI 0.10–0.48), and no significant influence of the intervention on balance of children with CP was shown in the subgroup analysis. In conclusion, VR games played a positive role in the improvement of balance of children with CP, but these results should be viewed with caution owing to current methodological defects (difference in measurement, heterogeneity of control groups, intervention combined with other treatments, etc.).
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Pin TW. Effectiveness of interactive computer play on balance and postural control for children with cerebral palsy: A systematic review. Gait Posture 2019; 73:126-139. [PMID: 31323621 DOI: 10.1016/j.gaitpost.2019.07.122] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 06/11/2019] [Accepted: 07/01/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Interactive computer play (ICP) becomes popular in rehabilitation for children with cerebral palsy (CP). With the nature of ICP, it could be an effective intervention specifically to improve balance and postural control for children with CP. The present paper aimed to review the effectiveness of ICP on postural control and balance for children with CP. METHODS Electronic databases including Medline, AMED, EBSCOhost, PsycINFO, Embase, the Cochrane Library and the DARE were searched up to September 2018. Studies were included if (1) participants were aged under 18 and had CP, (2) ICP intervention was performed, (3) an explicit objective was postural control and balance of the participants, and (4) results were fully published in English-language peer-reviewed journals. Characteristics of study participants, ICP protocols and study results were extracted. Level of evidence of each studies was graded using the guidelines from the American Academy of Cerebral Palsy and Developmental Medicine. Methodological quality was graded using the Physiotherapy Evidence Database (PEDro) scale. Effect sizes were calculated on available data. RESULTS Twenty studies were included, with nine of level I or II evidence. Most studies had fair methodological rigor. Huge variations in the study designs and protocols of ICP were found among the studies. CONCLUSIONS ICP seemed to be more effective than conventional therapy in improving postural control and balance, with medium to large effect sizes for children with mild to moderate severity of CP. Future studies of high methodological rigour are required to verify the role of on-site guidance of the children during ICP and the effect on children with more severe CP.
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Affiliation(s)
- Tamis W Pin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
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Preliminary Study of the Effect of Training With a Gaming Balance Board on Balance Control in Children With Cerebral Palsy: A Randomized Controlled Trial. Am J Phys Med Rehabil 2019; 99:142-148. [PMID: 31464757 DOI: 10.1097/phm.0000000000001300] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE A new protocol based on the use of a gaming balance board for children with cerebral palsy was tested. DESIGN A total of 56 children with cerebral palsy were enrolled and randomly divided into two groups: experimental and control. The children in experimental group underwent 12 wks of rehabilitation using their foot to play personal computer games with the proposed balance board, whereas those in the control group played personal computer games with a computer mouse in the standing position. Balance control was assessed before and after the intervention using the Zebris FDM System for measuring the center of pressure. The Pediatric Balance Scale and 2-min walk test were used for evaluating functional balance. RESULTS In the analysis of covariance, the proposed new balance board used for the personal computer games decreased the postural sway (sway path, F = 6.95, P = 0.011; sway area, F = 11.79, P = 0.001) and improved the performance of the functional balance tests. CONCLUSIONS This study demonstrated the possibility that this new gaming balance board can be used for balance control in children with cerebral palsy.
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