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Del Lucchese B, Parravicini S, Filogna S, Mangani G, Beani E, Di Lieto MC, Bardoni A, Bertamino M, Papini M, Tacchino C, Fedeli F, Cioni G, Sgandurra G. The wide world of technological telerehabilitation for pediatric neurologic and neurodevelopmental disorders - a systematic review. Front Public Health 2024; 12:1295273. [PMID: 38694988 PMCID: PMC11061864 DOI: 10.3389/fpubh.2024.1295273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/08/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction The use of Information and Communication Technology (ICT) for assessing and treating cognitive and motor disorders is promoting home-based telerehabilitation. This approach involves ongoing monitoring within a motivating context to help patients generalize their skills. It can also reduce healthcare costs and geographic barriers by minimizing hospitalization. This systematic review focuses on investigating key aspects of telerehabilitation protocols for children with neurodevelopmental or neurological disorders, including technology used, outcomes, caregiver involvement, and dosage, to guide clinical practice and future research. Method This systematic review adhered to PRISMA guidelines and was registered in PROSPERO. The PICO framework was followed to define the search strategy for technology-based telerehabilitation interventions targeting the pediatric population (aged 0-18) with neurological or neurodevelopmental disorders. The search encompassed Medline/PubMed, EMBASE, and Web of Science databases. Independent reviewers were responsible for selecting relevant papers and extracting data, while data harmonization and analysis were conducted centrally. Results A heterogeneous and evolving situation emerged from our data. Our findings reported that most of the technologies adopted for telerehabilitation are commercial devices; however, research prototypes and clinical software were also employed with a high potential for personalization and treatment efficacy. The efficacy of these protocols on health or health-related domains was also explored by categorizing the outcome measures according to the International Classification of Functioning, Disability, and Health (ICF). Most studies targeted motor and neuropsychological functions, while only a minority of papers explored language or multi-domain protocols. Finally, although caregivers were rarely the direct target of intervention, their role was diffusely highlighted as a critical element of the home-based rehabilitation setting. Discussion This systematic review offers insights into the integration of technological devices into telerehabilitation programs for pediatric neurologic and neurodevelopmental disorders. It highlights factors contributing to the effectiveness of these interventions and suggests the need for further development, particularly in creating dynamic and multi-domain rehabilitation protocols. Additionally, it emphasizes the importance of promoting home-based and family-centered care, which could involve caregivers more actively in the treatment, potentially leading to improved clinical outcomes for children with neurological or neurodevelopmental conditions. Systematic review registration PROSPERO (CRD42020210663).
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Affiliation(s)
- Benedetta Del Lucchese
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
| | - Stefano Parravicini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Pediatric Neuroscience Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Silvia Filogna
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
| | - Gloria Mangani
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
| | - Elena Beani
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Maria Chiara Di Lieto
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
| | | | - Marta Bertamino
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Marta Papini
- Scientific Institute, IRCCS E. Medea, Lecco, Italy
| | - Chiara Tacchino
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | | | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
| | - Giuseppina Sgandurra
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Petrevska M, Wright FV, Khan A, Munce S, Fehlings D, Biddiss E. Evaluating the impact of movement tracking feedback on engagement with home exercise programmes of children with cerebral palsy using a new therapy app: a protocol for a mixed-methods single-case experimental design with alternating treatments. BMJ Open 2024; 14:e082761. [PMID: 38503423 PMCID: PMC10952875 DOI: 10.1136/bmjopen-2023-082761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/26/2024] [Indexed: 03/21/2024] Open
Abstract
INTRODUCTION Children with cerebral palsy (CP) are prescribed home exercise programmes (HEPs) to increase the frequency of movement practice, yet adherence to HEPs can be low. This paper outlines the protocol for a single-case experimental design (SCED) with alternating treatments, using a new home therapy exercise application, Bootle Boot Camp (BBCamp), offered with and without movement tracking feedback. This study will explore the impact of feedback on engagement, movement quality, lower limb function and family experiences to help understand how technology-supported HEPs should be translated and the added value, if any, of movement tracking technology. METHODS AND ANALYSIS In this explanatory sequential mixed-methods study using a SCED, 16 children with CP (aged 6-12 years, Gross Motor Function Classification System levels I-II) will set lower limb goals and be prescribed an individualised HEP by their physiotherapist to complete using BBCamp on their home television equipped with a three-dimensional camera-computer system. Children will complete four weekly exercise sessions over 6 weeks. Children will be randomised to 1 of 16 alternating treatment schedules where BBCamp will provide or withhold feedback during the first 4 weeks. The version of BBCamp that results in the most therapeutic benefit will be continued for 2 final weeks. Goals will be re-evaluated and families interviewed. The primary outcome is adherence (proportion of prescribed exercise repetitions attempted) as a measure of behavioural engagement. Secondary outcomes are affective and cognitive engagement (smiley face ratings), exercise fidelity, lower limb function, goal achievement and participant experiences. SCED data will be analysed using visual and statistical methods. Quantitative and qualitative data will be integrated using joint displays. ETHICS AND DISSEMINATION Ethical approval was obtained from the Research Ethics Boards at Bloorview Research Institute and the University of Toronto. Results will be distributed through peer-reviewed journals and scientific conferences. TRIAL REGISTRATION NUMBER NCT05998239; pre-results.
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Affiliation(s)
- Marina Petrevska
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - F Virginia Wright
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ajmal Khan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Sarah Munce
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Darcy Fehlings
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Elaine Biddiss
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
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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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Ahn SN. A Scoping Review of the Serious Game-Based Rehabilitation of People with Cerebral Palsy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7006. [PMID: 37947563 PMCID: PMC10648355 DOI: 10.3390/ijerph20217006] [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: 09/26/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/12/2023]
Abstract
In a serious context, individuals with Cerebral Palsy (CP) have limited opportunities to engage in social interaction experiences. Through a review, this study provides an explanation and improved evidence of the methods for rehabilitation in games used in serious contexts for people with CP. Articles published from 2010 to 2022 focusing on serious game-based rehabilitation for people with CP are extracted from MEDILINE, Academic Search Ultimate, CINAHL, and the Web of Science. The articles were assessed based on the McMaster critical review form. This study analyzes the frequencies of goal and assessment tools according to the components using the International Classification of Functioning, Disability and Health (ICF). The evidence of all the studies is presented according to the principles of Population, Intervention, Comparison, Outcome (PICO) to organize the evidence. A total of 19 articles were selected. Five articles involved Randomized Controlled Trials (RCTs), six articles involved non-randomized one-group designs, three articles involved single experimental study designs, and five articles were case report designs. In the selected articles, the average score on the McMaster critical review form was 11.8 points. In the game-based rehabilitation for CP, more articles reported goals and assessment tools focusing on body function than goals and assessment tools focusing on activity and participation, according to the ICF. These findings provide a record of past work and identify the evidence to support the application of game-based rehabilitation for people with CP.
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Affiliation(s)
- Si Nae Ahn
- Department of Occupational Therapy, Cheongju University, Cheongju 28503, Republic of Korea
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Bossavit B, Arnedillo-Sánchez I. Motion-based technology to support motor skills screening in developing children: A scoping review. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 240:107715. [PMID: 37517185 DOI: 10.1016/j.cmpb.2023.107715] [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: 05/20/2022] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Acquiring motor skills is fundamental for children's development since it is linked to cognitive development. However, access to early detection of motor development delays is limited. AIM This review explores the use and potential of motion-based technology (MBT) as a complement to support and increase access to motor screening in developing children. METHODS Six databases were searched following the PRISMA guidelines to search, select, and assess relevant works where MBT recognised the execution of children's motor skills. RESULTS 164 studies were analysed to understand the type of MBT used, the motor skills detected, the purpose of using MBT and the age group targeted. CONCLUSIONS There is a gap in the literature aiming to integrate MBT in motor skills development screening and assessment processes. Depth sensors are the prevailing technology offering the largest detection range for children from age 2. Nonetheless, the motor skills detected by MBT represent about half of the motor skills usually observed to screen and assess motor development. Overall, research in this field is underexplored. The use of multimodal approaches, combining various motion-based sensors, may support professionals in the health domain and increase access to early detection programmes.
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Affiliation(s)
- Benoit Bossavit
- School of Computer Science & Statistics, Trinity College Dublin, Ireland; School of Computer Science & Programming Languages, Universidad de Málaga, Spain.
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Choi JY, Yi SH, Shim D, Yoo B, Park ES, Rha DW. Home-based virtual reality-enhanced upper limb training system in children with brain injury: a randomized controlled trial. Front Pediatr 2023; 11:1131573. [PMID: 37274815 PMCID: PMC10233002 DOI: 10.3389/fped.2023.1131573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 04/26/2023] [Indexed: 06/07/2023] Open
Abstract
Background Rehabilitation of upper limb function can be challenging in children with brain lesion. Recent virtual reality (VR) rehabilitation may be an additional treatment option in pediatric rehabilitation. Objectives To assess the feasibility and effectiveness of a home-based VR-enhanced rehabilitation program with wearable multi-inertial measurement unit (IMU) sensors on upper limb functions in children with brain injury. Methods This multicenter single blind randomized controlled trial included 40 children with cerebral palsy (CP) or static brain injury. Subjects were randomized 1:1 to experimental and control group. Both the groups maintained the same therapeutic content and dose of occupational therapy during the intervention period. The experimental group performed additional training at home using the VR-enhanced program for at least 30 min/day, 5 days/week, for 6 weeks. VR training consisted of daily activities or games promoting wrist and forearm articular movements using wearable IMU sensors. The Melbourne Assessment of Unilateral Upper Limb Function-version 2 (MA2), Upper Limb Physician's Rating Scale (ULPRS), Pediatric Evaluation of Disability Inventory-computer adaptive test (PEDI-CAT), computerized 3D motion analysis, and user satisfaction survey were performed. Mann-Whitney U test was used to compare treatment effects between groups, and Friedman and Wilcoxon signed-rank tests were used to compare pre and post intervention. Results Overall 35 children (15 in VR group and 20 in control group) completed the protocol. In the experimental group, an average VR training time was 855 min. The accuracy of motion measured by MA2, segmental movements by ULPRS, daily living capability and social cognitive function by PEDI-CAT, movement time and shoulder movement pattern by motion analysis showed significant improvements. However, there were no significant differences in any of the functional outcome measures compared to the control group. All the children and parents reported positive experiences. Conclusions Home-based VR training though it had limited impact on improving upper limb function, it could help improve social cognitive function, movement pattern, and efficiency in children with brain injury and could be an effective means of extending clinical therapy to the home. Clinical Trial Registration CRIS.nih.go.kr: identifier KCT0003172.
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Affiliation(s)
- Ja Young Choi
- Department of Physical and Rehabilitation Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Sook-hee Yi
- Department of Physical and Rehabilitation Medicine, Seoul Rehabilitation Hospital, Seoul, Republic of Korea
| | - Dain Shim
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Beomki Yoo
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Sook Park
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong-wook Rha
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Demeke ZD, Assefa YA, Abich Y, Chala MB. Home-based therapy and its determinants for children with cerebral palsy, exploration of parents' and physiotherapists' perspective, a qualitative study, Ethiopia. PLoS One 2023; 18:e0282328. [PMID: 36848380 PMCID: PMC9970053 DOI: 10.1371/journal.pone.0282328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 02/14/2023] [Indexed: 03/01/2023] Open
Abstract
OBJECTIVE This study aimed to explore the perceptions of parents and physiotherapists regarding home-based therapy programs for children with cerebral palsy and to understand the factors affecting adherence to home-based therapy programs. MATERIALS AND METHOD Thematic analysis method was used to identify, analyse and report findings. Twelve physiotherapists and five caregivers were purposively sampled and interviewed. RESULTS All transcripts were coded line by line, and the codes were then organized into categories for the development of descriptive themes and the generation of analytical themes. The data analysis followed the steps of the thematic analysis process. Seven themes emerged during the analysis: Why Home-Based Therapy? Ways of Teaching, Types of the therapy, Strategies of assessing adherence, Environmental factors, Attitude and knowledge; and Family participation. Physiotherapists use home-based therapy to prevent complications and improve functioning. They use various ways of teaching, such as explaining, demonstrating, and using pictures and videos. Physiotherapists consider several factors such as severity, age, and availability of resources before they decide the type of home therapy programs. However, parent's participation was low; and strategies to monitor and evaluate adherence were also low. Low family support, limited recourse, lack of knowledge and poor attitude negatively affected adherence to home-based therapy. CONCLUSIONS Our finding revealed that physiotherapists use quite limited methods of teaching, and do not properly monitor adherence of the home-based therapy. Additionally, family participation to select type of therapy and to set goal were low.
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Affiliation(s)
| | - Yohannes Awoke Assefa
- Occupational Therapy department, School of Medicine, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Yohannes Abich
- Physiotherapy Department, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Mulgeta Bayisa Chala
- Postdoctoral (OHT Impact) Fellow, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Ogourtsova T, Boychuck Z, O'Donnell M, Ahmed S, Osman G, Majnemer A. Telerehabilitation for Children and Youth with Developmental Disabilities and Their Families: A Systematic Review. Phys Occup Ther Pediatr 2023; 43:129-175. [PMID: 36042567 DOI: 10.1080/01942638.2022.2106468] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AIM To determine the level of evidence for the effectiveness of telerehabilitation against comparison interventions in improving child- and parent-related outcomes in children and youth with developmental disabilities. METHOD A systematic approach, comprised of a comprehensive search; transparent study selection, data extraction, quality assessment by independent reviewers; and synthesis of sufficiently similar data (per diagnostic group, health profession, and overall level of evidence for each outcome) was undertaken. RESULTS Fifty-five studies (29 randomized trials) were included across six diagnostic groups and ten health professions. Common telerehabilitation targets varied across diagnostic groups and included motor function, behavior, language, and parental self-efficacy. Telerehabilitation was found to be either more effective or as effective versus comparison intervention in improving 46.9% or 53.1% of outcomes, respectively. It was never found to be detrimental or less effective. Strong to moderate, limited, and insufficient levels of evidence were found for 36.5%, 24.5%, and 38.6% of the outcomes, respectively. CONCLUSION There is sufficient evidence suggesting that telerehabilitation is a promising alternative when face-to-face care is limited. It is comparable to usual care and is more effective than no treatment. Blending in-person and telerehabilitation approaches could be beneficial for the post-pandemic future of rehabilitation in pediatric care.
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Affiliation(s)
- Tatiana Ogourtsova
- Research Center of the Jewish Rehabilitation Hospital, CISSS (Center Intégré de Santé et de Services Sociaux) Laval, Site of CRIR, Quebec, Canada.,Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
| | - Zachary Boychuck
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, Canada.,CanChild Center for Childhood Disability Research and Department of Pediatrics, McMaster University, Ontario, Canada
| | - Maureen O'Donnell
- Provincial Health Services Authority BC, Vancouver, Canada.,Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Sara Ahmed
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada.,Center for Outcome Research and Evaluation (CORE), Research Institute of the McGill University Health Center, Montreal, Canada
| | - Galil Osman
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Annette Majnemer
- Research Center of the Jewish Rehabilitation Hospital, CISSS (Center Intégré de Santé et de Services Sociaux) Laval, Site of CRIR, Quebec, Canada.,Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, Canada.,Center for Outcome Research and Evaluation (CORE), Research Institute of the McGill University Health Center, Montreal, Canada
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Ochandorena-Acha M, Terradas-Monllor M, Nunes Cabrera TF, Torrabias Rodas M, Grau S. Effectiveness of virtual reality on functional mobility during treadmill training in children with cerebral palsy: a single-blind, two-arm parallel group randomised clinical trial (VirtWalkCP Project). BMJ Open 2022; 12:e061988. [PMID: 36328390 PMCID: PMC9639079 DOI: 10.1136/bmjopen-2022-061988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Treadmill training and virtual reality have been investigated in children with cerebral palsy. However, few studies have assessed the effectiveness of the combination of both treatments on children's functional and balance activities. The project aims to compare the effects of treadmill training with and without virtual reality on walking endurance and speed, static and dynamic balance, gross motor function, functional independence, quality of life and occupational participation in children with spastic cerebral palsy between the ages of 4 and 12 years classified at levels I, II and III of the Gross Motor Function Classification System. METHODS AND ANALYSIS This study is a single-blind, two-arm parallel group, randomised, controlled clinical trial. Participants will be recruited at the Pediatric Department of the Vic Hospital Consortium, and the research will be conducted at the University of Vic - Central University of Catalonia. The participants will be randomly allocated into two groups: (1) the experimental group, which will receive the treadmill training at the same time as the virtual reality; and (2) the control group, which will undertake treadmill gait training alone. The training will be provided in 10 sessions over 2 weeks with 30 min for each session. Assessments will be performed on three occasions: 1 week before the intervention, 1 week following the intervention and 1 month after the end of the intervention. The evaluations will involve the 6 min walk test, stabilometry, the Berg Balance Scale, the 10 m walk test, the Gross Motor Function Measure, the Functional Independence Measure, the paediatric quality of life inventory and the Children Participation Questionnaire. For between-within group comparison, a mixed-effect linear model will be used. ETHICS AND DISSEMINATION The study has been approved by the Clinical Research Ethics Committee of the Osona Foundation for Health Research and Education (2021061). Results will be published in peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER NCT05131724.
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Affiliation(s)
- Mirari Ochandorena-Acha
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC), C.Sagrada Família, 7, 08500 Vic, Spain
- Neurology department, Sant Joan de Deu Barcelona Children's Hospital, Barcelona, Catalonia, Spain
| | - Marc Terradas-Monllor
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC), C.Sagrada Família, 7, 08500 Vic, Spain
- Pain Medicine Section, Anesthesiology Department, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
| | - Tania Fabiola Nunes Cabrera
- Neurology department, Sant Joan de Deu Barcelona Children's Hospital, Barcelona, Catalonia, Spain
- Pediatric Department, Consorci Hospitalari de Vic, Vic, Catalunya, Spain
| | | | - Sergi Grau
- Faculty of Science and Technology, University of Vic - Central University of Catalonia, Vic, Spain
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Blasco M, García-Galant M, Berenguer-González A, Caldú X, Arqué M, Laporta-Hoyos O, Ballester-Plané J, Miralbell J, Jurado MÁ, Roser Pueyo. Interventions with an Impact on Cognitive Functions in Cerebral Palsy: a Systematic Review. Neuropsychol Rev 2022; 33:551-577. [PMID: 35972712 DOI: 10.1007/s11065-022-09550-7] [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: 09/03/2021] [Accepted: 06/18/2022] [Indexed: 10/15/2022]
Abstract
This systematic review aimed at investigating those interventions that impact on cognitive functioning in children and adults with cerebral palsy (CP). A systematic database search was conducted and twenty-eight studies suitable for inclusion were identified, of which only nine were randomized controlled trials (RCTs). Among all the studies included, ten were multi-modal (cognitive and physical tasks), eleven physical, five cognitive, and two alternative and augmentative communication interventions. The evidence suggests that multi-modal and physical interventions improve general cognitive functioning. Multi-modal and cognitive interventions have an impact on visual perception. Both interventions, together with physical interventions have an effect on a specific executive function domain (inhibitory control), and only cognitive interventions improved other executive function domains such as working memory. However, no RCT assessed the effects of all executive function domains. Few studies have looked at interventions to improve memory and language, and there is a scarcity of long-term research. Future RCTs must be of higher quality and better account for age and sex differences, as well as the clinical heterogeneity of CP. To date, there is evidence that multi-modal, cognitive or physical interventions have an impact on general cognitive functioning, visual perception and executive functions in children with CP, which may support their cognitive development.The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO): CRD42020152616.
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Affiliation(s)
- Montse Blasco
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - María García-Galant
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Alba Berenguer-González
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Xavier Caldú
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Miquel Arqué
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Olga Laporta-Hoyos
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Júlia Ballester-Plané
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Júlia Miralbell
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - María Ángeles Jurado
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Roser Pueyo
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain. .,Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain. .,Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain.
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11
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Cristinziano M, Assenza C, Antenore C, Pellicciari L, Foti C, Morelli D. Telerehabilitation during COVID-19 lockdown and gross motor function in cerebral palsy: an observational study. Eur J Phys Rehabil Med 2022; 58:592-597. [PMID: 34913329 PMCID: PMC9980529 DOI: 10.23736/s1973-9087.21.07132-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND COVID-19 (Coronavirus disease 2019) refers to a mainly respiratory disease, caused by a new SARS-CoV-2 virus predominantly transmitted through direct or indirect contact with mucous membranes of eyes, mouth, or nose. The main control measures are physical distancing, use of specific protective devices, hand hygiene and disinfection of environments and tools. During this health emergency, telemedicine and telerehabilitation guaranteed patients to receive continuity of care through a virtual support while maintaining physical distance. AIM The aim of this study was to evaluate the effects of telerehabilitation on gross motor skills in children with cerebral palsy (CP) during COVID-19 lockdown. DESIGN This is an observational study. SETTING Pediatric Outpatient Neurorehabilitation Service. POPULATION Fifty-three children with cerebral palsy aged between 6 months and 12 years classified according to the Gross Motor Function Classification System (GMFCS). METHODS Variation on the Gross Motor Function Measure-66 (GMFM-66) Score calculated before and after the telerehabilitation period was analyzed. RESULTS After telerehabilitation there was a statistically significant increase in the median value of GMFM scores both on the total sample (from 54.82% to 63.18%, P=0.000005) and in the subgroups. Specifically, in children classified as level I and II at the GMFCS, this value increased more after the telerehabilitation period. Only the GMFCS level V group did not show statistically significant changes and only in two cases a decrease in the GMFM Score after the telerehabilitation phase occurred. CONCLUSIONS Telerehabilitation can be considered an efficient tool that can temporarily replace the in-person therapy. It can allow the patient or caregiver to acquire skills in performing home exercises and to integrate and implement activity carried out at the Rehabilitation Center. CLINICAL REHABILITATION IMPACT This study shows a positive effect of telerehabilitation on gross motor function in children with cerebral palsy.
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Affiliation(s)
- Martina Cristinziano
- Unit of Physical and Rehabilitation Medicine, Tor Vergata University, Rome, Italy -
| | - Carla Assenza
- Department of Pediatric Neurorehabilitation, Scientific Institute for Research and Health Care Santa Lucia Foundation, Rome, Italy
| | - Clementina Antenore
- Department of Pediatric Neurorehabilitation, Scientific Institute for Research and Health Care Santa Lucia Foundation, Rome, Italy
| | | | - Calogero Foti
- Unit of Physical and Rehabilitation Medicine, Tor Vergata University, Rome, Italy
| | - Daniela Morelli
- Department of Pediatric Neurorehabilitation, Scientific Institute for Research and Health Care Santa Lucia Foundation, Rome, Italy
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12
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Efficacy of Rehabilitation Therapy and Pharmacotherapy on Children with Cerebral Palsy: A Meta-Analysis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:6465060. [PMID: 35855834 PMCID: PMC9288332 DOI: 10.1155/2022/6465060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022]
Abstract
Background. Cerebral palsy (CP) has a serious impact on children’s multiple motor functions and life behavior. Rehabilitation therapy or pharmacotherapy alone has been proven to have a good effect on patients’ strength and gait. However, the efficacy of rehabilitation combined with pharmacotherapy for CP in children needs to be further explored. This study is aimed at assessing the effectiveness of this combined method on life function and social behavior in children with CP. Methods. PubMed, China National Knowledge Infrastructure, WanFang Data, EMBASE, and Web of Science databases were searched for all kinds of literature related to the treatment of pediatric CP published between 2000 and 2021. Basic information and experimental data from the literature were screened and extracted, and a meta-analysis was performed using Stata 16. Results. A total of 605 studies were retrieved, and finally, 10 studies involving 805 pediatric patients were included in the analysis. The analysis results showed that rehabilitation combined with pharmacotherapy could improve the treatment effective rate in children with CP compared with the control group using either alone (
, 95% CI (1.102, 1.273),
). In addition, in terms of social behavior, the combined therapy could significantly improve activities of daily living (
, 95% CI (1.66, 4.22),
), motor ability (
, 95% CI (0.75, 2.96),
), adaptability behavior (
, 95% CI (0.45, 5.18),
), language behavior (
, 95% CI (0.95, 5.22),
), social behavior (
, 95% CI (2.22, 5.35),
), and fine motor behavior (
, 95% CI (1.17, 5.86),
). Conclusion. The current study shows that rehabilitation combined with pharmacotherapy can effectively improve the recovery, quality of life, and social behavior of children with CP.
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13
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Beckers L, Smeets R, de Mooij M, Piškur B, van der Burg J, Rameckers E, Aarts P, Author Group C, Janssen-Potten Y. Process Evaluation of Home-based Bimanual Training in Children with Unilateral Cerebral Palsy (The COAD-study): A Mixed Methods Study. Dev Neurorehabil 2022; 25:246-262. [PMID: 34955082 DOI: 10.1080/17518423.2021.2011459] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To evaluate the processes and factors that influenced implementation and impact of a home-based bimanual training program in children with unilateral cerebral palsy aged 2 through 7 years. METHODS The program encompassed bimanual task-specific training (3.5 hours/week for 12 weeks) adopting either implicit or explicit motor learning. A therapist and remedial educationalist coached parents. This mixed methods study included course attendance monitoring, questionnaires, registration form, video analysis, interviews, focus group discussion, and drop-out monitoring. RESULTS Fourteen families participated. The program was not fully implemented as intended. Parents positively experienced the training and were well able to provide it. The program was demanding for the children and time-consuming for parents. Several components positively contributed to the program: task-analysis, instructional videos, and coaching by a therapist and remedial educationalist. Several modifications to the program were proposed. CONCLUSION Home-based bimanual training forms a demanding but promising therapeutic approach with potential for optimization.
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Affiliation(s)
- Lwme Beckers
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University Maastricht, The Netherlands.,Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
| | - Rjem Smeets
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University Maastricht, The Netherlands.,CIR Revalidatie, Location Eindhoven, The Netherlands
| | - Mac de Mooij
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University Maastricht, The Netherlands
| | - B Piškur
- Research Centre for Autonomy and Participation for People with Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Jjw van der Burg
- Department of Pediatric Rehabilitation, Sint Maartenskliniek, Nijmegen, The Netherlands.,School of Pedagogical and Educational Sciences, Radboud University, Nijmegen, The Netherlands
| | - Eaa Rameckers
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University Maastricht, The Netherlands.,Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands.,Rehabilitation Science, University of Hasselt, Hasselt, Belgium
| | - Pbm Aarts
- Department of Pediatric Rehabilitation, Sint Maartenskliniek, Nijmegen, The Netherlands
| | | | - Yjm Janssen-Potten
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University Maastricht, The Netherlands.,Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
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14
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Liu W, Hu Y, Li J, Chang J. Effect of Virtual Reality on Balance Function in Children With Cerebral Palsy: A Systematic Review and Meta-analysis. Front Public Health 2022; 10:865474. [PMID: 35548088 PMCID: PMC9081327 DOI: 10.3389/fpubh.2022.865474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/28/2022] [Indexed: 12/12/2022] Open
Abstract
Virtual Reality (VR) therapy is popular in treating children with Cerebral Palsy (CP) as a new technology for rehabilitation. Nevertheless, no substantial evidence supporting VR therapy promotion has been developed to date. This study aimed to investigate the effects of VR therapy on balance in children with CP. We conducted a systematic search in PubMed and Web of Science (updated to December 30, 2021). The systematic review and meta-analysis included all randomized controlled trials that included children with CP. A total of 18 RCT studies were eligible for inclusion in the systematic review, and meta-analysis was performed on 16 of them. Results showed that the VR intervention was beneficial for balance (SMD 0.47 [95% CI, SD 0.28, 0.66]). We concluded that VR therapy interventions for children with CP have positive effects. However, cautious implementation is needed in clinical applications.
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Affiliation(s)
- Wei Liu
- School of Physical Education, Xuzhou Kindergarten Teachers College, Xuzhou, China
- Institute of Motor Quotient, Southwest University, Chongqing, China
| | - Yuanyan Hu
- School of Mathematics and Statistics, Yunlin Normal University, Yunlin, China
| | - Junfeng Li
- Ministry of Sports, Shandong Technology and Business University, Yantai, China
- *Correspondence: Junfeng Li
| | - Jindong Chang
- Institute of Motor Quotient, Southwest University, Chongqing, China
- Jindong Chang
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15
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Dontha B, Swearingen K, Swearingen S, Thrane SE, Kiourti A. Wearable Sensors Based on Force-Sensitive Resistors for Touch-Based Collaborative Digital Gaming. SENSORS 2022; 22:s22010342. [PMID: 35009884 PMCID: PMC8749883 DOI: 10.3390/s22010342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 02/04/2023]
Abstract
We report new classes of wearable sensors that monitor touch between fully-abled and disabled players in order to empower collaborative digital gaming between the two. Our approach relies on embroidered force-sensitive resistors (FSRs) embedded into armbands, which outperform the state-of-the-art in terms of sensitivity to low applied forces (0 to 5 N). Such low forces are of key significance to this application, given the diverse physical abilities of the players. With a focus on effective gameplay, we further explore the sensor’s touch-detection performance, study the effect of the armband fabric selection, and optimize the sensor’s placement upon the arm. Our results: (a) demonstrate a 4.4-times improvement in sensitivity to low forces compared to the most sensitive embroidered FSR reported to date, (b) confirm the sensor’s ability to empower touch-based collaborative digital gaming for individuals with diverse physical abilities, and (c) provide parametric studies for the future development of diverse sensing solutions and game applications.
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Affiliation(s)
- Balaji Dontha
- Department of Electrical and Computer Engineering, The Ohio State University, Columbus, OH 43210, USA;
- Correspondence:
| | - Kyoung Swearingen
- Department of Design, The Ohio State University, Columbus, OH 43210, USA; (K.S.); (S.S.)
| | - Scott Swearingen
- Department of Design, The Ohio State University, Columbus, OH 43210, USA; (K.S.); (S.S.)
| | - Susan E. Thrane
- College of Nursing, The Ohio State University, Columbus, OH 43210, USA;
| | - Asimina Kiourti
- Department of Electrical and Computer Engineering, The Ohio State University, Columbus, OH 43210, USA;
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16
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Schlichting T, Martins da Silva K, Silva Moreira R, Marques de Moraes MV, Cicuto Ferreira Rocha NA, Boyd RN, Neves Dos Santos A. Telehealth Program for Infants at Risk of Cerebral Palsy during the Covid-19 Pandemic: A Pre-post Feasibility Experimental Study. Phys Occup Ther Pediatr 2022; 42:490-509. [PMID: 35341469 DOI: 10.1080/01942638.2022.2057209] [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: 10/18/2022]
Abstract
Aim: To verify the effects of a telerehabilitation program for infants at high risk for Cerebral Palsy (CP) during the COVID-19 pandemic.Method: Longitudinal study. Infants were aged 3-18 months corrected age, at risk of developmental delay. The General Movement Assessment or a neurologic examination were performed to identify the risk of CP. Motor function was assessed using the Gross Motor Function Measure-88 (GMFM-88) and the Alberta Infant Motor Scale (AIMS). Caregivers of infants at high risk of CP applied a home-based program supervised by a Physical therapist, five times a week over 12 weeks. The program included guidance for optimal positioning, optimization of goal-directed activities, environmental enrichment, and educational strategies.Results: 100 infants at risk for delayed motor development were recruited. Eighteen infants were classified at high risk of CP, and 10 families completed telerehabilitation (83% final retention rate). No adverse events were reported. Adherence to the telecare program was high (90%). The costs were low. We found increased scores for all dimensions and the total score of the GMFM-88, and the AIMS percentile at the end of the intervention. Most infants presented a clinically significant change for the GMFM-88.Conclusions: The telecare program was feasible.
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Affiliation(s)
- Tatiane Schlichting
- Department of Health Science, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Kaitiana Martins da Silva
- Interdisciplinary Post-Graduation Program in Health Sciences, Federal University of São Paulo, Santos, São Paulo, Brazil
| | - Rafaela Silva Moreira
- Department of Health Science, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | | | | | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Adriana Neves Dos Santos
- Department of Health Science, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
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17
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Willerslev-Olsen M, Lorentzen J, Røhder K, Ritterband-Rosenbaum A, Justiniano M, Guzzetta A, Lando AV, Jensen AMB, Greisen G, Ejlersen S, Pedersen LZ, Andersen B, Lipthay Behrend P, Nielsen JB. COpenhagen Neuroplastic TRaining Against Contractures in Toddlers (CONTRACT): protocol of an open-label randomised clinical trial with blinded assessment for prevention of contractures in infants with high risk of cerebral palsy. BMJ Open 2021; 11:e044674. [PMID: 34230015 PMCID: PMC8261878 DOI: 10.1136/bmjopen-2020-044674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Contractures are frequent causes of reduced mobility in children with cerebral palsy (CP) already at the age of 2-3 years. Reduced muscle use and muscle growth have been suggested as key factors in the development of contractures, suggesting that effective early prevention may have to involve stimuli that can facilitate muscle growth before the age of 1 year. The present study protocol was developed to assess the effectiveness of an early multicomponent intervention, CONTRACT, involving family-oriented and supervised home-based training, diet and electrical muscle stimulation directed at facilitating muscle growth and thus reduce the risk of contractures in children at high risk of CP compared with standard care. METHODS AND ANALYSIS A two-group, parallel, open-label randomised clinical trial with blinded assessment (n=50) will be conducted. Infants diagnosed with CP or designated at high risk of CP based on abnormal neuroimaging or absent fidgety movement determined as part of General Movement Assessment, age 9-17 weeks corrected age (CA) will be recruited. A balanced 1:1 randomisation will be made by a computer. The intervention will last for 6 months aiming to support parents in providing daily individualised, goal-directed activities and primarily in lower legs that may stimulate their child to move more and increase muscle growth. Guidance and education of the parents regarding the nutritional benefits of docosahexaenic acid (DHA) and vitamin D for the developing brain and muscle growth will be provided. Infants will receive DHA drops as nutritional supplements and neuromuscular stimulation to facilitate muscle growth. The control group will receive standard care as offered by their local hospital or community. Outcome measures will be taken at 9, 12, 18, 24, 36 and 48 months CA. Primary and secondary outcome measure will be lower leg muscle volume and stiffness of the triceps surae musculotendinous unit together with infant motor profile, respectively. ETHICS AND DISSEMINATION Full approval from the local ethics committee, Danish Committee System on Health Research Ethics, Region H (H-19041562). Experimental procedures conform with the Declaration of Helsinki. TRIAL REGISTRATION NUMBER NCT04250454. EXPECTED RECRUITMENT PERIOD 1 January 2021-1 January 2025.
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Affiliation(s)
- Maria Willerslev-Olsen
- Department of Neuroscience, University of Copenhagen Faculty of Health Sciences, Copenhagen, Denmark
- Department of Research, Elsass Fonden, Charlottenlund, Denmark
| | - Jakob Lorentzen
- Department of Neuroscience, University of Copenhagen Faculty of Health Sciences, Copenhagen, Denmark
| | - Katrine Røhder
- Department of Psychology, Unversity of Copenhagen, Copenhagen, Denmark
| | - Anina Ritterband-Rosenbaum
- Department of Neuroscience, University of Copenhagen Faculty of Health Sciences, Copenhagen, Denmark
- Elsass Foundation, Charlottenlund, Denmark
| | - Mikkel Justiniano
- Department of Neuroscience, University of Copenhagen Faculty of Health Sciences, Copenhagen, Denmark
- Elsass Foundation, Charlottenlund, Denmark
| | - Andrea Guzzetta
- Department of Neurology, Stella Maris Institute, Pisa, Italy
| | | | | | - Gorm Greisen
- Neonatatal Department, Rigshospitalet, Kobenhavn, Denmark
| | - Sofie Ejlersen
- Department of Research, Elsass Fonden, Charlottenlund, Denmark
| | | | - Britta Andersen
- Department of Research, Elsass Fonden, Charlottenlund, Denmark
| | | | - Jens Bo Nielsen
- Department of Neuroscience, University of Copenhagen Faculty of Health Sciences, Copenhagen, Denmark
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18
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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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19
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Beckers LWME, Geijen MME, Kleijnen J, A A Rameckers E, L A P Schnackers M, J E M Smeets R, Janssen-Potten YJM. Feasibility and effectiveness of home-based therapy programmes for children with cerebral palsy: a systematic review. BMJ Open 2020; 10:e035454. [PMID: 33028544 PMCID: PMC7539606 DOI: 10.1136/bmjopen-2019-035454] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE To assess the feasibility and effectiveness of home-based occupational therapy and physiotherapy programmes in children with cerebral palsy (CP), focusing on the upper extremity and reporting on child-related and/or parent-related outcomes. DESIGN Systematic review. DATA SOURCES Electronic searches were performed in MEDLINE, EMBASE, CINAHL, PsycINFO, OTseeker and PEDro, and in ICTRP and CENTRAL trial registers, from inception to 6 June 2019. ELIGIBLE CRITERIA The review included all types of original studies concerning feasibility or effectiveness of home-based therapy in children aged <18 years with any type of CP. No language, publication status or publication date restrictions were applied. DATA EXTRACTION AND SYNTHESIS Study and intervention characteristics and the demographics of participating children and their parents were extracted. Feasibility was assessed by outcomes related to acceptability, demand, implementation, practicality, adaptation, expansion or integration. Regarding effectiveness, child-related outcome measures related to any level of the International Classification of Functioning, Disability and Health, or parent-related outcomes were investigated. Two authors independently extracted the data. Risk of bias was assessed using the Downs and Black checklist and the Joanna Briggs Institute Critical Appraisal Checklist. RESULTS The search resulted in a total of 92 records: 61 studies and 31 conference abstracts. Feasibility studies reported mainly on acceptability and implementation. Overall compliance to home-based training programmes (implementation) was moderate to high, ranging from 56% to 99%. In the effectiveness studies, >40 different child-related outcome measures were found. Overall, an improvement in arm-hand performance within group across time was shown. Only two studies reported on a parent-related outcome measure. No increase in parental stress was found during the intervention. CONCLUSIONS Based on the results of the included studies, home-based training programmes seem to be feasible. However, conclusions about the effectiveness of home programmes cannot be made due to the large variability in the study, patient and intervention characteristics, comparators, and outcome measures used in the included studies. PROSPERO REGISTRATION NUMBER CRD42016043743.
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Affiliation(s)
- Laura W M E Beckers
- Department of Rehabilitation Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, Limburg, The Netherlands
- Centre of Expertise in Rehabilitation and Audiology, Adelante, Hoensbroek, Limburg, The Netherlands
| | - Mellanie M E Geijen
- Department of Rehabilitation Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, Limburg, The Netherlands
| | | | - Eugene A A Rameckers
- Department of Rehabilitation Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, Limburg, The Netherlands
- Centre of Expertise in Rehabilitation and Audiology, Adelante, Hoensbroek, Limburg, The Netherlands
- University for Professionals for Pediatric Physical Therapy, AVANSpluc, Breda, The Netherlands
- Faculty of Rehabilitation Science, Pediatric Rehabilitation, Hasselt University, Hasselt, Belgium
| | - Marlous L A P Schnackers
- Behavioral Science Institute, Radboud Universiteit, Nijmegen, Gelderland, The Netherlands
- Department of Rehabilitation, Donders Centre for Brain, Cognition, and Behavior, Radboud University Medical Centre, Nijmegen, Gelderland, The Netherlands
| | - Rob J E M Smeets
- Department of Rehabilitation Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, Limburg, The Netherlands
- CIR revalidatie, Eindhoven, Brabant, The Netherlands
| | - Yvonne J M Janssen-Potten
- Department of Rehabilitation Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, Limburg, The Netherlands
- Centre of Expertise in Rehabilitation and Audiology, Adelante, Hoensbroek, Limburg, The Netherlands
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20
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MacIntosh A, Desailly E, Vignais N, Vigneron V, Biddiss E. A biofeedback-enhanced therapeutic exercise video game intervention for young people with cerebral palsy: A randomized single-case experimental design feasibility study. PLoS One 2020; 15:e0234767. [PMID: 32569284 PMCID: PMC7307764 DOI: 10.1371/journal.pone.0234767] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 06/01/2020] [Indexed: 11/18/2022] Open
Abstract
Importance/Background Movement-controlled video games have potential to promote home-based practice of therapy activities. The success of therapy gaming interventions depends on the quality of the technology used and the presence of effective support structures. Aim This study assesses the feasibility of a novel intervention that combines a co-created gaming technology integrating evidence-based biofeedback and solution-focused coaching (SFC) strategies to support therapy engagement and efficacy at home. Methods Following feasibility and single-case reporting standards (CONSORT and SCRIBE), this was a non-blind, randomized, multiple-baseline, AB, design. Nineteen (19) young people with cerebral palsy (8–18 years old) completed the 4-week home-based intervention in France and Canada. Participant motivations, personalized practice goals, and relevance of the intervention to daily activities were discussed in a Solution Focused Coaching-style conversation pre-, post-intervention and during weekly check-ins. Participants controlled a video game by completing therapeutic gestures (wrist extension, pinching) detected via electromyography and inertial sensors on the forearm (Myo Armband and custom software). Process feasibility success criteria for recruitment response, completion and adherence rates, and frequency of technical issues were established a priori. Scientific feasibility, effect size estimates and variance were determined for Body Function outcome measures: active wrist extension, grip strength and Box and Blocks Test; and for Activities and Participation measures: Assisting Hand Assessment (AHA), Canadian Occupational Performance Measure (COPM) and Self-Reported Experiences of Activity Settings (SEAS). Results Recruitment response (31%) and assessment completion (84%) rates were good and 74% of participants reached self-identified practice goals. As 17% of technical issues required external support to resolve, the intervention was graded as feasible with modifications. No adverse events were reported. Moderate effects were observed in Body Function measures (active wrist extension: SMD = 1.82, 95%CI = 0.85–2.78; Grip Strength: SMD = 0.63, 95%CI = 0.65–1.91; Box and Blocks: Hedge’s g = 0.58, 95%CI = -0.11–1.27) and small-moderate effects in Activities and Participation measures (AHA: Hedge’s g = 0.29, 95%CI = -0.39–0.97, COPM: r = 0.60, 95%CI = 0.13–0.82, SEAS: r = 0.24, 95%CI = -0.25–0.61). Conclusion A definitive RCT to investigate the effectiveness of this novel intervention is warranted. Combining SFC-style coaching with high-quality biofeedback may positively engage youth in home rehabilitation to complement traditional therapy. Trial registration ClinicalTrials.gov, U.S. National Library of Medicine: NCT03677193.
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Affiliation(s)
- Alexander MacIntosh
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada.,Complexité, Innovation, Activités Motrices et Sportives, Sciences du Sport, de la Motricité et du Mouvement Humain, Université Paris-Saclay, Orsay, France
| | - Eric Desailly
- Recherche et innovation, Fondation Ellen Poidatz, Saint Fargeau-Ponthierry, France
| | - Nicolas Vignais
- Complexité, Innovation, Activités Motrices et Sportives, Sciences du Sport, de la Motricité et du Mouvement Humain, Université Paris-Saclay, Orsay, France.,Complexité, Innovation, Activités Motrices et Sportives, Université d'Orléans, Orléans, France
| | - Vincent Vigneron
- Informatique, Bio-informatique et Systèmes Complexes, l'Université d'Evry Val-d'Essonne, Evry, France
| | - Elaine Biddiss
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
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21
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García-Galant M, Blasco M, Reid L, Pannek K, Leiva D, Laporta-Hoyos O, Ballester-Plané J, Miralbell J, Caldú X, Alonso X, Toro-Tamargo E, Meléndez-Plumed M, Gimeno F, Coronas M, Soro-Camats E, Boyd R, Pueyo R. Study protocol of a randomized controlled trial of home-based computerized executive function training for children with cerebral palsy. BMC Pediatr 2020; 20:9. [PMID: 31910803 PMCID: PMC6945450 DOI: 10.1186/s12887-019-1904-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 12/24/2019] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Cerebral palsy (CP) is frequently associated with specific cognitive impairments, such as executive dysfunction which are related to participation and quality of life (QOL). The proposed study will examine whether a computerized executive function (EF) training programme could provide superior benefits for executive functioning, participation, QOL and brain plasticity, as compared to usual care. METHODS A single-blind randomized controlled trial (RCT) design will be performed. Thirty children with CP aged 8 to 12 years will participate in a home-based computerized multi-modal executive training programme (12 weeks, 5 days a week, 30 min a day training, total dose = 30 h). Thirty children with CP matched by age, sex, motor and intelligence quotient (IQ) will compose the waitlist group. Cognitive, behavioural, emotional, participation and QOL measures will be obtained at three time points: before, immediately after and 9 months after completing the training. Additionally, structural and functional (resting state) magnetic resonance images (MRI) will be obtained in a subsample of 15 children from each group. Outcomes between groups will be compared following standard principles for RCTs. DISCUSSION The study will test whether the cognitive training programme exerts a positive effect not only on neuropsychological and daily functioning of children with CP but also on other measures such as participation and QOL. We will also use brain MRI to test brain functional and structural changes after the intervention. If this on-line and home-based training programme proves effective, it could be a cost-effective intervention with short- and long-term effects on EF, participation or QOL in CP. TRIAL REGISTRATION ClinicalTrials.gov: NCT04025749. Registered 19 July 2019. Retrospectively registered.
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Affiliation(s)
- María García-Galant
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig Vall d'Hebron 171, Barcelona, 08035, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig Vall d'Hebron 171, Barcelona, 08035, Spain
- Institut de Recerca Sant Joan de Déu, Passeig de Sant Joan de Déu 2, Barcelona, 08950, Spain
| | - Montse Blasco
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig Vall d'Hebron 171, Barcelona, 08035, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig Vall d'Hebron 171, Barcelona, 08035, Spain
- Institut de Recerca Sant Joan de Déu, Passeig de Sant Joan de Déu 2, Barcelona, 08950, Spain
| | - Lee Reid
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Brockway 65, Brisbane, 6014, Queensland, Australia
| | - Kerstin Pannek
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Brockway 65, Brisbane, 6014, Queensland, Australia
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Graham 62, Brisbane, 4101, Queensland, Australia
| | - David Leiva
- Departament de Psicologia Social i Psicologia Quantitativa, Universitat de Barcelona, Barcelona, 08035, Spain
| | - Olga Laporta-Hoyos
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig Vall d'Hebron 171, Barcelona, 08035, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig Vall d'Hebron 171, Barcelona, 08035, Spain
- Institut de Recerca Sant Joan de Déu, Passeig de Sant Joan de Déu 2, Barcelona, 08950, Spain
| | - Júlia Ballester-Plané
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig Vall d'Hebron 171, Barcelona, 08035, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig Vall d'Hebron 171, Barcelona, 08035, Spain
- Institut de Recerca Sant Joan de Déu, Passeig de Sant Joan de Déu 2, Barcelona, 08950, Spain
| | - Júlia Miralbell
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig Vall d'Hebron 171, Barcelona, 08035, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig Vall d'Hebron 171, Barcelona, 08035, Spain
- Institut de Recerca Sant Joan de Déu, Passeig de Sant Joan de Déu 2, Barcelona, 08950, Spain
| | - Xavi Caldú
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig Vall d'Hebron 171, Barcelona, 08035, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig Vall d'Hebron 171, Barcelona, 08035, Spain
- Institut de Recerca Sant Joan de Déu, Passeig de Sant Joan de Déu 2, Barcelona, 08950, Spain
| | - Xènia Alonso
- Servei de Neurologia, Hospital Universitari Sant Joan de Déu, Passeig Sant Joan de Déu 2, Barcelona, 08950, Spain
| | - Esther Toro-Tamargo
- Servei de Rehabilitació i Medicina Física, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, Barcelona, 08035, Spain
| | - Mar Meléndez-Plumed
- Servei de Rehabilitació i Medicina Física, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, Barcelona, 08035, Spain
| | - Francisca Gimeno
- Serveis de Rehabilitació, Associació de la Paràlisi Cerebral (ASPACE), Camí Tres Pins 31-35, Barcelona, 08038, Spain
| | - Marc Coronas
- Departament de Cognició, Desenvolupament i Psicologia de l'Educació, Universitat de Barcelona, Passeig Vall d'Hebron 171, Barcelona, 08035, Spain
- Unitat de Tècniques Augmentatives de Comunicació (UTAC), Universitat de Barcelona, Passeig Vall d'Hebron 171, Barcelona, 08035, Spain
| | - Emili Soro-Camats
- Departament de Cognició, Desenvolupament i Psicologia de l'Educació, Universitat de Barcelona, Passeig Vall d'Hebron 171, Barcelona, 08035, Spain
- Unitat de Tècniques Augmentatives de Comunicació (UTAC), Universitat de Barcelona, Passeig Vall d'Hebron 171, Barcelona, 08035, Spain
| | - Roslyn Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Graham 62, Brisbane, 4101, Queensland, Australia
| | - Roser Pueyo
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig Vall d'Hebron 171, Barcelona, 08035, Spain.
- Institut de Neurociències, Universitat de Barcelona, Passeig Vall d'Hebron 171, Barcelona, 08035, Spain.
- Institut de Recerca Sant Joan de Déu, Passeig de Sant Joan de Déu 2, Barcelona, 08950, Spain.
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Vision-based serious games and virtual reality systems for motor rehabilitation: A review geared toward a research methodology. Int J Med Inform 2019; 131:103909. [DOI: 10.1016/j.ijmedinf.2019.06.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 05/19/2019] [Accepted: 06/17/2019] [Indexed: 02/03/2023]
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23
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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: 20] [Impact Index Per Article: 4.0] [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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24
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Ren Z, Wu J. The Effect of Virtual Reality Games on the Gross Motor Skills of Children with Cerebral Palsy: A Meta-Analysis of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203885. [PMID: 31614990 PMCID: PMC6843701 DOI: 10.3390/ijerph16203885] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/05/2019] [Accepted: 10/12/2019] [Indexed: 12/24/2022]
Abstract
This review aimed to systematically evaluate the rehabilitatitive effect of Virtual Reality Games (VRGs) for gross motor skills of children with cerebral palsy (CP), and to give scientific grounds for the formulation of rehabilitation therapy for these children. To this end, the literature in Chinese databases (CNKI and Wanfang Data) as well as the databases of other countries (Web of Science, PubMed, EBSCOhost, Informit, Scopus, Science Direct and ProQuest) from the establishment dates of these databases to June 3rd 2019 was retrieved in order to collect randomized controlled trials with regard to the intervention effect of VRGs and traditional therapy on gross motor skills of children with CP, and the literature was screened as per inclusion and exclusion criteria. The PEDro scale was then used to evaluate the methodological quality of the included literature, and the software Review Manager 5.3 was employed to analyze the combined effect size. As a result, 7 randomized controlled trials and 234 children with CP were included. Meta-analysis showed that VRGs could improve gross motor skills of children with CP. Combined effect size of gross motor skills SMD = 0.37 [95% CI = (0.06, 0.68), p = 0.02)]. In conclusion, the VRG intervention program can enhance gross motor skills of children with CP to some extent. In view of the limitations regarding methodologies and the quality and quantity of the literature in this research, more quality randomized controlled trials are needed so as to draw convincing conclusions of effect of VRG intervention on gross motor skill development of children with CP in future studies.
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Affiliation(s)
- Zhanbing Ren
- Department of Physical Education, Shenzhen University, Shenzhen 518061, China.
| | - Jinlong Wu
- Department of Physical Education, Shenzhen University, Shenzhen 518061, China.
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25
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Biddiss E, Chan-Viquez D, Cheung ST, King G. Engaging children with cerebral palsy in interactive computer play-based motor therapies: theoretical perspectives. Disabil Rehabil 2019; 43:133-147. [PMID: 31104517 DOI: 10.1080/09638288.2019.1613681] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To provide a theoretically grounded understanding of engagement in interactive computer play-based motor therapies by children with cerebral palsy in home settings. METHODS A motivational framework for engagement and its relationship with three contemporary theories (self-determination theory, expectancy-value theory, social cognitive theory of self-regulation) was overviewed. A scoping review was conducted to understand how engagement is influenced by features of the technology and intervention design that impact intrinsic and extrinsic motivation, child and parent values and expectancies, and the processes of self-regulation. Multiple reviewers screened and extracted data from 26 articles describing home-based clinical trials of interactive computer play-based motor interventions for children with cerebral palsy. A narrative synthesis framework was used for analysis. RESULTS Features of the technology and the intervention influence feelings of autonomy (e.g., personalization), competence (e.g., calibration), and relatedness (e.g., social play, virtual therapist/coach). There may be multiple and differently valued goals in interactive computer play-based interventions (e.g., game- and therapy-focused) that, if disconnected or unmet, negatively impact engagement. Multiplayer interactions, real-time feedback and progress tracking provide information that influences self-regulation and engagement over time. CONCLUSIONS Optimizing engagement in interactive computer play-based motor interventions requires closer alignment with client-led values/goals; design of technologies and interventions that sustain intrinsic motivation; and feedback that informs/builds self-efficacy. Implications for rehabilitation The decision to prescribe an interactive computer play-based motor intervention should be guided by client-led goals and an informed understanding of the capacity of the interactive computer play-based intervention to meet individual client values/expectancies. Sustaining intrinsic motivation in interactive computer play-based motor therapies is greatly influenced by features of the technology (e.g., calibration, feedback, personalization) and the intervention (e.g., interactions with therapists, social play). Increased effort should be directed towards ensuring that interactive computer play-based interventions and technologies reward and reinforce efforts towards therapy goals.
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Affiliation(s)
- Elaine Biddiss
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Daniela Chan-Viquez
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Stephanie T Cheung
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
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26
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Ghorbanpour Z, Hosseini SA, Vameghi R, Rassafiani M, Dalvand H, Rezasoltani P. The effect of mothering handling training at home on the motor function of children with cerebral palsy: A pilot randomized controlled trial. JOURNAL OF OCCUPATIONAL THERAPY SCHOOLS AND EARLY INTERVENTION 2019. [DOI: 10.1080/19411243.2019.1590751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Zahra Ghorbanpour
- Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Syeed Ali Hosseini
- Social Determinants of Health Research Center, Occupational Therapy Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Roshanak Vameghi
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mehdi Rassafiani
- Occupational Therapy Department, Faculty of Allied Health Sciences, Health Science Center, Kuwait University, Kuwait
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hamid Dalvand
- Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Pooria Rezasoltani
- Department of Statistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Meyns P, Roman de Mettelinge T, van der Spank J, Coussens M, Van Waelvelde H. Motivation in pediatric motor rehabilitation: A systematic search of the literature using the self-determination theory as a conceptual framework. Dev Neurorehabil 2018; 21:371-390. [PMID: 28277817 DOI: 10.1080/17518423.2017.1295286] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Motivation is suggested as an important factor in pediatric motor rehabilitation. Therefore, we reviewed the existing evidence of (motivational) motor rehabilitation paradigms, and how motivation influences rehabilitation outcome using self-determination theory as conceptual framework. METHODS PubMed and Web-of-Science databases were systematically searched until June 2015. Data were independently extracted and critiqued for quality by three authors. Studies reporting motivational aspects were included. Most studies examined new technology (e.g., virtual reality [VR]). RESULTS Out of 479 records, three RCT, six case-control, and six non-comparative studies were included with mixed quality. Motivation was rarely reported. Training individualization to the child's capabilities with more variety seemed promising to increase motivation. Motivation increased when the exercises seemed helpful for daily activities. CONCLUSIONS Motivation in pediatric rehabilitation should be comprehensively assessed within a theoretical framework as there are indications that motivated children have better rehabilitation outcomes, depending on the aspect of motivation.
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Affiliation(s)
- Pieter Meyns
- a Faculty of Medicine and Health Sciences , Ghent University , Ghent , Belgium.,b Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam , VU University Medical Center , Amsterdam , The Netherlands
| | | | | | - Marieke Coussens
- a Faculty of Medicine and Health Sciences , Ghent University , Ghent , Belgium
| | - Hilde Van Waelvelde
- a Faculty of Medicine and Health Sciences , Ghent University , Ghent , Belgium
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28
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Clutterbuck G, Auld M, Johnston L. Active exercise interventions improve gross motor function of ambulant/semi-ambulant children with cerebral palsy: a systematic review. Disabil Rehabil 2018; 41:1131-1151. [PMID: 29303007 DOI: 10.1080/09638288.2017.1422035] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE Evaluate effectiveness of active exercise interventions for improving gross motor activity/participation of school-aged, ambulant/semi-ambulant children with cerebral palsy (CP). METHOD A systematic review was conducted following PRISMA guidelines. Five databases were searched for papers including school-aged children with CP, participating in active, exercise interventions with gross motor outcomes measured at the Activity/Participation level. Interventions with previous systematic reviews were excluded (e.g. hippotherapy). Evidence Level and conduct were examined by two raters. RESULTS Seven interventions (34 studies) met criteria. All studies reported on gross motor function, however, a limited number investigated participation outcomes. Strong positive evidence was available for Gross Motor Activity Training (n= 6, Evidence Level II-IV), and Gross Motor Activity Training with progressive resistance exercise plus additional physiotherapy (n = 3, all Evidence Level II). Moderate positive evidence exists for Gross Motor Activity Training plus additional physiotherapy (n = 2, all Evidence Level II) and Physical Fitness Training (n = 4, Evidence Level II-V). Weak positive evidence was available for Modified Sport (n = 3, Evidence Level IV-V) and Non-Immersive Virtual Reality (n = 12, Evidence Level II-V). There was strong evidence against Gross Motor Activity Training plus progressive resistance exercise without additional physiotherapy (n = 4, all Evidence Level II). INTERPRETATION Active, performance-focused exercise with variable practice opportunities improves gross motor function in ambulant/semi-ambulant children with CP. Implications for rehabilitation Active exercise interventions improve gross motor function of ambulant/semi-ambulant children with cerebral palsy. Gross Motor Activity Training is the most common and effective intervention. Practice variability is essential to improve gross motor function. Participation was rarely measured and requires further research, particularly in interventions that embed real-world participation opportunities like Modified Sport.
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Affiliation(s)
- Georgina Clutterbuck
- a School of Health and Rehabilitation Sciences , University of Queensland , Brisbane , Australia.,b The Cerebral Palsy League , Brisbane , Australia
| | - Megan Auld
- a School of Health and Rehabilitation Sciences , University of Queensland , Brisbane , Australia.,b The Cerebral Palsy League , Brisbane , Australia
| | - Leanne Johnston
- a School of Health and Rehabilitation Sciences , University of Queensland , Brisbane , Australia
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Page ZE, Barrington S, Edwards J, Barnett LM. Do active video games benefit the motor skill development of non-typically developing children and adolescents: A systematic review. J Sci Med Sport 2017; 20:1087-1100. [DOI: 10.1016/j.jsams.2017.05.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 04/14/2017] [Accepted: 05/09/2017] [Indexed: 10/19/2022]
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30
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Virtual Reality and Serious Games in Neurorehabilitation of Children and Adults: Prevention, Plasticity, and Participation. Pediatr Phys Ther 2017; 29 Suppl 3:S23-S36. [PMID: 28654475 PMCID: PMC5488703 DOI: 10.1097/pep.0000000000000387] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Use of virtual reality (VR) and serious games (SGs) interventions within rehabilitation as motivating tools for task specific training for individuals with neurological conditions are fast-developing. Within this perspective paper we use the framework of the IV STEP conference to summarize the literature on VR and SG for children and adults by three topics: Prevention; Outcomes: Body-Function-Structure, Activity and Participation; and Plasticity. Overall the literature in this area offers support for use of VR and SGs to improve body functions and to some extent activity domain outcomes. Critical analysis of clients' goals and selective evaluation of VR and SGs are necessary to appropriately take advantage of these tools within intervention. Further research on prevention, participation, and plasticity is warranted. We offer suggestions for bridging the gap between research and practice integrating VR and SGs into physical therapist education and practice.
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31
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Hansen SL, Ritterband-Rosenbaum A, Voigt CB, Hellgren LI, Sørensen ADM, Jacobsen C, Greve LZ, Jørgensen KD, Bilde PE, Kiens B, Nielsen JB. Supplementation of docosahexaenoic acid (DHA), vitamin D 3 and uridine in combination with six weeks of cognitive and motor training in prepubescent children: a pilot study. BMC Nutr 2017; 3:37. [PMID: 32153817 PMCID: PMC7050862 DOI: 10.1186/s40795-017-0155-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 04/05/2017] [Indexed: 11/10/2022] Open
Abstract
Background Learning and memory have been shown to be influenced by combination of dietary supplements and exercise in animal models, but there is little available evidence from human subjects. The aim of this pilot study was to investigate the effect of combining a motor- and cognitive exercise program with dietary supplementation consisting of 500 mg docosahexaenoic acid (DHA), 10 μg vitamin D3 and 1000 mg uridine (DDU-supplement) in 16 prepubescent children (age 8–11 years). Methods We designed a randomized, placebo-controlled, double-blinded study lasting 6 weeks in which DDU-supplement or placebo was ingested daily. During the intervention period, all children trained approximately 30 min 3 days/week using an internet-based cognitive and motor training program (Mitii). Prior to and post the intervention period dietary record, blood sampling, physical exercise tests and motor and cognitive tests were performed. Results Fourteen of the 16 children completed the intervention and ingested the supplement as required. 6 weeks DDU-supplementation resulted in a significant increase in the blood concentration of vitamin D2+3 and DHA (p = 0.023 and p < 0.001, respectively). Power calculation based on one of the cognitive tasks revealed a proper sample size of 26 children. Conclusion All children showed improved performance in the trained motor- and cognitive tasks, but it was not possible to demonstrate any significant effects on the cognitive tests from the dietary supplementation. However, DDU-supplementation did result in increased blood concentration of DHA and vitamin D2+3. Trial registration Clinical registration ID: NCT02426554 (clinical Trial.gov). January 2015 retrospectively registered.
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Affiliation(s)
- Solvejg L Hansen
- 1Department of Nutrition, Exercise and Sports, Section of Molecular Physiology, August Krogh Building University of Copenhagen, Universitetsparken 13, 2100 Copenhagen Ø, Denmark
| | - Anina Ritterband-Rosenbaum
- 2Center for Neuroscience, Panum Institute, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen N, Denmark.,The Elsass Institute, Holmegårdsvej 28, 2920 Charlottelund, Denmark
| | - Camilla B Voigt
- 2Center for Neuroscience, Panum Institute, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen N, Denmark.,The Elsass Institute, Holmegårdsvej 28, 2920 Charlottelund, Denmark
| | - Lars I Hellgren
- 3Center for Biological Sequence Analysis, Department of Systems Biology, Technical University of Denmark, Søltofts Plads, 2800 Kgs. Lyngby, Denmark
| | - Ann-Dorit M Sørensen
- 4National Food Institute, Division of Industrial Food Research, Technical University of Denmark, Søltofts Plads, 2800 Kgs. Lyngby, Denmark
| | - Charlotte Jacobsen
- 4National Food Institute, Division of Industrial Food Research, Technical University of Denmark, Søltofts Plads, 2800 Kgs. Lyngby, Denmark
| | - Line Z Greve
- The Elsass Institute, Holmegårdsvej 28, 2920 Charlottelund, Denmark
| | | | - Peder E Bilde
- The Elsass Institute, Holmegårdsvej 28, 2920 Charlottelund, Denmark
| | - Bente Kiens
- 1Department of Nutrition, Exercise and Sports, Section of Molecular Physiology, August Krogh Building University of Copenhagen, Universitetsparken 13, 2100 Copenhagen Ø, Denmark
| | - Jens B Nielsen
- 2Center for Neuroscience, Panum Institute, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen N, Denmark
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Sakzewski L, Lewis MJ, McKinlay L, Ziviani J, Boyd RN. Impact of multi-modal web-based rehabilitation on occupational performance and upper limb outcomes: pilot randomized trial in children with acquired brain injuries. Dev Med Child Neurol 2016; 58:1257-1264. [PMID: 27230022 DOI: 10.1111/dmcn.13157] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2016] [Indexed: 12/01/2022]
Abstract
AIMS To determine whether the multi-modal web-based rehabilitation 'Move it to improve it' (Mitii) is more effective than wait list control (usual care) to improve occupational performance, upper limb function, and visual perception in children with acquired brain injury (ABI). METHOD Fifty-eight randomly allocated children (53% males; mean age 11y 11mo, SD 2y 6mo; Manual Abilities Classification Scale equivalent I=32, II=24, III=2; mean Full-scale IQ 75.8, SD 16.2) received either 20 weeks of Mitii (n=29) or usual care (n=29). Mitii comprised upper limb, cognitive, visual perception, and gross motor tasks, recommended for 30 minutes per day, 6 days per week, over 20 weeks. Outcomes were the Assessment of Motor and Process Skills (AMPS), Melbourne Assessment of Unilateral Upper Limb Function, Jebsen-Taylor Test of Hand Function, Test of Visual Perceptual Skills, Assisting Hand Assessment (AHA), and Canadian Occupational Performance Measure. The primary comparison at 20 weeks between groups on the AMPS process and motor measures used generalized estimating equations. RESULTS Groups were equivalent at baseline. Participants completed on average 17.6 hours (range 0-46h) of Mitii. There were no differences between groups on the primary outcome (AMPS process: estimated mean difference -0.1, 95% CI -0.3 to 0.2, p=0.589; and AMPS motor: estimated mean difference 0.2, 95% CI -0.1 to 0.5, p=0.192). There were no differences between groups on overall visual perception, upper limb, and occupational performance outcomes. INTERPRETATION Mitii led to negligible changes on all primary and secondary outcomes compared with usual care. This likely reflects the small dose achieved and poses questions around the acceptability and feasibility of home-delivered Mitii in this population of children with ABI.
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Affiliation(s)
- Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia
| | - Melinda J Lewis
- Lady Cilento Children's Hospital, Queensland Health, Brisbane, Qld, Australia
| | - Lynne McKinlay
- Lady Cilento Children's Hospital, Queensland Health, Brisbane, Qld, Australia
| | - Jenny Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia
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James S, Ziviani J, King G, Boyd RN. Understanding Engagement in Home-Based Interactive Computer Play: Perspectives of Children With Unilateral Cerebral Palsy and Their Caregivers. Phys Occup Ther Pediatr 2016; 36:343-58. [PMID: 26606419 DOI: 10.3109/01942638.2015.1076560] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS This study aimed to understand engagement of children in a home-based computer program, "Move it to improve it" (Mitii™), designed to enhance motor, cognitive and visual perceptual skills. METHODS Participants were 10 children with unilateral cerebral palsy involved in the 20-week Mitii™ program (mean age = 11 years; 5 males) and their caregivers. Semi-structured interviews were audio recorded, transcribed verbatim and analyzed independently by two researchers. Themes were identified using an inductive approach to identify themes, and mapped against an engagement framework. (King et al., 2014 ). RESULTS Key themes were: (1) Child/family characteristics: children's interest captured through novelty and technology, motivation declines as novelty wears off, children require "finely tuned" programs, strong family support facilitates engagement, and children develop confidence and ownership; (2) Intervention characteristics: increased therapy frequency with reduced caregiver involvement, Mitii™ "becomes therapy" and competes with other interests; convenience within family routine, lack of real-time feedback and technical issues, and therapist guidance is essential; and (3) Service provider characteristics: initial and ongoing therapist input, family-friendly therapy approach, and tailored strategies to sustain engagement. CONCLUSIONS Therapists should be cognisant of factors that may impact on children's engagement in home-based computer programs and devise individual strategies with families to support sustained engagement.
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Affiliation(s)
- Sarah James
- a Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Royal Children's Hospital , Brisbane , Australia
| | - Jenny Ziviani
- b Children's Allied Health Research, Queensland Health and School of Health and Rehabilitation Sciences, The University of Queensland , Brisbane , Australia
| | - Gillian King
- c Bloorview Research Institute and University of Toronto , Toronto , Canada
| | - Roslyn N Boyd
- a Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Royal Children's Hospital , Brisbane , Australia
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Knights S, Graham N, Switzer L, Hernandez H, Ye Z, Findlay B, Xie WY, Wright V, Fehlings D. An innovative cycling exergame to promote cardiovascular fitness in youth with cerebral palsy. Dev Neurorehabil 2016; 19:135-40. [PMID: 24950349 DOI: 10.3109/17518423.2014.923056] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the effects of an internet-platform exergame cycling programme on cardiovascular fitness of youth with cerebral palsy (CP). METHODS In this pilot prospective case series, eight youth with bilateral spastic CP, Gross Motor Functional Classification System (GMFCS) level III, completed a six-week exergame programme. Outcomes were obtained at baseline and post-intervention. The primary outcome measure was the GMFCS III-specific shuttle run test (SRT-III). Secondary outcomes included health-related quality of life (HQL) as measured by the KIDSCREEN-52 questionnaire, six-minute walk test, Wingate arm cranking test and anthropomorphic measurements. RESULTS There were significant improvements in the SRT-III (t = -2.5, p = 0.04, d = 0.88) post-intervention. There were no significant changes in secondary outcomes. CONCLUSION An exergame cycling programme may lead to improvement in cardiovascular fitness in youth with CP. This study was limited by small sample size and lack of a comparison group. Future research is warranted.
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Affiliation(s)
- Shannon Knights
- a Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada and
| | - Nicholas Graham
- b School of Computing, Queen's University , Kingston , Ontario , Canada
| | - Lauren Switzer
- a Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada and
| | | | - Zi Ye
- b School of Computing, Queen's University , Kingston , Ontario , Canada
| | - Briar Findlay
- a Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada and
| | - Wen Yan Xie
- a Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada and
| | - Virginia Wright
- a Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada and
| | - Darcy Fehlings
- a Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada and
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Johari S, Rassafiani M, Dalvand H, Ahmadi Kahjoogh M, Daemi M. Effects of maternal handling training at home, on development of fine motor skills in the children with cerebral palsy: A randomized clinical trial. JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 2016. [DOI: 10.1080/19411243.2016.1220342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
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M Piovesana A, Ross S, Lloyd O, Whittingham K, Ziviani J, Ware RS, Boyd RN. Randomized controlled trial of a web-based multi-modal therapy program for executive functioning in children and adolescents with unilateral cerebral palsy. Disabil Rehabil 2016; 39:2021-2028. [PMID: 27665941 DOI: 10.1080/09638288.2016.1213899] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose state: Determine the efficacy of Move-it-to-improve-it (Mitii™), a multi-modal web-based program, in improving Executive Function (EF) in children with unilateral cerebral palsy (UCP). METHOD Participants (n = 102) were matched in pairs then randomized to: intervention (Mitii™ for 20 weeks; n = 51; 26 males; mean age = 11 years 8 months (SD = 2 years 4 months); Full Scale IQ = 84.65 (SD = 15.19); 28 left UCP; GMFCS-E&R (I = 20, II = 31) or waitlist control (n = 50; 25 males; mean age = 11 years 10 months (SD = 2 years 5 months); Full Scale IQ = 80.75 (SD = 19.81); 20 left UCP; GMFCS-E&R (I = 25, II = 25). Mitii™ targeted working memory (WM), visual processing (VP), upper limb co-ordination and physical activity. EF capacity was assessed: attentional control (DSB; WISC-IV); cognitive flexibility (inhibition and number-letter sequencing DKEFS); goal setting (D-KEFs Tower Test); and information processing (WISC-IV Symbol Search and Coding). EF performance was assessed via parent report (BRIEF). Groups were compared at 20 weeks using linear regression (SPSS 21). RESULTS There were no significant between group differences in attentional control (DSB; p = 0.20;CI= -0.40,1.87); cognitive flexibility (Inhibition, p = 0.34; CI= -0.73,2.11; number/letter sequencing, p = 0.17; CI= -0.55,2.94); problem solving (Tower; p = 0.28; CI= -0.61,2.09), information processing (Symbol; p = 0.08; CI= -0.16, 2.75; Coding; p = 0.07; CI= -0.12,2.52) or EF performance (p = 0.13; CI= -10.04,1.38). CONCLUSION In a large RCT, MitiiTM did not lead to significant improvements on measures of EF or parent ratings of EF performance in children with UCP. Implications for rehabilitation A large RCT of the multi-modal web based training; Move It to Improve It (MitiiTM) improves motor processing, visual perception, and physical capacity but does demonstrate statistically significant improvements or clinical significance in executive function in children with mild to moderate unilateral cerebral palsy (UCP). MitiiTM training completed by an intervention group was highly variable with few children reaching the target dosage of 60 h. Technical issues including server and internet connectively problems lead to disengagement with the program. Web-based training delivered in the home has the potential to increase therapy dose and accessibility, however, MitiiTM needs to be tailored to include tasks involving goal-setting, more complex problem solving using multi-dimensional strategies, mental flexibility, switching between two cognitively demanding tasks, and greater novelty in order to increase the cognitive component and challenge required to drive changes in EF.
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Affiliation(s)
- Adina M Piovesana
- a Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine , The University of Queensland, Centre for Children's Health Research , South Brisbane , QLD , Australia
| | - Stephanie Ross
- a Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine , The University of Queensland, Centre for Children's Health Research , South Brisbane , QLD , Australia
| | - Owen Lloyd
- b Queensland Paediatric Rehabilitation Service , Children's Health Queensland , South Brisbane , QLD , Australia
| | - Koa Whittingham
- a Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine , The University of Queensland, Centre for Children's Health Research , South Brisbane , QLD , Australia
| | - Jenny Ziviani
- c Children's Applied Health Research , Queensland Health , Brisbane , QLD , Australia.,d School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , QLD , Australia
| | - Robert S Ware
- e School of Population Health , The University of Queensland , Brisbane , QLD , Australia.,f Queensland Children's Medical Research Institute, The University of Queensland , Brisbane , QLD , Australia
| | - Roslyn N Boyd
- a Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine , The University of Queensland, Centre for Children's Health Research , South Brisbane , QLD , Australia
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Baque E, Barber L, Sakzewski L, Boyd RN. Randomized controlled trial of web-based multimodal therapy for children with acquired brain injury to improve gross motor capacity and performance. Clin Rehabil 2016; 31:722-732. [DOI: 10.1177/0269215516651980] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Emmah Baque
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - Lee Barber
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, QLD, Australia
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Sakzewski L, Lewis M, Ziviani J. Test-retest reproducibility of the Assessment of Motor and Process Skills for school-aged children with acquired brain injuries. Scand J Occup Ther 2016; 24:161-166. [PMID: 26980287 DOI: 10.3109/11038128.2016.1152296] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background Persistent impairments resulting from childhood acquired brain injury (ABI) can impact performance of activities of daily living (ADL). Objective and reliable measures of ADL skills are required for treatment planning and research. Aim To evaluate test-retest reproducibility of the Assessment of Motor and Process Skills (AMPS) for children with ABI. Methods Twenty-eight children with ABI (mean age 11 years 7 months, SD 2 years 4 months; males = 11) were recruited. Two AMPS tasks were performed over two consecutive days, as per standardized AMPS procedures. Intraclass correlation coefficients (ICC; 2,1), standard error of measurement (SEM), smallest detectable difference (SDD), and 95% limits of agreement (Bland-Altman) were calculated. Results Test-retest reliability was fair to good for AMPS ADL motor (ICC 0.55) and ADL process (ICC 0.58) measures. The SEM was 0.36 and 0.34 logits for AMPS ADL motor and ADL process measures respectively. The SDD was 1.0 (motor) and 0.93 logits (process) measures. A learning effect was evident. Conclusion Test-retest reproducibility of the AMPS was fair to good for children with ABI, which is poorer than previously published data. Administration of the AMPS in an unfamiliar environment, fatigue, and the small time interval between testing sessions may have contributed to poorer results. The AMPS remains a useful measure of ADL, contributing to our understanding of task execution processes.
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Affiliation(s)
- Leanne Sakzewski
- a Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland , Brisbane , Australia
| | - Melinda Lewis
- b Lady Cilento Children's Hospital , Brisbane , Australia
| | - Jenny Ziviani
- c School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Australia.,d Children's Allied Health Research, Children's Health Queensland , Brisbane , Australia
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Shierk A, Lake A, Haas T. Review of Therapeutic Interventions for the Upper Limb Classified by Manual Ability in Children with Cerebral Palsy. Semin Plast Surg 2016; 30:14-23. [PMID: 26869859 DOI: 10.1055/s-0035-1571256] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The aim of this literature review was to assemble an inventory of intervention strategies utilized for children diagnosed with cerebral palsy (CP) based on the Manual Ability Classification System (MACS). The purpose of the inventory is to guide physicians and therapists in intervention selection aimed at improving upper limb function in children with CP. The following databases were searched: CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Database of Systematic Reviews, ERIC (Educational Research Information Center), Google Scholar, OTSeeker (Occupational Therapy Systematic Evaluation of Evidence), OVID (Ovid Technologies, Inc.), and PubMed. Inclusion criteria were whether the study (1) identified MACS levels of participants, and (2) addressed the effectiveness of intervention on upper limb function. Overall, 74 articles met the inclusion criteria. The summarized data identified 10 categories of intervention. The majority of participants across studies were MACS level II. The most frequently cited interventions were constraint-induced movement therapy (CIMT), bimanual training, and virtual reality and computer-based training. Multiple interventions demonstrated effectiveness for upper limb improvement at each MACS level. However, there is a need for additional research for interventions appropriate for MACS levels IV and V. To fully develop an intervention inventory based on manual ability, future studies need to report MACS levels of participants, particularly for splinting and therapy interventions used in combination with surgery.
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Affiliation(s)
- Angela Shierk
- Occupational Therapy, Texas Scottish Rite Hospital for Children, Dallas, Texas
| | - Amy Lake
- Occupational Therapy, Texas Scottish Rite Hospital for Children, Dallas, Texas
| | - Tara Haas
- Physical Medicine and Rehabilitation, Texas Children's Hospital, Houston, Texas
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Cho C, Hwang W, Hwang S, Chung Y. Treadmill Training with Virtual Reality Improves Gait, Balance, and Muscle Strength in Children with Cerebral Palsy. TOHOKU J EXP MED 2016; 238:213-8. [PMID: 26947315 DOI: 10.1620/tjem.238.213] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Chunhee Cho
- Department of Physical Therapy, The Graduate School, Sahmyook University
| | - Wonjeong Hwang
- Department of Physical Therapy, The Graduate School, Sahmyook University
| | - Sujin Hwang
- Department of Physical Therapy, Baekseok University
| | - Yijung Chung
- Department of Physical Therapy, College of Health and Welfare, Sahmyook University
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van den Heuvel RJF, Lexis MAS, Gelderblom GJ, Jansens RML, de Witte LP. Robots and ICT to support play in children with severe physical disabilities: a systematic review. Disabil Rehabil Assist Technol 2015; 11:103-116. [PMID: 26330097 DOI: 10.3109/17483107.2015.1079268] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Play is an essential part of children's lives. Children with physical disabilities experience difficulties in play, especially those with severe physical disabilities. With the progress of innovative technology, the possibilities to support play are increasing. The purpose of this literature study is to gain insight into the aims, control options and commercial availability of information and communication technology (ICT) and robots to support play (especially play for the sake of play) in children with severe physical disabilities. METHODS A systematic literature search in the databases PubMed, CINAHL, IEEE and ERIC was carried out. Titles and abstracts were assessed independently by three reviewers. In addition, studies were selected using Google Scholar, conference proceedings and reference lists. RESULTS Three main groups of technology for play could be distinguished: robots (n = 8), virtual reality systems (n = 15) and computer systems (n = 4). Besides, ICT and robots developed for specific therapy or educational goals using play-like activities, five of the in total 27 technologies in this study described the aim of "play for play's sake". CONCLUSIONS Many ICT systems and robots to support play in children with physical disabilities were found. Numerous technologies use play-like activities to achieve therapeutic or educational goals. Robots especially are used for "play for play's sake". Implications for Rehabilitation This study gives insight into the aims, control options and commercial availability for application of robots and ICT to support play in children with severe physical disabilities. This overview can be used in both the fields of rehabilitation and special education to search for new innovative intervention options and it can stimulate them to use these innovative play materials. Especially robots may have great potential in supporting "play for play's sake".
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Affiliation(s)
- Renée J F van den Heuvel
- a Research Centre for Technology in Care , Zuyd University of Applied Sciences , Heerlen , The Netherlands and.,b Department of Health Services Research , CAPRHI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University , Maastricht , The Netherlands
| | - Monique A S Lexis
- a Research Centre for Technology in Care , Zuyd University of Applied Sciences , Heerlen , The Netherlands and
| | - Gert Jan Gelderblom
- a Research Centre for Technology in Care , Zuyd University of Applied Sciences , Heerlen , The Netherlands and
| | - Rianne M L Jansens
- a Research Centre for Technology in Care , Zuyd University of Applied Sciences , Heerlen , The Netherlands and
| | - Luc P de Witte
- a Research Centre for Technology in Care , Zuyd University of Applied Sciences , Heerlen , The Netherlands and.,b Department of Health Services Research , CAPRHI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University , Maastricht , The Netherlands
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Boyd RN, Baque E, Piovesana A, Ross S, Ziviani J, Sakzewski L, Barber L, Lloyd O, McKinlay L, Whittingham K, Smith AC, Rose S, Fiori S, Cunnington R, Ware R, Lewis M, Comans TA, Scuffham PA. Mitii™ ABI: study protocol of a randomised controlled trial of a web-based multi-modal training program for children and adolescents with an Acquired Brain Injury (ABI). BMC Neurol 2015; 15:140. [PMID: 26286324 PMCID: PMC4544804 DOI: 10.1186/s12883-015-0381-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 07/14/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Acquired brain injury (ABI) refers to multiple disabilities arising from damage to the brain acquired after birth. Children with an ABI may experience physical, cognitive, social and emotional-behavioural impairments which can impact their ability to participate in activities of daily living (ADL). Recent developments in technology have led to the emergence of internet-delivered therapy programs. "Move it to improve it" (Mitii™) is a web-based multi-modal therapy that comprises upper limb (UL) and cognitive training within the context of meaningful physical activity. The proposed study aims to compare the efficacy of Mitii™ to usual care to improve ADL motor and processing skills, gross motor capacity, UL and executive functioning in a randomised waitlist controlled trial. METHODS/DESIGN Sixty independently ambulant children (30 in each group) at least 12 months post ABI will be recruited to participate in this trial. Children will be matched in pairs at baseline and randomly allocated to receive either 20 weeks of Mitii™ training (30 min per day, six days a week, with a potential total dose of 60 h) immediately, or be waitlisted for 20 weeks. Outcomes will be assessed at baseline, immediately post-intervention and at 20 weeks post-intervention. The primary outcomes will be the Assessment of Motor and Process Skills and 30 s repetition maximum of functional strength exercises (sit-to-stand, step-ups and half kneel to stand). Measures of body structure and functions, activity, participation and quality of life will assess the efficacy of Mitii™ across all domains of the International Classification of Functioning, Disability and Health framework. A subset of children will undertake three tesla (3T) magnetic resonance imaging scans to evaluate functional neurovascular changes, structural imaging, diffusion imaging and resting state functional connectivity before and after intervention. DISCUSSION Mitii™ provides an alternative approach to deliver intensive therapy for children with an ABI in the convenience of the home environment. If Mitii™ is found to be effective, it may offer an accessible and inexpensive intervention option to increase therapy dose. TRIAL REGISTRATION ANZCTR12613000403730.
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Affiliation(s)
- Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Emmah Baque
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Adina Piovesana
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Stephanie Ross
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Jenny Ziviani
- Children's Allied Health Research, Children's Health Queensland, Brisbane, Queensland, Australia.
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.
| | - Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Lee Barber
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Owen Lloyd
- Children's Allied Health Research, Children's Health Queensland, Brisbane, Queensland, Australia.
| | - Lynne McKinlay
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
- Children's Allied Health Research, Children's Health Queensland, Brisbane, Queensland, Australia.
| | - Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Anthony C Smith
- Centre for Online Health, The University of Queensland, Brisbane, Australia.
| | - Stephen Rose
- CSIRO, ICT - Australian e-Health Research Centre, Royal Brisbane and Women's Hospital Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia.
| | - Simona Fiori
- Department of Developmental Neuroscience, IRCCS Stella Maris, Pisa, Italy.
| | - Ross Cunnington
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia.
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia.
| | - Robert Ware
- Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Queensland, Australia.
- School of Population Health, The University of Queensland, Brisbane, Queensland, Australia.
| | - Melinda Lewis
- Children's Allied Health Research, Children's Health Queensland, Brisbane, Queensland, Australia.
| | - Tracy A Comans
- Griffith Health Institute and School of Medicine, Griffith University, Brisbane, Queensland, Australia.
| | - Paul A Scuffham
- Griffith Health Institute and School of Medicine, Griffith University, Brisbane, Queensland, Australia.
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James S, Ziviani J, Ware RS, Boyd RN. Randomized controlled trial of web-based multimodal therapy for unilateral cerebral palsy to improve occupational performance. Dev Med Child Neurol 2015; 57:530-8. [PMID: 25955443 DOI: 10.1111/dmcn.12705] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2014] [Indexed: 10/23/2022]
Abstract
AIM The study aimed to investigate the effectiveness of a web-based therapy programme, 'Move it to improve it' (Mitii(™)), in children with unilateral cerebral palsy (UCP) on occupational performance, upper limb function, and visual perception. METHOD Participants (n=102) were matched in pairs and randomized to intervention (Mitii for 20wks; 26 males, mean age 11y 8mo [2y 4mo], Manual Ability Classification System level I=11, II=39, III=1) or control (standard care; 25 males, mean age 11y 10mo [2y 5mo], Manual Ability Classification System level I=13, II=37). Outcomes were the Assessment of Motor and Process Skills (AMPS), Assisting Hand Assessment, Jebsen-Taylor Test of Hand Function (JTTHF), Melbourne Assessment of Unilateral Upper Limb Function (MUUL), Canadian Occupational Performance Measure (COPM), and Test of Visual Perceptual Skills (TVPS-3). RESULTS Participants completed on average 32.4 hours of Mitii (range 3.7-74.7h). The Mitii group demonstrated significantly greater post-intervention scores than the comparison group on the AMPS, JTTHF dominant upper limb, COPM, and TVPS-3. The differences between groups were not clinically significant. There were no differences between groups on measures of impaired upper limb function. INTERPRETATION Mitii delivers individualized, web-based therapy at home and has potential to increase therapy dose. Mitii can be considered as an option to enhance occupational performance and visual perception for children with UCP.
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Affiliation(s)
- Sarah James
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Royal Children's Hospital, The University of Queensland, Brisbane, Qld, Australia
| | - Jenny Ziviani
- Children's Allied Health Research, Queensland Health, Brisbane, Qld, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia
| | - Robert S Ware
- School of Population Health, The University of Queensland, Brisbane, Qld, Australia.,Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Qld, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Royal Children's Hospital, The University of Queensland, Brisbane, Qld, Australia
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AlSaif AA, Alsenany S. Effects of interactive games on motor performance in children with spastic cerebral palsy. J Phys Ther Sci 2015; 27:2001-3. [PMID: 26180367 PMCID: PMC4500030 DOI: 10.1589/jpts.27.2001] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 03/14/2015] [Indexed: 12/30/2022] Open
Abstract
[Purpose] Motor control and muscle strength impairments are the prime reasons for motor behavior disorders in children with spastic cerebral palsy. These impairments lead to histological changes in muscle growth and the learning of motor skills. Therefore, such children experience reduced muscle force generation and decreased muscle flexibility. We investigated the effect of training with Nintendo Wii Fit games on motor performance in children with spastic cerebral palsy. [Subjects and Methods] Forty children with cerebral palsy spastic diplegia aged 6-10 years diagnosed with level-3 functional capabilities according to the Gross Motor Classification System (GMFCS) were enrolled. Participants were divided randomly into equal groups: group (A) that practiced with the Nintendo Wii Fit game for at least 20 minutes/day for 12 weeks and group (B) that underwent no training (control group). The Movement Assessment Battery for Children-2 (mABC-2) was used to assess motor performance, because it mainly involves motor tasks very similar to those involved in playing Nintendo Wii Fit games, e.g., goal-directed arm movements, balancing, and jumping. [Results] There were significant improvements in the subscales of the motor performance test of those who practiced with the Nintendo Wii, while the control group showed no significant changes. [Conclusion] Using motion interactive games in home rehabilitation is feasible for children with cerebral palsy.
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Affiliation(s)
- Amer A AlSaif
- Department of Physical Therapy, Faculty of Applied Medical Sciences, King Abdulaziz University, Saudi Arabia
| | - Samira Alsenany
- Public Health Department, Faculty of Nursing, King Abdulaziz University, Saudi Arabia
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Lorentzen J, Greve LZ, Kliim-Due M, Rasmussen B, Bilde PE, Nielsen JB. Twenty weeks of home-based interactive training of children with cerebral palsy improves functional abilities. BMC Neurol 2015; 15:75. [PMID: 25956055 PMCID: PMC4438624 DOI: 10.1186/s12883-015-0334-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 04/30/2015] [Indexed: 11/25/2022] Open
Abstract
Background Home-based training is becoming ever more important with increasing demands on the public health systems. We investigated whether individualized and supervised interactive home-based training delivered through the internet improves functional abilities in children with cerebral palsy (CP). Methods Thirty four children with CP (aged 9–16; mean age 10.9 ± 2.4 years) (GMFCS I-II; MACS I-II) were included in this non-randomized controlled clinical training study. 12 children (aged 7–16; mean age: 11.3+/−0.9 years) were allocated to a control group in which measurements were performed with 20 weeks interval without any intervening training. Daily activities, functional abilities of upper- and lower limbs, and balance were evaluated before, immediately after training and 12 weeks after training. The training consisted of 30 min daily home-based training for 20 weeks delivered through the internet. Results The training group on average completed 17 min daily training for the 20 week period (total of 40 h of training). The training group showed significant improvements of daily activities (AMPS), upper limb function (AHA) and functional tests of lower limbs (sit to stand, lateral step up, half knee to standing) after 20 weeks of training. No difference was found between the test after 20 weeks of training and the test 12 weeks after training. No significance was reached for balance after training. No difference was found for any parameter for the control group. Conclusions Interactive home training of children with CP is an efficient way to deliver training, which can enable functional motor improvements and increased activity to perform daily activities. Trial registration ISRCTN13188513. Date of registration: 04/12/2014
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Affiliation(s)
- Jakob Lorentzen
- The Helene Elsass Center, Holmegårdsvej 28, 2900, Charlottenlund (Copenhagen), Denmark. .,Department of Exercise and Nutrition, University of Copenhagen, Copenhagen, Denmark.
| | - Line Z Greve
- The Helene Elsass Center, Holmegårdsvej 28, 2900, Charlottenlund (Copenhagen), Denmark.
| | - Mette Kliim-Due
- The Helene Elsass Center, Holmegårdsvej 28, 2900, Charlottenlund (Copenhagen), Denmark.
| | - Betina Rasmussen
- The Helene Elsass Center, Holmegårdsvej 28, 2900, Charlottenlund (Copenhagen), Denmark.
| | - P E Bilde
- The Helene Elsass Center, Holmegårdsvej 28, 2900, Charlottenlund (Copenhagen), Denmark.
| | - Jens B Nielsen
- Department of Neuroscience and Pharmacology, Panum Institute, University of Copenhagen, Copenhagen, Denmark. .,Department of Exercise and Nutrition, University of Copenhagen, Copenhagen, Denmark.
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Nielsen JB, Willerslev-Olsen M, Christiansen L, Lundbye-Jensen J, Lorentzen J. Science-Based Neurorehabilitation: Recommendations for Neurorehabilitation From Basic Science. J Mot Behav 2015; 47:7-17. [DOI: 10.1080/00222895.2014.931273] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Weiss PLT, Tirosh E, Fehlings D. Role of virtual reality for cerebral palsy management. J Child Neurol 2014; 29:1119-24. [PMID: 24799367 DOI: 10.1177/0883073814533007] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 04/03/2014] [Indexed: 11/16/2022]
Abstract
Virtual reality is the use of interactive simulations to present users with opportunities to perform in virtual environments that appear, sound, and less frequently, feel similar to real-world objects and events. Interactive computer play refers to the use of a game where a child interacts and plays with virtual objects in a computer-generated environment. Because of their distinctive attributes that provide ecologically realistic and motivating opportunities for active learning, these technologies have been used in pediatric rehabilitation over the past 15 years. The ability of virtual reality to create opportunities for active repetitive motor/sensory practice adds to their potential for neuroplasticity and learning in individuals with neurologic disorders. The objectives of this article is to provide an overview of how virtual reality and gaming are used clinically, to present the results of several example studies that demonstrate their use in research, and to briefly remark on future developments.
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Affiliation(s)
- Patrice L Tamar Weiss
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Emanuel Tirosh
- The Hannah Khoushy Child Development Center, Bnai Zion Medical Center, The Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Darcy Fehlings
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Department of Paediatrics, University of Toronto, Toronto, Canada
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Chiu HC, Ada L, Lee HM. Upper limb training using Wii Sports Resort™ for children with hemiplegic cerebral palsy: a randomized, single-blind trial. Clin Rehabil 2014; 28:1015-24. [DOI: 10.1177/0269215514533709] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objective: To investigate whether Wii Sports Resort™ training is effective and if any benefits are maintained. Design: Randomized, single-blind trial. Participants: Sixty-two hemiplegic children with cerebral palsy (6–13 years). Intervention: Experimental group undertook six weeks of home-based Wii Sports Resort™ training plus usual therapy, while the control group received usual therapy. Main measures: Outcomes were coordination, strength, hand function, and carers’ perception of hand function, measured at baseline, six, and 12 weeks by a blinded assessor. Results: There was a trend of mean difference (MD) for the experimental group to have more grip strength by six (MD 4.0 N, 95% confidence interval (CI) −0.8 to 8.8, p = 0.10) and 12 (MD 4.1 N, 95% CI −2.1 to 10.3, p = 0.19) weeks, and to have a higher quantity of hand function according to carers’ perception by six (MD 4.5 N, 95% CI −0.7 to 9.7, p = 0.09) and strengthened by 12 (MD 6.4, 95% CI 0.6 to 12.3, p = 0.03) weeks than the control group. There was no difference between groups in coordination and hand function by six or 12 weeks. Conclusion: Wii™ training did not improve coordination, strength, or hand function. Beyond the intervention, carers perceived that the children used their hands more.
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Affiliation(s)
- Hsiu-Ching Chiu
- Department of Physical Therapy, I-Shou University, Kaohsiung City, Taiwan
| | - Louise Ada
- Discipline of Physiotherapy, The University of Sydney, Sydney, Australia
| | - Hsin-Min Lee
- Department of Physical Therapy, I-Shou University, Kaohsiung City, Taiwan
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James S, Ziviani J, Boyd R. A systematic review of activities of daily living measures for children and adolescents with cerebral palsy. Dev Med Child Neurol 2014; 56:233-44. [PMID: 23937056 DOI: 10.1111/dmcn.12226] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2013] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to systematically review the psychometric properties and clinical utility of measures of activities of daily living (ADL) for children with cerebral palsy (CP) aged 5 to 18 years. METHOD Five electronic databases were searched to identify available ADL measures with published psychometric data for school-aged children with CP. Measures were included if at least 60% of the items addressed ADL in the full assessment or in an independent domain. A modified CanChild Outcome Rating Form was used to report the validity, reliability, responsiveness, and clinical utility of the measures. RESULTS Twenty-six measures were identified and eight met inclusion criteria. The Pediatric Evaluation of Disability Inventory (PEDI) had the strongest psychometric properties but was limited by its age range. The Assessment of Motor and Process Skills (AMPS) was the most comprehensive evaluation of underlying motor and cognitive abilities yet further psychometric testing is required for children with CP. INTERPRETATION The PEDI should be used to measure ADL capability in elementary school aged children. The AMPS is the best measure to evaluate ADL performance or capacity and is suitable for all ages. Future research should examine the reliability of the AMPS to determine its stability in children and adolescents with CP.
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Affiliation(s)
- Sarah James
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Royal Children's Hospital, Brisbane, Qld, Australia
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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. J Phys Ther Sci 2013; 25:1123-7. [PMID: 24259928 PMCID: PMC3818755 DOI: 10.1589/jpts.25.1123] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 04/26/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Cerebral palsy is a sensorimotor disorder that affects the control of posture
and movement. The Nintendo® Wii Fit offers an inexpensive, enjoyable, suitable
alternative to more complex systems for children with cerebral palsy. The aim of this
study was to investigate the efficacacy of Wii-based balance therapy for children with
ambulatory cerebral palsy. [Subjects] This pilot study design included fourteen ambulatory
patients with cerebral palsy (11 males, 3 females; mean age 12.07 ± 3.36 years). [Methods]
Balance functions before and after treatment were evaluated using one leg standing, the
functional reach test, the timed up and go test, and the 6-minute walking test. The
physiotherapist prescribed the Wii Fit activities,and supervised and supported the
patients during the therapy sessions. Exercises were performed in a standardized program 2
times a week for 12 weeks. [Results] Balance ability of every patient improved.
Statistically significant improvements were found in all outcome measures after 12 weeks.
[Conclusion] The results suggest that the Nintendo® Wii Fit provides a safe,
enjoyable, suitable and effective method that can be added to conventional treatments to
improve the static balance of patients with cerebral palsy; however, further work is
required.
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Affiliation(s)
- Devrim Tarakci
- Program of Physiotherapy and Rehabilitation, Institude of Health Science, Istanbul University
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