Dataset Information

Intensive Training with Virtual Reality on Mobility in Adolescents with Cerebral Palsy-Single Subject Design.

ABSTRACT: To evaluate the effects of a short-term intensive virtual reality intervention in adolescents with cerebral palsy (CP). Single-subject design, type A-B-follow-up, with four participants (P) with CP, 15-18 years, GMFCS level II. A two-week intervention phase was performed with twelve Nintendo® Wii games in six sessions (90 min) per week. Outcome variables were semi-static balance (Pressure Center Oscillation-PCO), gait speed (Ten Meter Walk Test at usual speed-TMWT-U; and fast speed-TMWT-F), mobility (Timed Up and Go test-TUG), endurance (sit-to-stand test 5 times-STS-5), and gross motor activity (Gross Motor Function Measure-GMFM). Statistical improvements were observed in GMFM-D (P2-P3), TMWT-F (P2-P3-P4) and TMWT-U (P2), STS-5 (P3-P4), TUG (P3), and PCO (P2-P3), assessed by level, trend, latency, and visual inspection to analyze change. This study shows that a short-term intensive intervention using Nintendo® Wii-based games in adolescents, GMFCS level II, can be an effective therapy, leading to some recovery of functioning in these young people.

SUBMITTER: Valenzuela E

PROVIDER: S-EPMC8508310 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature

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Intensive Training with Virtual Reality on Mobility in Adolescents with Cerebral Palsy-Single Subject Design.

Valenzuela Elisa E Rosa Renata R Monteiro Carlos C Keniston Leslie L Ayupe Kênnea K Frônio Jaqueline J Chagas Paula P

International journal of environmental research and public health 20211005 19

<h4>Purpose</h4>To evaluate the effects of a short-term intensive virtual reality intervention in adolescents with cerebral palsy (CP).<h4>Methods</h4>Single-subject design, type A-B-follow-up, with four participants (P) with CP, 15-18 years, GMFCS level II. A two-week intervention phase was performed with twelve Nintendo<sup>®</sup> Wii games in six sessions (90 min) per week. Outcome variables were semi-static balance (Pressure Center Oscillation-PCO), gait speed (Ten Meter Walk Test at usual ...[more]

PMID: 34639757

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Project description:IntroductionTreadmill 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 analysisThis 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 disseminationThe 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 numberNCT05131724.

Project description:In the acute phase, burn patients undergo several painful procedures. Pediatric burn care procedures conducted in hydrotherapy have been known to generate severe pain intensity and moderate to high levels of anxiety. Hydrotherapy treatments are done with the use of opioids and benzodiazepines for pain and anxiety. Unfortunately, nonpharmacological methods are rarely combined with pharmacological treatments despite evidence showing that distraction can serve as an effective method for pain management and can potentially decrease analgesic requirements in other painful medical procedures. Virtual reality (VR) is a method that uses distraction to interact within a virtual environment. The use of VR is promising for pain reduction in varying settings. Considering the lack of optimal pain and anxiety management during burn wound care and the positive effect of an immersive distraction for painful procedures, using VR for burn wound care procedures may show promising results. This is a within-subject randomized controlled trial design in which each participant will serve as his/her own control. A minimum of 20 participants, aged 7 to 17 years old undergoing a burn care session, will receive both standard and experimental treatments during the same session in a randomized order. The experimental treatment will consist of combining VR distraction using the video game Dreamland® to the current standard pharmacological care as per unit protocol. The control group will only receive the unit's standard pharmacological care. The mean difference in both pain intensity scores and in anxiety between the two different sequences will be the primary outcomes of this study. This study evaluates the effect of VR on burn wound care. If results from this study show a positive effect of VR compared to standard care, this protocol may provide guidance on how to implement this type of immersive care as part of the tools available for distraction of painful procedures for acute burn victims.

Project description:INTRODUCTION:Gait is inefficient in children with cerebral palsy, particularly as they transition to adolescence. Gait inefficiency may be associated with declines in gross motor function and participation among adolescents with cerebral palsy. Resistance training may improve gait efficiency through a number of biomechanical and neural mechanisms. The aim of the Strength Training for Adolescents with cerebral palsy (STAR) trial is to evaluate the effect of resistance training on gait efficiency, activity and participation in adolescents with cerebral palsy. We also aim to determine the biomechanical and neural adaptations that occur following resistance training and evaluate the feasibility and acceptability of such an intervention for adolescents with cerebral palsy. METHODS AND ANALYSIS:60 adolescents (Gross Motor Function Classification System level I-III) will be randomised to a 10-week resistance training group or a usual care control group according to a computer-generated random schedule. The primary outcome is gait efficiency. Secondary outcomes are habitual physical activity, participation, muscle-tendon mechanics and gross motor function. General linear models will be used to evaluate differences in continuous data between the resistance training and usual care groups at 10 and 22 weeks, respectively. A process evaluation will be conducted alongside the intervention. Fidelity of the resistance training programme to trial protocol will be quantified by observations of exercise sessions. Semistructured interviews will be conducted with participants and physiotherapists following the resistance training programme to determine feasibility and acceptability of the programme. ETHICS AND DISSEMINATION:This trial has ethical approval from Brunel University London's Department of Clinical Sciences' Research Ethics Committee and the National Research Ethics Service (NRES) Committee London-Surrey Borders. The results of the trial will be submitted for publication in academic journals, presented at conferences and distributed to adolescents, families and healthcare professionals through the media with the assistance of the STAR advisory group. TRIAL REGISTRATION NUMBER:ISRCTN90378161; Pre-results.

Project description:BackgroundIncreasing evidence supports the use of virtual reality systems to improve upper limb motor functions in individuals with cerebral palsy. While virtual reality offers the possibility to include key components to promote motor learning, it remains unclear if and how motor learning principles are incorporated into the development of rehabilitation interventions using virtual reality.ObjectiveThe objective of this study was to determine the extent to which motor learning principles are integrated into virtual reality interventions targeting upper limb function in individuals with cerebral palsy.MethodsA systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search was performed in 10 databases using a combination of keywords related to cerebral palsy, virtual reality, video games, and rehabilitation. Studies were divided into 2 categories: commercial video game platforms and devices and custom virtual reality systems. Study quality was assessed using the modified Downs and Black checklist.ResultsThe initial search yielded 1497 publications. A total of 26 studies from 30 publications were included, with most studies classified as "fair" according to the modified Downs and Black checklist. The majority of studies provided enhanced feedback and variable practice and used functionally relevant and motivating virtual tasks. The dosage varied greatly (total training time ranged from 300 to 3360 minutes), with only 6 studies reporting the number of movement repetitions per session. The difficulty progression and the assessment of skills retention and transfer were poorly incorporated, especially for the commercial video games.ConclusionsMotor learning principles should be better integrated into the development of future virtual reality systems for optimal upper limb motor recovery in individuals with cerebral palsy.Trial registrationPROSPERO International Prospective Register of Systematic Reviews CRD42020151982; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020151982.

Dataset Information

Intensive Training with Virtual Reality on Mobility in Adolescents with Cerebral Palsy-Single Subject Design.

Publications

Intensive Training with Virtual Reality on Mobility in Adolescents with Cerebral Palsy-Single Subject Design.

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