Abstract

Background

Balance issues and poor gross motor function affect the daily needs of children with cerebral palsy.

Purpose

The study objective was to examine the effects of virtual reality gaming and physiotherapy on balance, gross motor performance and daily functioning among children with bilateral spastic cerebral palsy.

Method

Thirty-eight children with bilateral spastic cerebral palsy aged 6–12 years with GMFCS- level II-III, Manual Ability Classification System level I-III participated in this randomized controlled trial. The experimental group performed virtual reality games and physiotherapy, while the control group underwent physiotherapy alone. The exercise intensity was 60 minutes session a day, 4-days a week for 6-weeks. Paediatric Balance Scale (PBS), Kids-Mini-Balance Evaluation System Test (Kids-Mini-BESTest), Gross Motor Function Measure-88 (GMFM-88), and Wee-Functional Independence Measure (WeeFIM) were the outcome measures collected at baseline, 6-week post-training and 2-months follow-up.

Results

The time by group interaction of repeated measures ANOVA revealed no statistical significance for all the outcome measures except Kids-Mini-BESTest (p < 0.05). The PBS and, Kids-Mini-BESTest improved by a mean (standard deviation) score of 5.1(1.7) and 8.7(2.8) points, respectively in the experimental group as compared to control group [3.4(1.6) and 5.8(2.5) points]. These gains remained at follow-up (p < 0.001).

Conclusion

Combined virtual reality gaming and physiotherapy is not superior over physiotherapy alone in improving the gross motor performance and daily functioning among children with bilateral spastic cerebral palsy. Virtual gaming, along with physiotherapy, appears to be beneficial in their balance capacity, warranting further trials to investigate the same in children with GMFCS level-III.

中文翻译：

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虚拟现实游戏和物理治疗对双侧痉挛性脑瘫儿童平衡、粗大运动表现和日常功能的随机试验

摘要

背景

平衡问题和粗大运动功能差会影响脑瘫儿童的日常需求。

目的

该研究的目的是检查虚拟现实游戏和物理治疗对双侧痉挛性脑瘫儿童的平衡、粗大运动表现和日常功能的影响。

方法

38 名 6-12 岁双侧痉挛性脑瘫患儿 GMFCS Ⅱ-Ⅲ级，手力分类系统Ⅰ-Ⅲ级参加了本随机对照试验。实验组进行虚拟现实游戏和物理治疗，而对照组单独进行物理治疗。运动强度为每天 60 分钟，每周 4 天，持续 6 周。儿科平衡量表 (PBS)、Kids-Mini-Balance 评估系统测试 (Kids-Mini-BESTest)、Gross Motor Function Measure-88 (GMFM-88) 和 Wee-Functional Independence Measure (WeeFIM) 是在基线、训练后 6 周和 2 个月的随访。

结果

重复测量的组间交互时间方差分析显示，除 Kids-Mini-BESTest 外，所有结果测量均无统计学意义（p  < 0.05）。与对照组相比，实验组的 PBS 和 Kids-Mini-BESTest 的平均（标准差）得分分别提高了 5.1(1.7) 和 8.7(2.8) 分 [3.4(1.6) 和 5.8(2.5)点]。这些收益在随访中保持不变（p  < 0.001）。

结论

虚拟现实游戏和物理治疗相结合在改善双侧痉挛性脑瘫儿童的粗大运动表现和日常功能方面并不优于单独的物理治疗。虚拟游戏和物理治疗似乎对他们的平衡能力有益，需要进一步试验以在 GMFCS 三级儿童中进行同样的研究。