Effects of a multi-component virtual reality program on motor skills and functional postural control in children with hemiplegic cerebral palsy

BACKGROUND: Pediatric neurorehabilitation has recently employed virtual reality (VR) technologies as a platform to design and implement novel modalities. AIMS: To evaluate the feasibility of a multi-component VR-based program on motor skills and functional postural control for children with hemiplegic cerebral palsy (HCP). METHODS: A single-case-experimental design was conducted on eight children with HCP (12.33 ± 4.71 years and GMFCS= II, I). The VR-based program consisted of 3 sessions per week for four weeks. Timed Up and Go (TUG) test, Functional Reach Test (FRT), Pediatric Balance Scale (PBS), Activities Scale for Kids (ASK), ABILHAND-Kids, and Box and Block Test (BBT) were used to evaluate functional changes. OUTCOMES AND RESULTS: Statistical analysis showed that improvements in functional postural control were significant on at least one balance measure for seven out of eight participants during the intervention phase. For all participants, a significant increase was observed in the BBT scores. Before-after intervention analysis revealed statistically significant improvements in PBS (z = −2.52, p ≤ 0.01), ABILHAND-Kids (z = −2.25, p ≤ 0.01), and ASK (z = −2.38, p ≤ 0.01). CONCLUSIONS AND IMPLICATIONS: This study provided early evidence of the effectiveness of the multi-component VR-based program in children with HCP. However, future studies with randomized controlled trial design are needed to evaluate the long-term effects and compare them with conventional rehabilitation practice.