J. Stander1, J. Du Preez1, C. Kritzinger1, N. Obermeyer1, S. Struwig1, N. Van Wyk1, J. Zaayman1, M. Burger1
1Stellenbosch University, Physiotherapy, Cape Town, South Africa
Background: Down syndrome is a genetic condition caused by an error in cell division, occurring at conception, which results in an additional copy of chromosome 21. Individuals struggle to perform anticipatory postural adjustments and are slower to adapt to motor task demands and environmental changes, as a result of decreased motor proficiency. Limited research exists regarding the efficacy of virtual reality therapy combined with standard physiotherapy versus standard physiotherapy alone in the management of individuals with Down syndrome.
Purpose: The purpose of this systematic review was to determine the effectiveness of virtual reality therapy, specifically Nintendo Wii, combined with physiotherapy for improving motor proficiency in individuals with Down syndrome, compared to standard physiotherapy alone.
Methods: Nine computerised databases were searched from inception to July 2020. Search terms included Down syndrome, motor proficiency, virtual reality, Nintendo Wii, and/or physiotherapy. Methodological quality was appraised using the PEDro scale. Results were described narratively using text and tables due to the heterogeneity across the studies. Systematic review registration: PROSPERO registration number: CRD42020190829
Results: Three randomised controlled trials were included, with an average PEDro score of 7/11. Motor proficiency was evaluated in four categories: balance, coordination, strength and agility. Only agility showed significant improvement after 24 weeks of intervention. Results for balance, coordination and strength were inconclusive.
Conclusion(s): Level II evidence suggests virtual reality therapy may be valuable to include in a physiotherapy program, specifically to improve agility in Down syndrome individuals as well as balance in children with Down syndrome. Clinicians are advised to consider virtual reality therapy, when available, in addition to standard physiotherapeutic interventions.
Implications: Clinicians are advised to use virtual reality therapy, when available, in addition to standard physiotherapeutic intervention in improving agility in individuals with Down syndrome as it could be a valuable addition to standard physiotherapy practice. Virtual reality therapy can also be used for balance training in a younger population, specifically children. The advised duration of intervention is 6 to 24 weeks. However, this expensive electronic device may not be feasible in low- and middle-income countries. The results for balance, strength and coordination are inconclusive.
Funding, acknowledgements: The authors received no financial support.
Keywords: Down syndrome, Virtual reality therapy, Motor proficiency
Topic: Paediatrics
Did this work require ethics approval? No
Institution: Stellenbosch University
Committee: Health Research Ethics Committee
Reason: This research project was a systematic review.
All authors, affiliations and abstracts have been published as submitted.
