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M. Elhamadany1
1School of Medicine and Health Sciences, University of North Dakota, Department of Physical Therapy, Grand Forks, ND, United States
Background: One of the first concerns for parents of children with neuromotor dysfunction is whether their child will walk. Impaired gait is highly associated with balance dysfunction; improvement in balance has been shown to be the most important determinant for improving gait.
Research over the past decade using Virtual Reality (VR) intervention has reported benefits to children with neuromotor dysfunctions.
Studying a large amount of outcome variables led to inconclusive results in the previous reviews about the effect of VR in children rehabilitation.
Research over the past decade using Virtual Reality (VR) intervention has reported benefits to children with neuromotor dysfunctions.
Studying a large amount of outcome variables led to inconclusive results in the previous reviews about the effect of VR in children rehabilitation.
Purpose: The purpose of this review is to analyze the current evidence available regarding the effectiveness of VR with a focus on balance and gait ability in children with neuromotor dysfunctions.
Methods: Number of subjects: Fourteen studies met the inclusion criteria for review.
Materials/methods: A systematic review of controlled trials (RCTs) was conducted. Five electronic databases, PubMed, CINAHL Complete, SPORTDiscus, Google Scholar and Embase, were searched up to May 2020. Only RCTs that compared VR with conventional therapy were included. The quality of RCTs was evaluated using the Physiotherapy Evidence Database (PEDro) scale. The evaluation was conducted independently by 2 reviewers. Consensus was reached by discussion or consulting a third person.
Materials/methods: A systematic review of controlled trials (RCTs) was conducted. Five electronic databases, PubMed, CINAHL Complete, SPORTDiscus, Google Scholar and Embase, were searched up to May 2020. Only RCTs that compared VR with conventional therapy were included. The quality of RCTs was evaluated using the Physiotherapy Evidence Database (PEDro) scale. The evaluation was conducted independently by 2 reviewers. Consensus was reached by discussion or consulting a third person.
Results: Fourteen studies were included. The total pooled sample size was 490 participants with CP, DS, Acquired Brain Injury, and Developmental Delay. All studies included male and female subjects aged 3 to 18 years. The dynamic balance and gait were assessed by the numerous clinical tests such as Pediatric Balance Scale (PBS), and 10 Meter Walk Test (10MWT).
Data collected from these studies demonstrate that VR is more effective than conventional therapy on improving balance and gait ability in children with neuromotor dysfunctions. However, these results should be interpreted with great caution due to the large diversity of intervention protocols.
Data collected from these studies demonstrate that VR is more effective than conventional therapy on improving balance and gait ability in children with neuromotor dysfunctions. However, these results should be interpreted with great caution due to the large diversity of intervention protocols.
Conclusion(s): Evidence suggests that VR is an effective intervention for improving gait and balance ability in children with neuromotor dysfunctions. VR has the capability to create a virtual rehabilitation scene in which the intensity of practice and sensory feedback can be systematically manipulated to provide the most appropriate, individualized real-life motor retraining that consequently assists children in practicing goal-directed tasks.
Implications: Based on this systematic review, VR based therapy might be useful intervention for the motor rehabilitation of children with neuromotor dysfunctions. Therefore, the addition of VR to therapeutic planning of these children may benefit the rehabilitation process by promoting motor gains. However, it would be useful for clinicians to recognize which types of VR and which training protocol would be more valuable for patients in each subgroup.
Further quantitative research should be conducted to determine the gold standard in VR systems and intervention protocols as well as to clarify the sub-groups of the population of each diagnosis that would most benefit from VR based training.
Further quantitative research should be conducted to determine the gold standard in VR systems and intervention protocols as well as to clarify the sub-groups of the population of each diagnosis that would most benefit from VR based training.
Funding, acknowledgements: NA
Keywords: Virtual-Reality, Children, Gait
Topic: Paediatrics
Did this work require ethics approval? No
Institution: University of North Dakota (UND)
Committee: NA
Reason: it is a systematic Review
All authors, affiliations and abstracts have been published as submitted.
