Abstract
Virtual reality-assisted physical therapy and mirror visual feedback (MVF) are promising treatments for children with cerebral palsy (CP). However, thus far, neither interventions’ use has been reported in adults with CP. The following case report examines the safety and feasibility of using customized virtual reality (VR) interventions to deliver MVF to an adult with hemiplegic CP and right sided pain, weakness, and dystonias. A weekly intervention was delivered in an ambulatory care setting over one year. Self-reported pain, motor function, anxiety, disability, quality of life and depression were monitored weekly. The treatment was acceptable and well tolerated with no instances of cybersickness. The intervention showed immediate and consistent pain relief during treatment, similar to those reported in other studies, with the percentage of pain relief during sessions ranging from 6.25% to 38.5%. Motor function, including range of motion, control, and dexterity, were improved per patient report. However, the duration of pain relief lasted only 2–4 days between sessions. The authors believe that the present findings may inspire others treating adults and children with CP to explore the use of MVF and VR to enhance rehabilitation with an emphasis on adapting technologies for home use. Further implications of these findings for the future are discussed.
Highlights
Cerebral palsy (CP) is a diverse condition categorized by permanent central motor problems caused by a variety of factors during fetal development
Given the mounting evidence supporting the use of virtual reality (VR) and mirror visual feedback (MVF) for pediatric CP patients and the paucity of treatment studies for adults with CP, we report on the use of virtually delivered MVF (VR-MVF) in a single case of an adult with CP during the course of care in an outpatient setting
We examined the potential acceptability and feasibility of this approach to determine if further investigation or clinical trials of VR-MVF for adults with CP is warranted
Summary
Cerebral palsy (CP) is a diverse condition categorized by permanent central motor problems caused by a variety of factors during fetal development. Several promising trials investigating children with CP have included Mirror Visual Feedback (MVF) [3,4,5] and virtual reality (VR)-mediated physical and occupational therapy [6] in their approach. While more than 23 randomized controlled trials of fair-to-good methodological quality have investigated the use of VR for children with CP, no reports of its use in adults were found. These studies have been summarized in a systematic review [6], which concluded that VR may demonstrate short-term benefits to limb function, postural control, and balance in pediatric CP. Written informed consent was provided by the patient in accordance with Stanford University School of Medicine and Healthcare Hospital and Clinics (Stanford, CA, USA)
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