Abstract

The objective of this exploratory randomized controlled trial (RCT) was to provide evidence for the feasibility and therapeutic value of a novel game-based dual-task balance exercise program in children with cerebral palsy (CP). Twenty children with CP were recruited and randomized into two groups: (a) the conventional balance training group (CG) and (b) the experimental group (XG), which received a game-based dual-task (DT) balance exercise program. Both groups received their respective therapy programs for 12 weeks at a frequency of three sessions per week. Semi-structured interviews with the parents and children and qualitative analysis were conducted to evaluate the children’s experiences with the game-based exercise program. The quantitative analysis included (a) the Pediatric Balance Scale (PBS), (b) Gross Motor Function Measure-88 (GMFM-88), and (c) computerized measures of standing balance performance during various dual-task conditions. Compliance was 100% for all 20 participants. Four themes captured the range of each participant’s experiences and opinions: (a) reasons for participation, (b) likes and dislikes with the technologies, (c) positive effects of the program, and (d) future expectations. Children in the XG demonstrated greater improvements in PBS, GMFM, and DT balance measures as compared to children in the CG. The findings demonstrate feasible trial procedures and acceptable DT-oriented training with a high compliance rate and positive outcomes. These findings support further research and development and progression to the next phase of a full-scale RCT to evaluate the clinical effectiveness of the game-based DT balance exercise program for children with CP.

Highlights

  • Cerebral palsy (CP) is one of the most common motor neurodevelopmental disorders, which affects five of every thousand live births in India and three of every thousand live births in North America [1,2]

  • There were no significant group effects observed for any of the outcome measures except for Visual cognitive game (VCG) success rate (SR), where performance was significantly better in the XG as compared to the control group (CG)

  • The game-based DT methods presented in this study broaden the type of visuospatial cognitive activities that can be combined with balance training in children with CP

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Summary

Introduction

Cerebral palsy (CP) is one of the most common motor neurodevelopmental disorders, which affects five of every thousand live births in India and three of every thousand live births in North America [1,2]. Balance impairments and mobility limitations are common in children with CP [3,4,5]. Due to the many problems associated with reduced balance control, providing an effective rehabilitation program is essential in the development of the child’s mobility skills and in helping to prevent non-use sequelae, such as bone deformities, contractures, and obesity [6,7]. Clinicians and researchers have established the importance of task-specific repetitive training in the rehabilitation of motor function in children with cerebral palsy [7,8].

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