Immersive Virtual Environments and Wearable Haptic Devices in rehabilitation of children with neuromotor impairments: a single-blind randomized controlled crossover pilot study

Ilaria Bortone,Luca Bonfiglio,Antonio Frisoli,Alessandra Crecchi,Daniele Leonardis,Michele Barsotti,Alessandra Tozzini

doi:10.1186/s12984-020-00771-6

Abstract

BackgroundThe past decade has seen the emergence of rehabilitation treatments using virtual reality. One of the advantages in using this technology is the potential to create positive motivation, by means of engaging environments and tasks shaped in the form of serious games. The aim of this study is to determine the efficacy of immersive Virtual Environments and weaRable hAptic devices (VERA) for rehabilitation of upper limb in children with Cerebral Palsy (CP) and Developmental Dyspraxia (DD).MethodsA two period cross-over design was adopted for determining the differences between the proposed therapy and a conventional treatment. Eight children were randomized into two groups: one group received the VERA treatment in the first period and the manual therapy in the second period, and viceversa for the other group. Children were assessed at the beginning and the end of each period through both the Nine Hole Peg Test (9-HPT, primary outcome) and Kinesiological Measurements obtained during the performing of similar tasks in a real setting scenario (secondary outcomes).ResultsAll subjects, not depending from which group they come from, significantly improved in both the performance of the 9-HPT and in the parameters of the kinesiological measurements (movement error and smoothness). No statistically significant differences have been found between the two groups.ConclusionsThese findings suggest that immersive VE and wearable haptic devices is a viable alternative to conventional therapy for improving upper extremity function in children with neuromotor impairments.Trial registration ClinicalTrials, NCT03353623. Registered 27 November 2017-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03353623

Highlights

The past decade has seen the emergence of rehabilitation treatments using virtual reality
We reviewed all research studies published over the last 5 years, where Virtual reality (VR)-based interventions were promoted for upper limb therapy and have been conducted with children with neuromotor impairments
The report of the measured performance is divided in the three panels of Figs. 4, 5 and 6, referred to the clinical scale (9-HPT and UFI), to the Velocity Weighted Error, and to the Smoothness metrics respectively

Summary

Introduction

The past decade has seen the emergence of rehabilitation treatments using virtual reality. The aim of this study is to determine the efficacy of immersive Virtual Environments and weaRable hAptic devices (VERA) for rehabilitation of upper limb in children with Cerebral Palsy (CP) and Developmental Dyspraxia (DD). Bortone et al J NeuroEngineering Rehabil (2020) 17:144 therapeutic options for these children frequently remain an unmet need [1, 2]. New digital technologies offer an exciting means of engaging children in therapy and providing intervention environments and experiences that can be adapted to individual needs [3]. We reviewed all research studies published over the last 5 years, where VR-based interventions were promoted for upper limb therapy and have been conducted with children with neuromotor impairments (cerebral palsy, CP, or developmental dyspraxia, DD).

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