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Abstract
OBJECTIVE: To verify the effect of an intervention protocol using virtual reality (VR) on the motor performance and balance of a child with cerebral palsy (CP).CASE DESCRIPTION: To comply with the proposed objectives, a 7-year old child with spastic hemiplegic cerebral palsy (CP), GMFCS level I, was submitted to a physiotherapy intervention protocol of 12 45-minute sessions, twice a week, using virtual reality-based therapy. The protocol used a commercially-available console (XBOX(r)360Kinect(r)) able to track and reproduce body movements on a screen. Prior to the intervention protocol, the child was evaluated using the Motor Development Scale (MDS) and the Pediatric Balance Scale (PBS) in order to assess motor development and balance, respectively. Two baseline assessments with a 2-week interval between each other were carried out for each tool. Then, the child was re-evaluated after the twelfth session. The results showed no changes in the two baseline scores. After the intervention protocol, the child improved his scores in both tools used: the PBS score increased by 3 points, reaching the maximal score, and the MDS increased from a much inferior motor performance to just an inferior motor performance.COMMENTS: The evidence presented in this case supports the use of virtual reality as a promising tool to be incorporated into the rehabilitation process of patients with neuromotor dysfunction.
Highlights
Acquired brain injuries, such as hypoxic-ischemic lesions up to the age of three, are among the ten main causes of spastic hemiplegic cerebral palsy (CP).[1,2] it does not severely impair functionality in children, hemiplegic motor impairment produces neuromotor alterations that cause precision deficits in movement performance and deficits in postural control, which is responsible for the stability and alignment between the body segments during the performance of activities.[3]
The progression of the therapy in these children is often compromised by the difficulty in finding tasks that motivate them, while at the same time showing therapeutic efficacy. Considering all these factors, we report a case that evaluated the effect of an intervention using virtual reality (VR) through the commercially available XBOX®360 Kinect® console (Microsoft®, New York, United States) on the motor performance and functional balance of a child with mild motor impairment CP
Regarding baseline measures 1 and 2 (B1 and baseline 2 (B2)), the score values in the tools used for the assessment remained the same
Summary
Acquired brain injuries, such as hypoxic-ischemic lesions up to the age of three, are among the ten main causes of spastic hemiplegic cerebral palsy (CP).[1,2] it does not severely impair functionality in children, hemiplegic motor impairment produces neuromotor alterations that cause precision deficits in movement performance and deficits in postural control, which is responsible for the stability and alignment between the body segments during the performance of activities.[3]. The presence of neuromotor impairments in hemiplegic CP and its high incidence in the pediatric age range[5] justify the development of studies assessing the effect of therapeutic interventions on the balance and quality of postural responses in these children,[6,7,8] aiming to determine the most effective approaches in functional recovery In this sense, virtual reality (VR)-based therapy is an increasingly acknowledged interactive tool used for patient immersion in a virtual environment.[9,10,11]. The progression of the therapy in these children is often compromised by the difficulty in finding tasks that motivate them, while at the same time showing therapeutic efficacy Considering all these factors, we report a case that evaluated the effect of an intervention using VR through the commercially available XBOX®360 Kinect® console (Microsoft®, New York, United States) on the motor performance and functional balance of a child with mild motor impairment CP. The two games used for the protocol were: a) A game in which the child saw himself projected inside an aquarium, which contained holes that had to be stopped using the upper or lower limbs; and b) A game in which the child, on top of a moving trailer, had to overcome obstacles by jumping, squatting and performing side-to-side movements of the body
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