Effects of Virtual Rehabilitation on Upper Extremity Motor Learning in Hemiplegic Cerebral Palsy

Abstract

Background: Cerebral palsy is a prevalent neurodevelopmental disorder causing a non-progressive disturbance of motor function that influences posture, movement, and motor coordination. Objective: To investigate the effects of virtual rehabilitation on upper extremity motor learning in patients with hemiplegic cerebral palsy. Methodology: A randomized controlled trial was conducted from April to July 2022 on 25 spastic hemiplegic cerebral palsy patients enrolled with a non-probability purposive sampling technique. The population was selected from the neurology department of Allied Hospital and the physical therapy department of Madina Teaching Hospital, Faisalabad. About 25 spastic hemiplegic cerebral palsy patients of both genders enrolled with non-probability purposive sampling and were allocated into two groups Group A (13 participants) and B (12 participants) randomly to avoid biases with the help of a random generator. The study focused on patients between 5 and 10 years old who had been diagnosed with hemiplegic cerebral palsy and GMFCS levels 1, 2, and 3. Group A underwent virtual reality training as well as conventional therapy and Group B underwent conventional treatment which includes passive stretching and strengthening exercises. Group A received 2 sessions/week including virtual reality gaming by Kinect X-BOX system for 20 minutes in addition to upper extremity exercises for 20 minutes for eight weeks and Group B received conventional therapy including passive stretching and strengthening exercises. Each exercise took place for 20 minutes 10 repetitions, twice a week, for 8 weeks. ABILHAND kids and the Pediatric Motor Activity Log were the outcome-measuring tools. Measurements were taken at baseline and after the 16^th session. Results: There was a significant increase in the ABILHAND kids’ assessment and the Pediatric Motor Activity Log scores after treatment compared to baseline values in the study group (p<0.001). Both virtual reality along conventional therapy improved upper limb motor response in pre- to post-intervention analysis (p<0.05) as compared to conventional therapy (p>0.583). Conclusion: Virtual reality rehabilitation as provided by Kinect-based game training showed improvement in motor functions in hemiplegic cerebral palsy patients.