Rehabilitation of Children with Hemiparesis: A Pilot Study on the Use of Virtual Reality

Background. A wide range of treatments have been used to improve upper arm motor performances in children with congenital hemiplegia. Recent findings are suggesting that virtual reality based intervention could be a promising tool also in pediatric rehabilitation. Methods. Six patients with congenital hemiplegia (age: 4–16 years) were recruited among those treated in the Child Neuropsychiatry and Rehabilitation Unit of the IRCCS “Santa Maria Nascente” (Milan, Italy), for a preliminary investigation about using nonimmersive virtual reality for upper limb rehabilitation. Ten sessions using VRRS system (Khymeia, Padova, Italy) were weekly administered as a part of the rehabilitative treatment. Melbourne Assessment of Unilateral Limb Movement, Ashworth Scale, and Arm's PROM were selected as main outcome measures. At the end of treatment, participants filled in an ad hoc satisfaction questionnaire. Results. All subjects completed the proposed treatment, and they also gave a positive judgment regarding this rehabilitative method. Melbourne score increased in all patients. Conclusion. Our findings seem to support the evidence that VR treatment could be a promising and engaging tool for pediatric rehabilitation. However, the limited size of the population and the small number of sessions require further investigations and RCTs to confirm our positive results.

[1]  R. Palisano,et al.  Development and reliability of a system to classify gross motor function in children with cerebral palsy , 1997, Developmental medicine and child neurology.

[2]  G. Hagberg,et al.  The Changing Panorama of Cerebral Palsy in Sweden , 1984, Acta paediatrica Scandinavica.

[3]  Dido Green,et al.  Use of virtual reality in rehabilitation of movement in children with hemiplegia − A multiple case study evaluation , 2012, Disability and rehabilitation.

[4]  Jenny Ziviani,et al.  The effect of virtual reality interventions on physical activity in children and adolescents with early brain injuries including cerebral palsy , 2012, Developmental medicine and child neurology.

[5]  Jane Galvin,et al.  Does intervention using virtual reality improve upper limb function in children with neurological impairment: A systematic review of the evidence , 2011, Brain injury.

[6]  STACEY MILLER,et al.  Doing Play: Competency, Control, and Expression , 2003, Cyberpsychology Behav. Soc. Netw..

[7]  P. Tonin,et al.  Motor Learning Principles for Rehabilitation: A Pilot Randomized Controlled Study in Poststroke Patients , 2010, Neurorehabilitation and neural repair.

[8]  Jenny Ziviani,et al.  Systematic Review and Meta-analysis of Therapeutic Management of Upper-Limb Dysfunction in Children With Congenital Hemiplegia , 2009, Pediatrics.

[9]  K. Himmelmann,et al.  The changing panorama of cerebral palsy in Sweden. X. Prevalence and origin in the birth‐year period 1999–2002 , 2010, Acta paediatrica.

[10]  M. Chiappedi,et al.  Importance of a critical reading of neuropsychological testing. , 2011, Minerva pediatrica.

[11]  J. Deutsch,et al.  Cochrane review: virtual reality for stroke rehabilitation. , 2012, European journal of physical and rehabilitation medicine.

[12]  D. Reid,et al.  Virtual Reality in Pediatric Neurorehabilitation: Attention Deficit Hyperactivity Disorder, Autism and Cerebral Palsy , 2010, Neuroepidemiology.

[13]  Richard W. Bohannon,et al.  Interrater reliability of a modified Ashworth scale of muscle spasticity. , 1987, Physical therapy.

[14]  Dianne J. Russell,et al.  Gross Motor Function Measure (GMFM-66 and GMFM-88) User's Manual , 2013 .