Do Ji-Hye, Yoo Eun-Young, Jung Min-Ye, Park Hae Yean
Department of Occupational Therapy, The Graduate School, Yonsei University, Kangwon-do, Republic of Korea.
Department of Occupational Therapy, College of Health Science, Yonsei University, Kangwon-do, Republic of Korea.
NeuroRehabilitation. 2016;38(2):115-27. doi: 10.3233/NRE-161302.
Hemiplegic cerebral palsy is a neurological symptom appearing on the unilateral arm and leg of the body that causes affected upper/lower limb muscle weakening and dysesthesia and accompanies tetany and difficulties in postural control due to abnormal muscle tone, and difficulties in body coordination.
The purpose of this study was to examine the impact of virtual reality-based bilateral arm training on the motor skills of children with hemiplegic cerebral palsy, in terms of their upper limb motor skills on the affected side, as well as their bilateral coordination ability.
The research subjects were three children who were diagnosed with hemiplegic cerebral palsy. The research followed an ABA design, which was a single-subject experimental design. The procedure consisted of a total of 20 sessions, including four during the baseline period (A1), 12 during the intervention period (B), and four during the baseline regression period (A2), For the independent variable bilateral arm training based on virtual reality, Nintendo Wii game was played for 30 minutes in each of the 12 sessions. For the dependent variables of upper limb motor skills on the affected side and bilateral coordination ability, a Wolf Motor Function Test (WMFT) was carried out for each session and the Pediatric Motor Activity Log (PMAL) was measured before and after the intervention, as well as after the baseline regression period. To test bilateral coordination ability, shooting baskets in basketball with both hands and moving large light boxes were carried out under operational definitions, with the number of shots and time needed to move boxes measured. The results were presented using visual graphs and bar graphs.
The study's results indicated that after virtual reality-based bilateral arm training, improvement occurred in upper limb motor skills on the affected sides, and in bilateral coordination ability, for all of the research subjects. Measurements of the effects of sustained therapy after completion of the intervention, during the baseline regression period, revealed that upper limb motor skills on the affected side and bilateral coordination ability were better than in the baseline period for all subjects.
This study confirmed that for children with hemiplegic with cerebral palsy, bilateral arm training based on virtual reality can be an effective intervention method for enhancing the upper limb motor skills on the affected side, as well as bilateral coordination ability.
偏瘫型脑瘫是一种出现在身体单侧手臂和腿部的神经症状，会导致患侧上肢/下肢肌肉无力和感觉异常，并伴有因肌张力异常引起的手足搐搦以及姿势控制困难和身体协调障碍。
本研究旨在探讨基于虚拟现实的双侧手臂训练对偏瘫型脑瘫患儿运动技能的影响，包括患侧上肢运动技能以及双侧协调能力。
研究对象为三名被诊断为偏瘫型脑瘫的儿童。研究采用ABA设计，这是一种单受试者实验设计。该程序总共包括20个疗程，其中基线期（A1）有4个疗程，干预期（B）有12个疗程，基线回归期（A2）有4个疗程。对于基于虚拟现实的自变量双侧手臂训练，在12个疗程中的每个疗程都玩30分钟的任天堂Wii游戏。对于患侧上肢运动技能和双侧协调能力的因变量，每个疗程都进行一次沃尔夫运动功能测试（WMFT），并在干预前后以及基线回归期后测量儿科运动活动日志（PMAL）。为了测试双侧协调能力，按照操作定义进行双手投篮和移动大型灯箱测试，记录投篮次数和移动灯箱所需时间。结果用视觉图表和柱状图呈现。
研究结果表明，在基于虚拟现实的双侧手臂训练后，所有研究对象的患侧上肢运动技能和双侧协调能力均有改善。在干预完成后的基线回归期对持续治疗效果的测量显示，所有受试者的患侧上肢运动技能和双侧协调能力均优于基线期。
本研究证实，对于偏瘫型脑瘫患儿，基于虚拟现实 的双侧手臂训练可以是一种有效的干预方法，用于增强患侧上肢运动技能以及双侧协调能力。
