Levac Danielle, McCormick Anna, Levin Mindy F, Brien Marie, Mills Richard, Miller Elka, Sveistrup Heidi
a Department of Physical Therapy, Movement and Rehabilitation Sciences , Northeastern University , Boston , Massachusetts , USA.
b Department of Pediatrics, Faculty of Medicine , University of Ottawa , Ottawa , Ontario , Canada.
Phys Occup Ther Pediatr. 2018 Feb;38(1):74-87. doi: 10.1080/01942638.2017.1287810. Epub 2017 Apr 4.
To compare changes in gross motor skills and functional mobility between ambulatory children with cerebral palsy who underwent a 1-week clinic-based virtual reality intervention (VR) followed by a 6-week, therapist-monitored home active video gaming (AVG) program and children who completed only the 6-week home AVG program.
Pilot non-randomized controlled trial. Five children received 1 hour of VR training for 5 days followed by a 6-week home AVG program, supervised online by a physical therapist. Six children completed only the 6-week home AVG program. The Gross Motor Function Measure Challenge Module (GMFM-CM) and Six Minute Walk Test (6MWT) evaluated change.
There were no significant differences between groups. The home AVG-only group demonstrated a statistically and clinically significant improvement in GMFM-CM scores following the 6-week AVG intervention (median difference 4.5 points, interquartile range [IQR] 4.75, p = 0.042). The VR + AVG group demonstrated a statistically and clinically significant decrease in 6MWT distance following the intervention (median decrease 68.2 m, IQR 39.7 m, p = 0.043). All 6MWT scores returned to baseline at 2 months post-intervention.
Neither intervention improved outcomes in this small sample. Online mechanisms to support therapist-child communication for exercise progression were insufficient to individualize exercise challenge.
比较接受了为期1周的基于诊所的虚拟现实干预（VR），随后进行为期6周的、由治疗师监督的家庭主动视频游戏（AVG）计划的脑瘫门诊儿童与仅完成了为期6周的家庭AVG计划的儿童在粗大运动技能和功能活动能力方面的变化。
先导性非随机对照试验。五名儿童接受了为期5天、每天1小时的VR训练，随后进行为期6周的家庭AVG计划，并由一名物理治疗师在线监督。六名儿童仅完成了为期6周的家庭AVG计划。采用粗大运动功能测量挑战模块（GMFM-CM）和六分钟步行测试（6MWT）评估变化情况。
两组之间无显著差异。仅接受家庭AVG干预的组在为期6周的AVG干预后，GMFM-CM评分在统计学和临床上均有显著改善（中位数差异4.5分，四分位间距[IQR]4.75，p = 0.042）。VR + AVG组在干预后6MWT距离在统计学和临床上均有显著下降（中位数下降68.2米，IQR 39.7米，p = 0.043）。所有6MWT评分在干预后2个月恢复到基线水平。
在这个小样本中，两种干预措施均未改善结果。支持治疗师与儿童就运动进展进行沟通的在线机制不足以实现运动挑战的个性化。
