虚拟现实游戏与物理治疗对双侧痉挛型脑瘫患儿平衡能力、粗大运动表现及日常功能影响的随机试验
Randomised trial of virtual reality gaming and physiotherapy on balance, gross motor performance and daily functions among children with bilateral spastic cerebral palsy.
作者信息
Jha Krishna Kumari, Karunanithi Gandhi Balaji, Sahana A, Karthikbabu Suruliraj
机构信息
Chitkara School of Health Sciences, Chitkara University, Punjab, India.
Manipal Academy of Higher Education, Manipal College of Health Professions, Department of Physiotherapy, MHB, Bangalore, India.
出版信息
Somatosens Mot Res. 2021 Jun;38(2):117-126. doi: 10.1080/08990220.2021.1876016. Epub 2021 Mar 3.
BACKGROUND
Balance issues and poor gross motor function affect the daily needs of children with cerebral palsy.
PURPOSE
The study objective was to examine the effects of virtual reality gaming and physiotherapy on balance, gross motor performance and daily functioning among children with bilateral spastic cerebral palsy.
METHOD
Thirty-eight children with bilateral spastic cerebral palsy aged 6-12 years with GMFCS- level II-III, Manual Ability Classification System level I-III participated in this randomized controlled trial. The experimental group performed virtual reality games and physiotherapy, while the control group underwent physiotherapy alone. The exercise intensity was 60 minutes session a day, 4-days a week for 6-weeks. Paediatric Balance Scale (PBS), Kids-Mini-Balance Evaluation System Test (Kids-Mini-BESTest), Gross Motor Function Measure-88 (GMFM-88), and Wee-Functional Independence Measure (WeeFIM) were the outcome measures collected at baseline, 6-week post-training and 2-months follow-up.
RESULTS
The time by group interaction of repeated measures ANOVA revealed no statistical significance for all the outcome measures except Kids-Mini-BESTest ( < 0.05). The PBS and, Kids-Mini-BESTest improved by a mean (standard deviation) score of 5.1(1.7) and 8.7(2.8) points, respectively in the experimental group as compared to control group [3.4(1.6) and 5.8(2.5) points]. These gains remained at follow-up ( < 0.001).
CONCLUSION
Combined virtual reality gaming and physiotherapy is not superior over physiotherapy alone in improving the gross motor performance and daily functioning among children with bilateral spastic cerebral palsy. Virtual gaming, along with physiotherapy, appears to be beneficial in their balance capacity, warranting further trials to investigate the same in children with GMFCS level-III.
背景
平衡问题和较差的粗大运动功能影响脑瘫儿童的日常需求。
目的
本研究的目的是探讨虚拟现实游戏和物理治疗对双侧痉挛性脑瘫儿童平衡能力、粗大运动表现和日常功能的影响。
方法
38名年龄在6至12岁、GMFCS水平为II - III级、手动能力分类系统水平为I - III级的双侧痉挛性脑瘫儿童参与了这项随机对照试验。实验组进行虚拟现实游戏和物理治疗,而对照组仅接受物理治疗。运动强度为每天60分钟,每周4天,共6周。在基线、训练后6周和2个月随访时收集儿科平衡量表(PBS)、儿童迷你平衡评估系统测试(Kids - Mini - BESTest)、粗大运动功能测量-88(GMFM - 88)和小儿功能独立性测量(WeeFIM)作为结果指标。
结果
重复测量方差分析的组间交互作用时间显示,除Kids - Mini - BESTest外(<0.05),所有结果指标均无统计学意义。与对照组[3.4(1.6)和5.8(2.5)分]相比,实验组的PBS和Kids - Mini - BESTest平均(标准差)得分分别提高了5.1(1.7)和8.7(2.8)分。这些改善在随访时仍然存在(<0.001)。
结论
在改善双侧痉挛性脑瘫儿童的粗大运动表现和日常功能方面,虚拟现实游戏与物理治疗相结合并不优于单纯物理治疗。虚拟现实游戏与物理治疗一起,似乎对他们的平衡能力有益,有必要进一步试验以研究GMFCS III级儿童的情况。