Virtual reality rehabilitation in children with brain injury: a randomized controlled trial

• Published in: Developmental medicine and child neurology Vol. 63; no. 4; pp. 480 - 487
• Main Authors: Choi, Ja Young, Yi, Sook‐Hee, Ao, Lijuan, Tang, Xin, Xu, Xuan, Shim, Dain, Yoo, Beomki, Park, Eun Sook, Rha, Dong‐wook
• Format: Journal Article
• Language: English
• Published: England 01-04-2021
• ISSN: 0012-1622; 1469-8749
• DOI: 10.1111/dmcn.14762

Aim
To investigate the efficacy of a virtual reality rehabilitation system of wearable multi‐inertial sensors to improve upper‐limb function in children with brain injury.
Method
Eighty children (39 males, 41 females) with brain injury including cerebral palsy aged 3 to 16 years (mean age 5y 8mo, SD 2y 10mo) were assessed as part of a multicentre, single‐blind, randomized controlled trial. The intervention group received a 30‐minute virtual reality intervention and a 30‐minute session of conventional occupational therapy while the control group received 60 minutes of conventional occupational therapy per session, with 20 sessions over 4 weeks. The virtual reality rehabilitation system consisted of games promoting wrist and forearm articular movements using wearable inertial sensors. The Melbourne Assessment of Unilateral Upper Limb Function‐2 (MA‐2), Upper Limb Physician’s Rating Scale, Pediatric Evaluation of Disability Inventory Computer Adaptive Test, and computerized three‐dimensional motion analysis were performed.
Results
Both groups (virtual reality, n=40; control, n=38) significantly improved after treatment compared to baseline; however, the virtual reality group showed more significant improvements in upper‐limb dexterity functions (MA‐2, virtual reality group: Δ=10.09±10.50; control: Δ=3.65±6.92), performance of activities of daily living, and forearm supination by kinematic analysis (p<0.05). In the virtual reality group, children with more severe motor impairment showed significant improvements compared to those with less severe impairment.
Interpretation
The virtual reality rehabilitation system used in this study, which consists of wearable inertial sensors and offers intensive, interactive, and repetitive motor training, is effective in children with brain injury.
What this paper adds
Both virtual reality rehabilitation and conventional occupational therapy were effective for upper‐limb training.
Virtual reality training was superior in improving dexterity, performance of activities of daily living, and active forearm supination motion.
The effect of virtual reality training was significant in children with more severe motor impairments.
What this paper adds
Both virtual reality rehabilitation and conventional occupational therapy were effective for upper‐limb training.
Virtual reality training was superior in improving dexterity, performance of activities of daily living, and active forearm supination motion.
The effect of virtual reality training was significant in children with more severe motor impairments.
This article is commented on by Rathinam on pages 370–371 of this issue.