Development of virtual reality in the upper extremities function in children with Cerebral Palsy. A pilot randomized controlled trial.
Apiphan Iamchaimongkol, Siriluck Sangkrai, Pimtida Alberts and 6 others
PMID 42351213WHAT IT FOUND
Virtual reality training did not significantly improve upper-extremity range of motion or motor function versus conventional therapy in 42 children with cerebral palsy.
A younger 10 to 12 year subgroup showed better self-reported manual ability.
Key findings
01Both conventional therapy and VR training improved shoulder and elbow range of motion, Box and Block Test scores and ABILHAND-Kids scores, but the improvement did not differ significantly between groups.
02The ABILHAND-Kids score did not differ significantly between groups overall (p = 0.164), but children aged 10 to 12 years showed a significant VR advantage (p = 0.011).
03No adverse physical or mental effects, such as dizziness, nausea, vomiting, or motion-induced seizure, were reported after VR training.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This was a pilot randomized controlled trial with 42 children, and the authors state that the sample size was not enough to detect changes in the outcomes. Participants completed only 6.48 sessions in the control group and 7 sessions in the VR group, representing 50% of the total sessions, because school closures and absences interrupted data collection during the COVID-19 pandemic. The VR games targeted shoulder and elbow movement, but wrist range of motion and grip strength were not measured, so the study cannot explain changes in tasks that need hand grasp and release. Participants and therapists could not be blinded to allocation, so motivation and effort may have differed between groups. The only significant result was in an age subgroup on a secondary self-report outcome, not the primary outcome, so it should not be treated as proof that VR works. The study included children with different cerebral palsy types and brain pathology, which may have influenced the results.
Declared interests
The National Research Council of Thailand funded the study.
The easy way to misread this
Do not conclude that VR improves upper-extremity function in children with cerebral palsy. The primary range-of-motion outcome did not differ significantly between groups, and the significant ABILHAND-Kids result was only in the 10 to 12 year subgroup on a secondary outcome.