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Virtual reality helps teens with CP.


WASHINGTON -- The use of virtual reality games not only improved functional balance and mobility in adolescents with cerebral palsy, but also had lasting effects even 1 month after training.

Dr. Marie Brien of the Ottawa (Ont.) Children's Treatment Centre, said these results are promising, especially for adolescents with CP who tend to have a "lack of motivation and engagement."

According to Dr. Brien, this age group has been reported to reach a plateau in gross motor skills, and virtual reality can open the door for occupational therapists to give these youngsters more intensive therapy. Adolescents with CP do "respond to short duration and high-intensity virtual reality training."

Although it was a small study of four males aged 13-18 years, the results were significant for every participant, Dr. Brien said at the meeting.

After a month of 90-minute intensive virtual reality-based training (two 45-minute daily training sessions for 5 consecutive days), the participants showed improvement in Community Balance and Mobility Scale (CB&M) scores and the 6-Minute Walking Test (6MWT). In fact, improvement in both measures for all patients was seen as early as week 1.

Three of the adolescents were diagnosed with spastic diplegia and one with choreoathetosis. To assess balance and functional mobility, Dr. Brien and her colleagues used the CB&M, the 6MWT, the Timed Up and Down Stairs (TUDS) test, and the Gross Motor Function Measure (GMFM)--Dimension E. Each participant served as his own control, Dr. Brien said.

The patients chose from a variety of 2D scenarios including soccer (goalie), snowboarding, and "shark bait." They were evaluated between three and six times in the baseline phase, five times in the intervention phase, and four times in the follow-up phase (three times at 1 week and once at 1-month post training). GestureTek's Interactive Rehabilitation and Exercise System (IREX) applications lasted 2 minutes, and patients were given a 10-second rest interval between each application.

"The virtual reality scenarios presented ever-changing challenges," Dr. Brien said, including repeated sustained and unpredictable patterns of movement such as side lunges or rapid changes in direction.

Difficulty and speed increased as the participant skill level improved. There were also statistically significant improvements for one patient in the TUDS, and for another in the GMFM-Dimension E test.

Dr. Brien reported no relevant disclosures.

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Title Annotation:CLINICAL ROUNDS
Author:Bullock, Lorinda
Publication:Pediatric News
Date:Nov 1, 2010
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