VR on UE in Children with CP: Meta-analysis

Effect of Virtual Reality on Upper Extremity Function in Children with Cerebral Palsy: A Meta-analysis
Chen, Y-P., Lee, S-Y. & Howard A.M. Pediatric Physical Therapy 2014:00 1 - 12
DOI: 10.1097/PEP.0000000000000046

Link to abstract:
www.ncbi.nlm.nih.gov/pubmed/24819682

Purpose: To systematically examine studies that consider the effect of active video games, virtual reality and robot therapy (VR) on improving upper extremity motor function in children with CP.

Method: A considered search strategy was used to include 14 research articles. A scoring system was used for the 3 RCTs, for 10 case series and one cohort study; a level of evidence was assigned to each based on the Oxford Centre for Evidence Based Medicine rating system.

Results: The RCT studies compared VR to traditional therapy, and the case series compared children before and after VR interventions. 5 studies were based on commercially available systems: Wii (1), Sony EyeToy Play (1), Gesturetek (3); the rest were experimental, custom engineered systems (7) or robot assisted interventions (2). The meta-analysis reports the 3 RCTs showed effectiveness for VR vs. traditional therapy, and ‘at least one positive change in one outcome measure in all the case series’. No relationship was seen between effectiveness and intervention length, duration, or frequency. Engineer-built experimental systems are found to be more effective than commercial systems. Commercially available active video games do not meet children’s needs as they cannot be adjusted individually to the child. Overall, the evidence was poor to fair. This meta-analysis makes no conclusive recommendations.

The GestureTek Virtual Reality system in Rehabilitation: a Scoping Review

Scoping Review

Glegg, S.M.N., Tatla, S.K. & Holstii, L., Disability and Rehabilitation Assistive Technology 2014, 9(2); 89 – 111

Link to abstract:
www.ncbi.nlm.nih.gov/pubmed/23713408

Objective: This scoping review examines research literature with quantitative data specific to the GestureTek virtual reality system used in physical and cognitive rehabilitation. The purpose of this scoping review is to determine the practicality of a systematic review, to identify areas for further research, “…and to allow therapists to be able to seek out readily pertinent evidence to support their clinical decisions about their use of the technology”.

Method: An explicit search strategy was used, resulting in 44 included studies mostly relating to stroke. For cerebral palsy, five studies were reported with evidence level I, II or III: one single case study reported level III evidence for balance and mobility improvement, and another single case reported level I evidence for improved reach, by American Academy for Cerebral Palsy and Developmental Medicine criteria.

Findings: Few strong quality or high level evidence studies are available: lack of common outcome measures limits the possibility of a systematic review. High level, larger studies are needed. This scoping review provides a database of rated studies related to cerebral palsy habilitation and outcomes of balance, mobility and upper extremity improvement.