Motor learning through virtual reality in cerebral palsy

A Literature Review

Massetti, T., da Silva, T. D., Ribeiro, D. C., Pinheiro Malheiros, S. R., Nicolai Re, A. H., Favero, F. M. & de Mello Monteiro, C., B.

Medical Express 2014; 1(6): 302-306 DOI: 10.5935/MedicalExpress.2014.06.04

Link to full text: www.medicalexpress.net.br/details/99/motor-learning-through-virtual-reality-in-cerebral-palsy---a-literature-review

Objective: to investigate benefits to motor skills improvement from VR in children with CP.

Process: A pubmed search resulted in 40 studies were found regarding virtual reality and cerebral palsy. Few (10) studies reference “the use of virtual reality in children with cerebral palsy in gross motor function and improvements in motor learning with skill transfer to real-life situations”. These studies were evaluated using the Pediatric Evidence Database (PEDro); 3 scored ‘good’ or better, limited largely by small sample sizes.

Outcome: “Improvements in performance were specific to the practice environment; there was no transfer of learning”.

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Case-Based Reasoning for Active Video Games

Tool development

Helping Therapists Make Evidence-Based Decisions about Commercial Motion Gaming
Putnam, C. & Cheng, J.
Proceedings of the 15th International ACM SIGACCESS Conference on Computers and Accessibility; 10/2013, published in SIGACCESS Newsletter 107, September, 2013

Link to Abstract: www.researchgate.net/publication/260587395_Motion-games_in_brain_injury_rehabilitation_an_in-situ_multi-method_study_of_inpatient_care

Objective: The authors identified an information gap where "therapists did not have access to information (games that best met their therapeutic goals) that would help them make evidence-based decisions about which games to use in therapies."

Method: Interviews and observation revealed that therapists are frustrated with finding relevant information about newer games.

Outcome: Authors created a case-based reasoning tool which includes patient variables, session goals, game attributes, subjective and objective outcome measures. Development of this tool should help therapists better employ active video games in therapies.

CP Video Gaming

Video Game Review

Design and Evaluation of a Networked Game to Support Social Connection of Youth with Cerebral Palsy
Hernandez, H. A., Ketcheson, M., Scheider, A., Ye, Z., Fehlings, D., Switzer, L., Wright, V., Bursick, S. K., Richards, C. & Graham, T. C. N.
Proceedings of The 16th International ACM SIGACCESS Conference on Computers and Accessibility, October 20-22, 2014.
Abstract... DOI: http://dx.doi.org/10.1145/2661334.2661370

Liberi game was created for youth with GMFCS III to facilitate group game play through making the game easy to join and able to be played by those of differing physical abilities. Because there were no barriers to joining group play (automatic grouping), differences in skill level were managed by oral communication between players and by causing all avatars to move at the same speed (collective feedback). Automatic voice communication facilitated cooperative (and parallel) play. Liberi created a venue for differently-abled youth to 1) interact and 2) game.

Video Games Through Therapist’s Eyes

Qualitative Research Report

Integrating Virtual Reality Video Games into Practice: Clinician’s Experiences
Levac, D. E. & Miller, P. A.
Physiotherapy Theory and Practice, 29(7) 504-512, 2013
DOI: 10.3109/09593985.2012.762078

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/23362843

Objective: Physical therapists report on using Wii video games with children with brain injuries.

Process: Six physical therapists were interviewed. Two themes arose "technology meets clinical practice", and "onus is on the therapist".

Outcome: There are benefits and challenges where technology meets clinical practice that call on the therapist to be committed to the technology to implement it successfully. "There is a substantial need for knowledge translation initiatives for clinicians in this area".

Building a Clinical Videogame Tool

Qualitative Study

"Kinect-ing" with Clinicians: A Knowledge Translation Resource to Support Decision Making about Video Game Use in Rehabilitation
Levac, D., Espy, D., Fox, E., Pradhan, S. & Deutsch, J. E.
Physical Therapy Online, Sept 25, 2014
DOI: 10.2522/ptj.20130618

Link to abstract: ptjournal.apta.org/content/early/2014/09/24/ptj.20130618.abstract

Objective: Virtual reality and active video gaming offer promise yet lack evidence of effectiveness when used in clinical practice. Additionally, clinicians require knowledge translation resources to decide how to use video games in clinical practice. This paper describes development of a clinician’s resource for using Kinect video games in physical therapy.

Method: Sixteen clinicians from four sites completed questionnaires; five physical therapists analyzed the results towards developing a knowledge product.

Findings: "This paper described the process and feedback…for improving and further evaluating the 'Kinecting with Clinicians' resource using the 'Knowledge-to-Action cycle' framework to guide the proposed research methods." Next steps are to put the resource online and evaluate usefulness of online resources in clinical practice.

Survey of VR Clinical Use

Survey

Using Virtual Reality in Clinical Practice: A Multi-Site Exploratory Study
Glegg, M. N. S., Holsti, L., Stanton, S., Hanna, S., Velikonja, D., Ansley, B., Sartor, D. & Brum, C.
NeuroRehabilitation : 2014 Sep 18 pg
DOI: 10:3233/NRE-141152

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/25238866

Objective: For inpatients with acquired brain injury, how is GestureTek virtual reality used for rehabilitation?

Method: 11 therapists at two rehab centres collected data over 8 months on 39 clients; their VR interventions and the therapists’ treatment goals.

Findings and conclusions: Clinical “treatment characteristics and several outcomes of interest paralleled those in the literature; however, novel outcome areas were identified as research gaps. By study’s end, more than half of clients’ VR programs had been discontinued, for reasons consistent with documented barriers to VR use. These findings can help… inform the design of research that has high clinical relevance, and… provide a point of reference for clinicians incorporating VR into their practices.”