Down syndrome and VR effectiveness

Systematic Review

Motor Learning and Virtual Reality in Down Syndrome: A Literature Review

Del Ciello de Menezes, L., Massetti, T., Olivereira, F. R., de Abreu, L., C., Herrero, D., Malheiros, S. R. P., Trevizan, I. L., Moriyama, C. H. & de Mello Monteiro, C. B.

International Archives of Medicine, 8:119 2015.

DOI:10.3823/1718

Link to full text: www.imed.pub/ojs/index.php/iam/article/download/1157/945

Objective: In children with Down syndrome, do virtual reality games result in positive outcomes compared with conventional therapy interventions?

Method: Literature search results were screened and full texts were read by two reviewers. Of 194 studies, 7 articles were selected; 5 studies analyzed Down syndrome and motor learning, and 2, Down syndrome and virtual reality. Three studies had PEDRO (Physiotherapy Evidence Database http://www.pedro.org.au/ ) scores of 6/10 "good", three had 5/10 and one had 4/10 "fair".

Findings: "The motor learning in individuals with Down syndrome… is more effective in the presence of visual feedback and self-control. Individuals with Down syndrome respond positively and effectively…when stimulated with different and complementary tasks to conventional therapy".

Measured family-supported Wii use

Case report
Berg, P., Becker, T., Martian, A., Primrose, K. D. & Wingen, J.
Motor control outcomes following Nintendo wii use by a child with down syndrome. Pediatric Physical Therapy 2012 Spring;42(1):78-84

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/22207475

The benefit of this study is that it is well documented and easily reproduced.

Objective: A child with Down Syndrome plays family-supported Wii for eight weeks, tested before and after to compare motor and self-efficacy outcomes.

Process: An 11-year-old boy, eldest of three siblings had minimal prior exposure to the Wii. Family members were encouraged to participate in the suite of four games the boy chose. He was encouraged to play for at least 20 minutes at a time, four times a week for eight weeks. Outcome measures assessed change in activity and body structure and function, and included measures of strength, agility, coordination, balance, visual perceptual skills and body composition. The tests administered were the Test of Visual Perceptual Skills (TVPS), Self-Perception Profile for Children (SPPC), Perceived Physical Ability Scale (PPSA), Bruininks-Oseretsky Test of Motor Proficiency (BOT-2), Biodex BioSway Balance System, and the BodyStat Quadscan 4000.

Findings: The results show positive significant changes in BOT-2 scores for balance, manual dexterity, and running speed and dexterity across the 4 games. Postural stability and limits of stability were improved (undeclared significance) according to balance system data.

Wii vs.Standard Occupational Therapy for Children with Down Syndrome

Effectiveness of virtual reality using Wii gaming technology in children with Down syndrome

Article published in Research in Developmental Disabilities, No.32 (2011) pages 312-321, by Yee-Pay Wuang, Ching-Sui Chiang, Chwen-Yng Su and Chih-Chung Wang in 2011.

This well written paper asks the question: do children with Down syndrome using Nintendo Wii compared with standard sensory-motor training by occupational therapists show differences in sensorimotor functions?

Three groups were created of children with Down syndrome and without comorbidities to populate two treatment conditions and a control. Fifty of the160 children who agreed to participate but were subsequently unable to attend the treatment sessions were assigned to the control group. The interventions were randomly assigned to children who received either Wii or SOT for one-hour sessions twice weekly for 24 weeks. Wii gameplay was compared with standard occupational therapy (SOT) treatments utilizing sensory integrative therapy, neurodevelopment treatment and perceptual-motor approach. The three groups’ outcomes were measured using the Bruininks-Oseretsky test of motor proficiency-second edition (BOT-2), the test of sensory integration function (TSIF) and the developmental test of visual motor integration (VMI).

Video games played with Wii showed significantly improved sensorimotor functions; both intervention conditions showed significant improvement over the control group.The Wii group outperformed SOT on three of eight BOT-2 subtests, six of seven TSIF subtests and both the VMI subtest measures. Statistically significant differences showed between both intervention groups and the control group. A moderate to large effect size was seen across all measures (Wii group vs. control) and across all measures except the BOT-2 strength subtest (SOT group vs. control group). Pre- and post-intervention analysis within groups showed the largest effect size for the Wii group, (14 of 17 pooled subtests).

Link to the article abstract: linkinghub.elsevier.com/retrieve/pii/S0891422210002404