Virtual reality versus task oriented training on gait and balance in spastic hemiplegic cerebral palsied children / Walaa Eldesoukey Tolba Heneidy ; Supervised Hoda Abdelazem Eltalawy , Hala Ibrahim Ahmed Kassem , Naglaa Ahmed Zaky

Thesis (Ph.D.) - Cairo University - Faculty of Physical Therapy - Department of Growth and Development Disorders in Pediatrics

Background: Spastic hemiplegia is a type of cerebral palsy which affects one side of the body. Spastic hemiplegic children have mixture of asymmetry between the two sides of the body, spasticity, weakness, sensory loss and impaired postural balance that contribute to their gait abnormalities. There are various approaches and strategies to improve balance including virtual reality and task oriented training. Purpose: This study was conducted to compare between the effect of virtual reality (VR) and task oriented training (TO) on gait and balance in spastic hemiplegic cerebral palsied children. Methods: Forty-five spastic hemiplegic cerebral palsied children who fulfilled the inclusion criteria were randomly allocated into three groups of equal number (control, VR and TO). Participants in the three groups received a selected therapeutic exercise program in addition, VR group received virtual reality training program using Nintendo Wii device for 30 min., while TO group received task oriented training for 30 min. The total treatment provided for the three groups was 90 min/day, 3 days/week for 4 successive months. Baseline and post-treatment assessment for balance including; overall, antero-posterior, and medio-lateral stability indices were evaluated by using Biodex balance system. A 3DMA video based gait assessment system (CLIMA) was used to determine percentage (%) of swing phase, percentage (%) of weight support, swing time, support time, stride duration, step duration, stride length, step length and cadence. Results: Children in the three groups showed significant improvement in the post-treatment mean values of all measured variables when compared to their pre-treatment mean values (p<0.05). Significant improvement was observed in favor of the VR group regarding balance when comparing its post treatment mean values with the post treatment mean values of the control and TO groups (p< 0.05). However, significant improvement was observed in gait in favor of the TO group when comparing the post treatment mean values of gait parameters with the post treatment mean values of the measured variables of the control and VR groups (p< 0.05)

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