scholarly journals Do virtual interventions in individuals with cerebral palsy make use of motor learning principles? A systematic review (Preprint)

2020 ◽  
Author(s):  
Marika Demers ◽  
Karen Fung ◽  
Sandeep Subramanian ◽  
Martin Lemay ◽  
Maxime Robert
Keyword(s):  
Systematic Review ◽  
Virtual Reality ◽  
Cerebral Palsy ◽  
Video Games ◽  
Motor Learning ◽  
Upper Limb ◽  
Video Game ◽  
Training Time ◽  
Skills Retention ◽  
Learning Principles

BACKGROUND Increasing evidence supports the use of virtual reality to improve upper limb motor functions in individuals with cerebral palsy. While virtual reality offers the possibility to include key components to promote motor learning, it remains unclear if and how motor learning principles are incorporated in the development of rehabilitation interventions using virtual reality. OBJECTIVE To determine the extent to which motor learning principles are integrated in virtual reality interventions targeting upper limb function in individuals with cerebral palsy. METHODS A systematic review was conducted according to the PRISMA guidelines. The search was done in 10 databases using the key words and variations ‘cerebral palsy’, ‘virtual reality’, ‘video game’ and ‘rehabilitation’. Studies were divided in 2 categories: commercial video games or custom virtual reality system. Study quality was assessed using the Downs and Black checklist. RESULTS The initial search yielded 1497 publications. A total of 26 studies from 30 publications were included, with most studies classified as ‘fair’ on the Downs and Black checklist. The majority of studies provided enhanced feedback, variable practice and used functionally-relevant and motivating virtual tasks. Dosage varied greatly (total training time ranging from 300-3360 minutes) with only 6 studies reporting the number of movement repetitions per session. The difficulty progression, the assessment of skills retention and transfer, were poorly incorporated, especially for the commercial video games. CONCLUSIONS Motor learning principles should be better integrated in the development of future virtual reality systems for optimal upper limb motor recovery in individuals with cerebral palsy. CLINICALTRIAL PROSPERO Registration: #151982

scholarly journals Emergence of Virtual Reality as a Tool for Upper Limb Rehabilitation: Incorporation of Motor Control and Motor Learning Principles

2015 ◽  
Vol 95 (3) ◽  
pp. 415-425 ◽  
Author(s):  
Mindy F. Levin ◽  
Patrice L. Weiss ◽  
Emily A. Keshner
Keyword(s):  
Virtual Reality ◽  
Motor Control ◽  
Motor Learning ◽  
Upper Limb ◽  
Limb Movement ◽  
Motor Recovery ◽  
Upper Limb Rehabilitation ◽  
Wide Range ◽  
Learning Principles ◽  
Limb Rehabilitation

The primary focus of rehabilitation for individuals with loss of upper limb movement as a result of acquired brain injury is the relearning of specific motor skills and daily tasks. This relearning is essential because the loss of upper limb movement often results in a reduced quality of life. Although rehabilitation strives to take advantage of neuroplastic processes during recovery, results of traditional approaches to upper limb rehabilitation have not entirely met this goal. In contrast, enriched training tasks, simulated with a wide range of low- to high-end virtual reality–based simulations, can be used to provide meaningful, repetitive practice together with salient feedback, thereby maximizing neuroplastic processes via motor learning and motor recovery. Such enriched virtual environments have the potential to optimize motor learning by manipulating practice conditions that explicitly engage motivational, cognitive, motor control, and sensory feedback–based learning mechanisms. The objectives of this article are to review motor control and motor learning principles, to discuss how they can be exploited by virtual reality training environments, and to provide evidence concerning current applications for upper limb motor recovery. The limitations of the current technologies with respect to their effectiveness and transfer of learning to daily life tasks also are discussed.

scholarly journals Virtual Reality in Neurorehabilitation: An Umbrella Review of Meta-Analyses

2021 ◽  
Vol 10 (7) ◽  
pp. 1478
Author(s):  
Alexandra Voinescu ◽  
Jie Sui ◽  
Danaë Stanton Fraser
Keyword(s):  
Virtual Reality ◽  
Cerebral Palsy ◽  
Brain Injury ◽  
Upper Limb ◽  
Umbrella Review ◽  
High Quality ◽  
Quality Of Evidence ◽  
Upper Limb Function ◽  
Meta Analyses

Neurological disorders are a leading cause of death and disability worldwide. Can virtual reality (VR) based intervention, a novel technology-driven change of paradigm in rehabilitation, reduce impairments, activity limitations, and participation restrictions? This question is directly addressed here for the first time using an umbrella review that assessed the effectiveness and quality of evidence of VR interventions in the physical and cognitive rehabilitation of patients with stroke, traumatic brain injury and cerebral palsy, identified factors that can enhance rehabilitation outcomes and addressed safety concerns. Forty-one meta-analyses were included. The data synthesis found mostly low- or very low-quality evidence that supports the effectiveness of VR interventions. Only a limited number of comparisons were rated as having moderate and high quality of evidence, but overall, results highlight potential benefits of VR for improving the ambulation function of children with cerebral palsy, mobility, balance, upper limb function, and body structure/function and activity of people with stroke, and upper limb function of people with acquired brain injury. Customization of VR systems is one important factor linked with improved outcomes. Most studies do not address safety concerns, as only nine reviews reported adverse effects. The results provide critical recommendations for the design and implementation of future VR programs, trials and systematic reviews, including the need for high quality randomized controlled trials to test principles and mechanisms, in primary studies and in meta-analyses, in order to formulate evidence-based guidelines for designing VR-based rehabilitation interventions.

scholarly journals Motor learning-based activities may improve functional ability in adults with severe cerebral palsy: A controlled pilot study

2021 ◽  
pp. 1-11
Author(s):  
Helle Hüche Larsen ◽  
Rasmus Feld Frisk ◽  
Maria Willerslev-Olsen ◽  
Jens Bo Nielsen
Keyword(s):  
Cerebral Palsy ◽  
Motor Learning ◽  
Motor Function ◽  
Functional Ability ◽  
Active Group ◽  
Control Group ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Learning Principles

BACKGROUND: Cerebral palsy (CP) is a neurodevelopmental disturbance characterized by impaired control of movement. Function often decreases and 15% of adults are classified as severely affected (Gross Motor Function Classification Scale III-V). Little is known about interventions that aim to improve functional abilities in this population. OBJECTIVE: To evaluate a 12-week intervention based on motor learning principles on functional ability in adults with severe CP. METHODS: 16 adults (36±10 years, GMFCS III-V) were enrolled and divided into an intervention group (Active group) and a standard care group (Control group). Primary outcome measure was Gross Motor Function Measure (GMFM-88). Secondary measures were neurological status. The Active group were measured at baseline, after the intervention and at one-month follow-up. The Control group were measured at baseline and after one month. RESULTS: Analysis showed statistically significant improvement in GMFM-88 for the Active group from baseline to post assessment compared with the Control group (group difference: 5 points, SE 14.5, p = 0.008, CI: 1.2 to 8.7). Improvements were maintained at follow-up. Results from the neurological screening showed no clear tendencies. CONCLUSIONS: The study provides support that activities based on motor learning principles may improve gross motor function in adults with severe CP.

Reducing Outgroup Bias through Intergroup Contact with Non-Playable Video Game Characters in VR

2020 ◽  
Vol 27 (3) ◽  
pp. 257-273 ◽  
Author(s):  
Priska Breves
Keyword(s):  
Virtual Reality ◽  
Video Games ◽  
Video Game ◽  
Black People ◽  
Negative Consequences ◽  
Racially Diverse ◽  
Virtual Reality Technology ◽  
Explicit Bias ◽  
Research Gap ◽  
The Impact

Video games are one of the most popular media forms in today's society, but are often criticized for various reasons. For instance, mainstream video games do not incorporate enough racially diverse game characters or are often connected to adolescents’ levels of aggression and have thus been the focus of many debates. While the negative consequences of video games have been analyzed by many academic studies, research on the prosocial effects of video games is scarce. To address this research gap and support the ongoing call for more diverse video game characters, this study used a 3 × 1 between-subjects design ( N = 86) to test the impact of racially diverse non-playable characters (NPCs). The parasocial contact hypothesis was used as the theoretical foundation, incorporating virtual reality technology as an intensifier of effects. The results showed that helping a Black NPC did not reduce implicit bias, but reduced explicit bias towards Black people. This improvement was stronger when the video game was played using virtual reality technology than when using a traditional two-dimensional gaming device.

Rationale for prescription, and effectiveness of, upper limb orthotic intervention for children with cerebral palsy: a systematic review

2017 ◽  
Vol 40 (12) ◽  
pp. 1361-1371 ◽  
Author(s):  
Simon Garbellini ◽  
Yvette Robert ◽  
Melinda Randall ◽  
Catherine Elliott ◽  
Christine Imms
Keyword(s):  
Systematic Review ◽  
Cerebral Palsy ◽  
Upper Limb ◽  
Children With Cerebral Palsy

Advantages of virtual reality in the rehabilitation of balance and gait

Neurology ◽  
2018 ◽  
Vol 90 (22) ◽  
pp. 1017-1025 ◽  
Author(s):  
Desiderio Cano Porras ◽  
Petra Siemonsma ◽  
Rivka Inzelberg ◽  
Gabriel Zeilig ◽  
Meir Plotnik
Keyword(s):  
Virtual Reality ◽  
Motor Learning ◽  
Cochrane Collaboration ◽  
Intervention Programs ◽  
Randomized Controlled ◽  
Methodologic Quality ◽  
Newcastle Ottawa Scale ◽  
Meta Analyses ◽  
Learning Principles ◽  
Ottawa Scale

BackgroundVirtual reality (VR) has emerged as a therapeutic tool facilitating motor learning for balance and gait rehabilitation. The evidence, however, has not yet resulted in standardized guidelines. The aim of this study was to systematically review the application of VR-based rehabilitation of balance and gait in 6 neurologic cohorts, describing methodologic quality, intervention programs, and reported efficacy.MethodsThis study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. VR-based treatments of Parkinson disease, multiple sclerosis, acute and chronic poststroke, traumatic brain injury, and cerebral palsy were researched in PubMed and Scopus, including earliest available records. Therapeutic validity (CONTENT scale) and risk of bias in randomized controlled trials (RCT) (Cochrane Collaboration tool) and non-RCT (Newcastle-Ottawa scale) were assessed.ResultsNinety-seven articles were included, 68 published in 2013 or later. VR improved balance and gait in all cohorts, especially when combined with conventional rehabilitation. Most studies presented poor methodologic quality, lacked a clear rationale for intervention programs, and did not utilize motor learning principles meticulously. RCTs with more robust methodologic designs were widely recommended.ConclusionOur results suggest that VR-based rehabilitation is developing rapidly, has the potential to improve balance and gait in neurologic patients, and brings additional benefits when combined with conventional rehabilitation. This systematic review provides detailed information for developing theory-driven protocols that may assist overcoming the observed lack of argued choices for intervention programs and motor learning implementation and serves as a reference for the design and planning of personalized VR-based treatments.RegistrationPROSPERO CRD42016042051.

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