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Rehabilitation for Children With Dystonic Cerebral Palsy Using Haptic Feedback in Virtual Reality: Protocol for a
Reika Nicole McNish1, Pramod Chembrammel2, Nathaniel Christopher Speidel3
1Department of Kinesiology and Community Health, Neuroscience Program, Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Chamapign, Urbana, IL, United States.
Insights
This study will investigate if virtual reality games with haptic feedback improve movement in children with dystonic cerebral palsy (CP). The randomized controlled trial will assess movement smoothness and clinical measures before and after the intervention.
Area of Science:
- Rehabilitation Medicine
- Pediatric Neurology
- Human-Computer Interaction
Background:
- Cerebral palsy (CP) is a common childhood motor disorder affecting muscle tone and control.
- Dystonic symptoms, present in 4-17% of children with CP, exacerbate with physical therapy.
- Virtual reality (VR) and haptic feedback offer potential novel interventions.
Purpose of the Study:
- To determine the efficacy of a VR game intervention with robotic haptic feedback for children with dystonic CP.
- To analyze the impact on movement outcomes and motor control in affected children.
Main Methods:
- A randomized controlled trial involving 68 children (34 with dystonic CP, 34 typically developing) aged 7-17.
- A 6-session VR game intervention with automated robotic haptic feedback.
- Movement smoothness, accelerometry, clinical tests, and spasticity measures assessed pre-, post-, and 1-month follow-up.
Main Results:
- The trial is pending institutional review board approval and has not yet commenced.
- No data is available at this time.
Conclusions:
- The study aims to examine changes in muscle activation and clinical measures in children with dystonic CP and typically developing controls.
- Paired t-tests will analyze movement outcomes, with all results reported.
Background:
Cerebral palsy (CP) is the most common developmental motor disorder in children. Individuals with CP demonstrate abnormal muscle tone and motor control. Within the population of children with CP, between 4% and 17% present dystonic symptoms that may manifest as large errors in movement tasks, high variability in movement trajectories, and undesired movements at rest. These symptoms of dystonia typically worsen with physical intervention exercises.
Objective:
The aim of this study is to establish the effect of haptic feedback in a virtual reality (VR) game intervention on movement outcomes of children with dystonic CP.
Methods:
The protocol describes a randomized controlled trial that uses a VR game-based intervention incorporating fully automated robotic haptic feedback. The study consists of face-to-face assessments of movement before, after, and 1 month following the completion of the 6-session game-based intervention. Children with dystonic CP, aged between 7 and 17 years, will be recruited for this study through posted fliers and laboratory websites along with a group of typically developing (TD) children in the same age range. We anticipate to recruit a total of 68 participants, 34 each with CP and TD. Both groups of children will be randomly allocated into an intervention or control group using a blocked randomization method. The primary outcome measure will be the smoothness index of the interaction force with the robot and of the accelerometry signals of sensors placed on the upper limb segments. Secondary outcomes include a battery of clinical tests and a quantitative measure of spasticity. Assessors administering clinical measures will be blinded. All sessions will be administered on-site by research personnel.
Results:
The trial has not started and is pending local institutional review board approval.
Conclusions:
Movement outcomes will be examined for changes in muscle activation and clinical measures in children with dystonic CP and TD children. Paired t tests will be conducted on movement outcomes for both groups of children independently. Positive and negative results will be reported and addressed.
Trial Registration:
ClinicalTrials.gov NCT03744884; https://clinicaltrials.gov/ct2/show/NCT03744884 (Archived by WebCite at http://www.webcitation.org/74RSvmbZP).
International Registered Report Identifier (Irrid):
PRR1-10.2196/11470.
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