Development and Feasibility of a Kinect-Based Constraint-Induced Therapy Program in the Home Setting for Children
Hao-Ling Chen1,2, Szu-Yu Lin2, Chun-Fu Yeh2
1Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.
Insights
This study shows a virtual reality (VR) based constraint-induced therapy (CIT) program using the Kinect system is feasible and beneficial for improving upper limb (UL) function in children with cerebral palsy (CP). The VR-CIT program motivated children and led to stable improvements in motor skills.
Area of Science:
- Pediatric Rehabilitation
- Neurorehabilitation
- Assistive Technology
Background:
- Cerebral palsy (CP) is a leading cause of childhood physical disability, often affecting upper limb (UL) function.
- Constraint-induced therapy (CIT) is effective for UL impairment in unilateral CP but faces challenges with child motivation and adherence.
- Virtual reality (VR) offers a potential solution to enhance engagement and mitigate CIT disadvantages.
Purpose of the Study:
- To evaluate the feasibility of a VR-based CIT program using the Kinect system for children with unilateral CP.
- To assess the motivational aspects and motor training efficacy of the developed VR-CIT program.
Main Methods:
- Phase 1: Ten children with unilateral CP evaluated program design, motor goals (UL joint angles), and game perception via questionnaire.
- Phase 2: Eight children with unilateral CP underwent an 8-week Kinect-based CIT intervention, with weekly tracking of game performance and Box and Block Test (BBT) scores.
Main Results:
- Phase 1 confirmed the VR-CIT program's design was specific to CIT principles and motivational for children.
- Phase 2 demonstrated stable improvements in game performance and BBT scores starting from the fifth week of intervention.
Conclusions:
- The Kinect-based CIT program is a feasible and beneficial intervention for improving affected UL motor function in children with unilateral CP.
- Results support further larger, controlled studies to establish the clinical utility and effectiveness of this VR-CIT approach.
Abstract:
Introduction: Cerebral palsy (CP) is the leading cause of childhood-onset physical disability. Children with CP often have impaired upper limb (UL) function. Constraint-induced therapy (CIT) is one of the most effective UL interventions for children with unilateral CP. However, concerns about CIT for children have been repeatedly raised due to frustration caused by restraint of the child's less-affected UL and lack of motivation for the intensive protocol. Virtual reality (VR), which can mitigate the disadvantages of CIT, potentially can be used as an alternative mediator for implementing CIT. Therefore, we developed a VR-based CIT program for children with CP using the Kinect system. Aims: The feasibility of the Kinect-based CIT program was evaluated for children with unilateral CP using a two-phase study design. Materials and Methods: In phase 1, ten children with unilateral CP were recruited. To confirm the achievement of the motor training goals, maximal UL joint angles were evaluated during gameplay. To evaluate children's perceptions of the game, a questionnaire was used. In phase 2, eight children with unilateral CP were recruited and received an 8 weeks Kinect-based CIT intervention. Performance scores of the game and outcomes of the box and block test (BBT) were recorded weekly. Results: In phase 1, results supported that the design of the program was CIT-specific and was motivational for children with unilateral CP. In phase 2, game performance and the BBT scores began showing stable improvements in the fifth week of intervention. Conclusion: It suggested the Kinect-based CIT program was beneficial to the motor function of the affected UL for children with unilateral CP. According to the results of this feasibility study, larger and controlled effectiveness studies of the Kinect-based CIT program can be conducted to further improve its clinical utility. Clinical Trial Registration: ClinicalTrials.gov, NCT02808195; Comparative effectiveness of a Kinect-based unilateral arm training system vs. CIT for children with CP.
