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Effects of Augmented Reality Interventions on the Function of Upper Extremity and Balance in Children With Spastic
Wardah Hussain Malick1, Rizwana Butt1, Waqar Ahmed Awan2
1Physiotherapy Department, National Institute of Rehabilitation Medicine, Islamabad, Pakistan.
Insights
Augmented reality (AR) games effectively improved upper extremity (UE) function and balance in children with spastic hemiplegic cerebral palsy (SHCP). The Balance It game showed particular promise for enhancing balance in these children.
Area of Science:
- Pediatric Rehabilitation
- Rehabilitation Technology
- Neurology
Background:
- Spastic hemiplegic cerebral palsy (SHCP) significantly impacts motor function in children.
- Upper extremity (UE) function and balance deficits are common challenges for children with SHCP.
- Innovative therapeutic interventions are needed to address these functional impairments.
Purpose of the Study:
- To evaluate the efficacy of augmented reality (AR) interventions for improving UE function and balance in children with SHCP.
- To compare the effects of three different AR games on motor outcomes.
- To identify potential differences in effectiveness between AR game interventions.
Main Methods:
- Thirty children (aged 6-12 years) with SHCP were randomly assigned to three AR intervention groups (Balance It, Bubble Pop, Scoop'd).
- Interventions lasted 8 weeks, with UE function assessed using the Disability of Arm, Shoulder, and Hand (DASH) questionnaire and balance using the Pediatric Balance Scale (PBS).
- Statistical analyses included mixed ANOVA, Wilcoxon signed-rank test, and Kruskal Wallis test to compare outcomes within and between groups.
Main Results:
- All AR intervention groups demonstrated significant improvements in total DASH and PBS scores post-intervention.
- A significant difference was observed in 'standing with one foot in front' balance between the Bubble Pop and Balance It groups (p=0.03).
- The total PBS score also showed a significant difference between the Bubble Pop and Balance It groups (p=0.02).
Conclusions:
- Augmented reality interventions are effective in enhancing UE function and balance in children with SHCP.
- The 'Balance It' AR game demonstrated a notable advantage in improving balance compared to other games.
- No significant differences were found between the three AR games regarding improvements in UE function.
Objective:
To determine the effects of augmented reality (AR) interventions on the function of the upper extremity (UE) and balance in children with spastic hemiplegic cerebral palsy (SHCP).
Methods:
In total, 30 children with SHCP, aged 6 to 12 years, were randomly divided into three interventional groups. Each group received an AR game, i.e., Balance It, Bubble Pop, or Scoop'd (WonderTree, Pakistan). The UE function and balance were assessed at the baseline and after 8 weeks of intervention through the Disability of Arm, Shoulder, and Hand (DASH) questionnaire and Pediatric Balance Scale (PBS), respectively. The mixed ANOVA was used to determine the combined with-in and between-the-groups differences in the function of the upper extremity. The Wilcoxon sign ranked test was used for with-in group changes, while the Kruskal Wallis test with the bonferroni correction post-hoc analysis was used to compare the groups in terms of balance. The data were analyzed by using SPSS version 21 and the level of significance was set at p < 0.05. Paired sample t-test and Wilcoxon signed-rank test was used for analyzing the changes in the total DASH and PBS scores within the groups, respectively. One-way ANOVA was used to determine the differences between the groups in the total DASH and PBS scores, while the Kruskal Wallis test was used for the differences between the groups in the PBS items. The data were analyzed by using SPSS version 21.
Results:
All the groups improved significantly in the total DASH and PBS scores post-intervention. A significant difference was determined in standing with one foot in front between Bubble Pop and Balance It groups (p = 0.03). The total score of PBS also showed a significant difference between Bubble Pop and Balance It groups (p = 0.02).
Conclusion:
The AR interventions used in this study were found to be effective in improving the UE function and balance of children with SHCP. The Balance It game showed more promising results in improving the balance as compared with the other games, however, no significant difference was determined between the three AR games in terms of the UE function of the participants.
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