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Augmenting Conventional Rehabilitation with Virtual Reality for Cerebral Palsy: A Systematic Review and Meta-Analysis
Hendrawan Chandra Kusuma1, Kenly Chandra1, Jenny Lauvita1
1Department of General Medicine, Atma Jaya Catholic University of Indonesia School of Medicine and Health Sciences, North Jakarta, Indonesia.
Objective:
This systematic review and meta-analysis aimed to evaluate the clinical efficacy of virtual reality (VR) as a complementary intervention to conventional rehabilitation for improving motor and functional outcomes in children with cerebral palsy (CP).
Methods:
This study followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines to assess the impact of VR as a complementary intervention for CP rehabilitation. Through a systematic search of databases such as PubMed, Science Direct, EBSCO, ProQuest, and the Lancet, the review isolated randomized controlled trials (RCTs) focused on VR use in children with CP (with no specific neuromotor subtype required for inclusion) and normal cognition. Key outcomes, including balance, gross motor function, and daily independence, were analyzed using random-effects models to derive pooled mean differences (MDs) and 95% CIs. The researchers utilized Review Manager 5.4 for statistical analysis, while risk of bias and evidence certainty were evaluated using the Cochrane 2.0 tool and Grading of Recommendations Assessment, Development, and Evaluation(GRADE) methodology.
Results:
This study included 11 RCTs involving 345 patients selected for quantitative analysis. Virtual reality augmentation significantly improved balance (MD=3.34, 95% CI: 0.75-5.93, P=.01; moderate certainty) and reduced spasticity (MD=-0.61, 95% CI: -1.09 to -0.13, P=.01; low certainty). Nonsignificant trends emerged for gross motor function, daily activity independence, and functional capability.
Conclusion:
Virtual reality might serve most effectively as a supplement to traditional rehabilitation for pediatric CP patients, offering motivational and interactive benefits, though its role requires confirmation through larger, high-quality trials with standardized protocols.
