This study will detect the effect of virtual reality in spider cage on gross motor performance and balance in children with spastic diplegia.
The current study will be directed to investigate effect of virtual reality on gross motor and balance as the weakness of the trunk muscles and lower limb muscles along with spasticity potentially predispose balance and walking issues of children with bilateral spastic CP . The balance deficits in children with CP are multifactorial. According to the system's model proposed by Woollacott and Shumway-Cook, multiple systems contribute to postural dysfunction in children with CP. Muscle weakness and stiffness of lower limb muscles account for biomechanical constraints and postural malalignment during standing and functional balancing. Virtual reality is one of the novel technology-based approaches to treat balance and motor function in children with CP. It utilizes the interactive simulations created in computer hardware and software, in which the children find opportunities to engage in environments appearing real to them . After reviewing the available previous published studies, it was found that there is no previous study directly compared between the effects of virtual reality and physical therapy in spider cage on gross motor performance and balance with diplegic children CP children. Both therapeutic modalities were found to induce good clinical outcomes when studied separately, so this study will be conducted to examine the effectiveness of virtual reality. The greater demand for physical therapy for Paediatrics' signifies the need for more effective, safer and evident therapeutic modalities. The findings of this study will help both; the therapists and the children to save time, effort and reach the best results in concise times.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
30
A specialized VR glasses will be used and VR games application in spider cage
The selected physical therapy program: 1. Neurodevelopmental approach: aims to facilitate typical motor development and function and to prevent secondary impairments (figure 4). 2. Approximation: aims to control spasticity and stimulate the joint mechanoreceptors (figure 5). 3. Stretching exercise: aims to maintain length and flexibility of shorten muscles (figure 6). 4. Strengthening exercise: aims to improve the functional ability (figure 7). 5. Spider suspension exercise for 30 minutes (figure 8). 5\. Gait training activities: aims to improve balance (figure 9). 6. Balance training program: aims to improve balance (figure 10).
Physical Therapy
Kafr ash Shaykh, Kafrelsheikh, Egypt
GROSS MOTOR PERFORMANCE
we will use Gross Motor Function Measure 88 (GMFM-88) to measure Gross motor performance. this score range from (0 to 100 ) zero is the minimum value and 100 is the maximum value
Time frame: 3 monthes
BALANCE
we will use Pediatric Balance Scale (PBS) to measure Balance. this score range from (0 to 56 ) zero is the minimum value and 56 is the maximum value
Time frame: 3 monthes
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