To investigate and compare the effect of virtual reality and task-oriented circuit training on pinch grip and quality of life in children with with immature brain injury. BACKGROUND: Children with immature brain injury may have limited use of their hands for functional activities and for fine motor skills. The primary function of the hand is hand grip, which has a great Influence on activities and tasks of daily life
To investigate and compare the effect of virtual reality and task-oriented circuit training on pinch grip and quality of life in children with with immature brain injury. BACKGROUND: Children with immature brain injury may have limited use of their hands for functional activities and for fine motor skills. The primary function of the hand is hand grip, which has a great Influence on activities and tasks of daily life Hypothesis This study hypothesized that: there is no difference between the effect of virtual reality and task-oriented circuit training on pinch grip and quality of life in children with spastic cerebral palsy. RESEARCH QUESTION: Is there difference between the effect of virtual reality and task-oriented circuit training on pinch grip and quality of life in children with immature brain injury?
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
44
Virtual reality (VR) will be applied as an interactive, task-oriented rehabilitation intervention targeting upper-extremity function. Participants will perform virtual tasks involving purposeful reaching, grasping, object manipulation, and directional movements of the affected upper limb. The difficulty and range of the tasks will be progressively adjusted according to each participant's functional ability to encourage active movement, repetitive practice, and motor learning.
Task-oriented circuit training will be provided to improve upper-extremity functional performance through repetitive, goal-directed activities. Participants will perform a series of functional tasks involving reaching, grasping, lifting, transferring, and manipulating objects. The training will be organized as a circuit of exercise stations, with each station targeting a specific upper-extremity functional skill. Tasks will be progressively modified by increasing the movement complexity, speed, repetitions, or task demands according to the participant's functional ability. Participants will receive verbal instructions and feedback from the physiotherapist to facilitate accurate task performance and encourage active participation.
Pinch dynamometer
Pinch strength will be assessed using a pinch dynamometer to quantify the maximal voluntary pinch force of the affected hand. The dynamometer will be positioned between the thumb and the specified finger(s), and participants will be instructed to apply maximal pinch force for approximately 3-5 seconds. Three trials will be performed with adequate rest between trials, and the highest recorded value or mean of the three trials will be used for analysis.
Time frame: three months
fugl myer assessment for sensorimotor function of upper limb
The Fugl-Meyer Assessment (FMA) will be used to evaluate sensorimotor function of the upper extremity. The upper-extremity section of the FMA will assess motor function, reflex activity, coordination, and speed of movement. The assessment will include movements of the shoulder, elbow, forearm, wrist, and hand, with each item scored according to the standardized FMA scoring system. Higher scores will indicate better sensorimotor performance of the affected upper extremity
Time frame: three months
Pediatric Quality of Life Inventory CP Module
The Pediatric Quality of Life Inventory Cerebral Palsy Module (PedsQL CP Module) will be used to assess health-related quality of life in children with cerebral palsy. The questionnaire will evaluate the child's perceived difficulties and limitations across cerebral palsy-specific domains, including daily activities, movement and balance, pain and hurt, fatigue, eating activities, and communication, as applicable to the child's age and functional level. Items will be scored according to the standardized PedsQL CP Module scoring system, with higher scores indicating better health-related quality of life.
Time frame: three months
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