The Effect of Virtual Reality Practice on Postural Control and Balance in Children With Cerebral Palsy: A Single-Subject Study

Objectives: Virtual reality is a new technology that has been recently used for different purposes in the rehabilitation of children. This study aimed to investigate the effectiveness of this method in balance rehabilitation of children with Cerebral Palsy (CP). Methods: This was an A-B-A design single subject study in which 3 children with hemiplegic CP participated. The baseline phase and intervention phase, lasted 2 and 4 weeks, respectively. Then, the secondary evaluation phase was held at an evaluation session. Intervention sessions as the baseline phase were repeated 3 times a week. In each session, children performed different computer games with displacement of the center of pressure in frontal and sagittal planes (for 21 min). The secondary evaluation phase of this study was held 2 to 3 months after the completion of the intervention phase. The changes made in this study were evaluated by assessment tools of Pediatric Reach Test (PRT), Single Limb Stance (SLS), Plate sensitive to pressure of Biometrics Ltd E-LINK force plate, and Activity Scale for Kids (ASK). Finally, the results were evaluated by C static and the visual analysis method.  Results: Comparison of the results of PRT, ASK and the evaluation of planes sensitive to pressure of Biometrics Ltd E-LINK in all 3 phases revealed the significant improvement of dynamic balance and the enhancement of the independence performance of children in daily living activities and the sustainability of the recovery in the secondary evaluation phase. Although, the SLS test results and data of force Plate indicated no significant improvements in the static balance of patients. Discussion: The study results suggest that weight shift exercises with the use of virtual reality can effectively improve the dynamic balance of children with CP. However, it fails to make a significant change in the static balance of these children.