The Effect of using Wii balance board on functional balance in children with Ataxic Cerebral Palsy

Abstract Objective: Ataxic cerebral palsy has an incidence of 5- 10 percent among the general population of children with cerebral palsy. It is characterized by poor balance and coordination, in addition to clumsiness, involuntary tremor and poorly developed equilibrium responses. As a result, balance training is one of the most important parts of the rehabilitation program in children with Ataxic cerebral palsy. Wii Balance Board (WBB) is an efficient system for balance training in children with different neurological conditions especially Cerebral palsy. The efficacy of this system has been demonstrated in many studies. This study aimed to investigate the influence of WBB on the functional balance and the persistence of the results two months after the end of the balance training intervention in children with Ataxic CP. Material and Methods: This research was organized in a single subject study, A-B-A design for 3 children (2 females and 1 male) with ataxic CP, mean±SD age:10.56±1.09 years and level I and II of gross motor function classification system(GMFCS). All the participants received a conventional occupational therapy program, 3 sessions per week, 45min per session in baseline and follow-up phases, and 25min followed by 20min of WBB therapy in the intervention phase. Thus, in the current study, WBB therapy had been done for 3 months (12 hours). The changes made in this study were evaluated by the Pediatric Balance Scale (PBS) and Timed Up and Go (TUG) test. A pediatric occupational therapist who was masked to the study design carried out the testing. Outcomes were measured twice during the baseline phase before the initiation of the intervention. Then three times during the intervention phase (at the end of the 12th, 24th, and 36th sessions), and as the two follow-up sessions (one month and two months after the intervention ended). Finally, the results were evaluated by PND, 2SD, Hedgeschr('39')s g, and the visual analysis methods. Results: The results of PBS and TUG indicated improvement of functional balance in all participants from the baseline phase to intervention and follow-up phases. PND between baseline and follow phases for all participants show a significant difference between phases. Therefore, according to PND, all participants showed a significant change in PBS and TUG results. Hedeges’g for all 3 participants was more than 0.8 that indicates significant difference between baseline and follow-up phases. According to the 2SD method, all of the PBS measurements in intervention and follow-up phases were more than the mean+2SD of the baseline phase that shows improvement in PBS. Also, all of the TUG measurements in intervention and follow phases were less than the mean-2SD of the baseline phase that shows improvement in the TUG test. In addition, the visual analysis revealed a significant improvement in functional balance in the intervention phase and stability of these changes in the follow-up phase. Discussion: The study results suggested that balance training by WBB can be an effective method for functional balance improvement in children with Ataxic CP. For conclusive result, it is necessary to perform studies with a larger sample size to confirm its effectiveness.