This study evaluated the effectiveness of combining non-immersive virtual reality (VR) with conventional therapy to improve balance, coordination, motivation, and functional performance in children with spastic diplegia cerebral palsy (CP). A single-blinded randomized trial was conducted with 32 children (mean age = 10.4 years, SD = 2.08), of whom 30 completed the study. Participants were randomly assigned to an experimental group (non-immersive VR + conventional therapy) or a control group (conventional therapy alone). The experimental group received 45 min of VR therapy and 45 min of conventional therapy thrice weekly for eight weeks. The control group received 90 min of conventional therapy per session. The VR intervention involved a car racing game using an inertial measurement unit sensor module (ESP32 with IMU). Outcomes were assessed using the pediatric balance scale (PBS), the intrinsic motivation inventory (IMI), and VR game performance metrics. Statistical analyses included t-tests, Wilcoxon signed-rank tests, Mann–Whitney U tests, and effect size calculations. Both groups showed significant improvements in balance; however, the experimental group demonstrated a greater increase in PBS scores (Mann–Whitney U = 40.000, Z = <InlineEquation ID="IEq1"> <EquationSource Format="TEX">$-$</EquationSource> <EquationSource Format="MATHML"><math> <mo>-</mo> </math></EquationSource> </InlineEquation>3.015, p = 0.003, 95% CI = [<InlineEquation ID="IEq2"> <EquationSource Format="TEX">$-$</EquationSource> <EquationSource Format="MATHML"><math> <mo>-</mo> </math></EquationSource> </InlineEquation>1.0, 9.0]). This group also exhibited significantly higher intrinsic motivation, with increased scores in interest/enjoyment (z = 2.539, p = 0.017, 95% CI = [0.1967, 1.8433]) and Perceived Competence (z = 3.284, p = 0.003, 95% CI = [0.4199, 1.8335]). Improvements in coordination were reflected by more coins collected (z = 3.301, p < 0.001, 95% CI = [6.00, 17.00]) and fewer collisions (z = <InlineEquation ID="IEq3"> <EquationSource Format="TEX">$-$</EquationSource> <EquationSource Format="MATHML"><math> <mo>-</mo> </math></EquationSource> </InlineEquation>2.250, p = 0.024, 95% CI = [<InlineEquation ID="IEq4"> <EquationSource Format="TEX">$-$</EquationSource> <EquationSource Format="MATHML"><math> <mo>-</mo> </math></EquationSource> </InlineEquation>6.00, <InlineEquation ID="IEq5"> <EquationSource Format="TEX">$-$</EquationSource> <EquationSource Format="MATHML"><math> <mo>-</mo> </math></EquationSource> </InlineEquation>1.00]). These findings suggest that combining non-immersive VR with conventional therapy enhances balance, motivation, coordination, and functional performance more effectively than conventional therapy alone. Further research is recommended to explore long-term effects and optimize intervention protocols.

Augmenting Conventional Therapy with Non-immersive Virtual Reality to Enhance Balance, Coordination, Motivation, and Functional Performance in Children with Spastic Diplegia Cerebral Palsy: A Single-Blinded Randomized Trial

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发表日期：

2025年8月12日

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Agrawal Luckykumar Dwarkadas,
Viswanath Talasila,
Nishad Kassim,
Rama Krishna Challa,
K. G. Srinivasa,
N. S. Senthil Kumar

摘要

This study evaluated the effectiveness of combining non-immersive virtual reality (VR) with conventional therapy to improve balance, coordination, motivation, and functional performance in children with spastic diplegia cerebral palsy (CP). A single-blinded randomized trial was conducted with 32 children (mean age = 10.4 years, SD = 2.08), of whom 30 completed the study. Participants were randomly assigned to an experimental group (non-immersive VR + conventional therapy) or a control group (conventional therapy alone). The experimental group received 45 min of VR therapy and 45 min of conventional therapy thrice weekly for eight weeks. The control group received 90 min of conventional therapy per session. The VR intervention involved a car racing game using an inertial measurement unit sensor module (ESP32 with IMU). Outcomes were assessed using the pediatric balance scale (PBS), the intrinsic motivation inventory (IMI), and VR game performance metrics. Statistical analyses included t-tests, Wilcoxon signed-rank tests, Mann–Whitney U tests, and effect size calculations. Both groups showed significant improvements in balance; however, the experimental group demonstrated a greater increase in PBS scores (Mann–Whitney U = 40.000, Z = $-$ $-$ 3.015, p = 0.003, 95% CI = [ $-$ $-$ 1.0, 9.0]). This group also exhibited significantly higher intrinsic motivation, with increased scores in interest/enjoyment (z = 2.539, p = 0.017, 95% CI = [0.1967, 1.8433]) and Perceived Competence (z = 3.284, p = 0.003, 95% CI = [0.4199, 1.8335]). Improvements in coordination were reflected by more coins collected (z = 3.301, p < 0.001, 95% CI = [6.00, 17.00]) and fewer collisions (z = $-$ $-$ 2.250, p = 0.024, 95% CI = [ $-$ $-$ 6.00, $-$ $-$ 1.00]). These findings suggest that combining non-immersive VR with conventional therapy enhances balance, motivation, coordination, and functional performance more effectively than conventional therapy alone. Further research is recommended to explore long-term effects and optimize intervention protocols.