Virtual reality as a therapeutic modality for children with cerebral palsy
Abstract
OBJECTIVE: The evidence for using virtual reality (VR) with children with cerebral palsy (CP) was examined. METHODS: A search of 13 electronic databases identified all types of studies examining VR as an intervention for children with CP. The most recent article included was published in October 2008. For each study, the quality of the methods was assessed using the appropriate scale. A total of 19 articles were retrieved. Thirteen studies from 11 articles were included in the final analysis. RESULTS: Outcomes documented brain reorganization/plasticity, motor capacity, visual-perceptual skills, social participation and personal factors. Two studies were randomized controlled trials. These reported conflicting results regarding motor outcomes. Twelve of the 13 studies presented positive outcomes in at least one domain. CONCLUSIONS: VR has potential benefits for children with CP. However, the current level of evidence is poor and empirical data is lacking. Future methodologically rigorous studies are required.
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A review of virtual reality use by children with cerebral palsy, which included motor but not postural control outcomes, concluded that substantial benefits could be gained from using virtual reality, but current evidence is weak.
“A review of virtual reality use by children with CP, which included motor but not postural control outcomes, agrees that substantial benefits could be gained from using virtual reality; however, the current evidence is weak. 66”
From Exercise interventions improve postural control in children with cerebral palsy: a systematic review (2015) · cites this paper as [66]
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“,[27,28] which considered the level of evidence of studies, with an “excellent” score of 9–10, “good” score of 6–8, “fair” of 4–5 and “poor” score of <4.”
Giusto, V. D., Purpura, G., Zorzi, C. F., Blonda, R., Brazzoli, E., Meriggi, P., Reina, T., Rezzonico, S., Sala, R., Olivieri, I., et al. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1241860 · Cited by 40 · see citing works
“Its use has progressively increased among healthcare professionals in order to provide maximum support and to improve quality of care of adult and pediatric patients (Snider et al., 2010; Maggio et al., 2019).”
BackgroundTechnology to Enhance Patient Motivation in Virtual Reality Rehabilitation: A Review
Zhang, C., & Yu, S. (2024) · Games for Health Journal · doi:10.1089/g4h.2023.0069 · Cited by 40 · see citing works
“10,23,24 25–27 Despite the growing interest in VR rehabilitation and its demonstrated ability to enhance patient motivation and participation, 10,28–31 Few studies have focused on the role of the technology in enhancing patient motivation.”
Pin, T. W., & Butler, P. B. (2019) · Clinical Rehabilitation · doi:10.1177/0269215518821714 · Cited by 40 · see citing works
Virtual reality in rehabilitation and therapy.
Matijević, V., Šečić, A., Mašić, V., Šunić, M., Kolak, Ž., & Znika, M. (2013) · PubMed · Cited by 39 · see citing works
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“VR has been applied successfully as a therapeutic modality to train physical and motor skills following stroke [18–21], in children with cerebral palsy [22], and individuals with Parkinson’s disease [23].”
MethodChen, Y., García-Vergara, S., & Howard, A. M. (2015) · Rehabilitation Research and Practice · doi:10.1155/2015/812348 · Cited by 38 · see citing works
“Virtual reality (VR) systems offer a way to create an interactive, motivating environment for intensive training practice for children with CP [15, 16]: these systems can provide immediate feedback as players see themselves immersed in the virtual world and can observe themselves as they move.”
BackgroundPreterm birth and leisure participation: A synthesis of the literature
Dahan‐Oliel, N., Mazer, B. L., & Majnemer, A. (2012) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2012.02.011 · Cited by 38 · see citing works
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“VR has demonstrated utility in cognitive retraining in cerebral palsy [10], motor retraining in stroke [11], balance and control in vestibular disorders [12], balance and mobility in traumatic brain injury [13], and community training skills in acquired brain injury [14].”
BackgroundAran, O. T., Şahın, S., Köse, B., Ağce, Z. B., & Kayıhan, H. (2019) · International Journal of Rehabilitation Research · doi:10.1097/mrr.0000000000000378 · Cited by 37 · see citing works
“There is an increase in the usage of VR in the rehabilitation area in the last two decades due to its intervention and assessment usability (Snider et al., 2010).”
BackgroundAlrashidi, M., Wadey, C. A., Tomlinson, R., Buckingham, G., & Williams, C. A. (2022) · Disability and Rehabilitation · doi:10.1080/09638288.2022.2071484 · Cited by 37 · see citing works
Facilitating the Implementation of Virtual Reality-Based Therapies in Pediatric Rehabilitation
Banerjee-Guénette, P., Bigford, S., & Glegg, S. (2019) · Physical & Occupational Therapy In Pediatrics · doi:10.1080/01942638.2019.1650867 · Cited by 36 · see citing works
“Several reviews summarize the promising evidence in the field of pediatric VR/AVG rehabilitation (Sandlund et al., 2009; Snider et al., 2010; Weiss et al., 2014); however, the integration of VR/AVG systems and other interactive technologies within clinical practice can include many challenges.”
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“The use of VR training for children with cerebral palsy has been studied intently to demonstrate the effects on subjects with limited ability or other impairments of body structure and function who are unable to participate in other rehabilitation programs [16].”
InfluentialPavão, S. L., Arnoni, J. L. B., de Oliveira, A. K. C., & Rocha, N. A. C. F. (2014) · Revista Paulista de Pediatria · doi:10.1016/j.rpped.2014.04.005 · Cited by 35 · see citing works
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“We refer interested parties to the reviews [ 31, 32 ] .”
A survey of research trends in assistive technologies using information modelling techniques
Modi, N., & Singh, J. (2020) · Disability and Rehabilitation Assistive Technology · doi:10.1080/17483107.2020.1817992 · Cited by 35 · see citing works
“Virtual reality as assistive technology Virtual reality has become an influential learning tool for students suffering from autism and cerebral palsy [157,171].”
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Pavão, S. L., Arnoni, J. L. B., de Oliveira, A. K. C., & Rocha, N. A. C. F. (2014) · Revista Paulista de Pediatria · doi:10.1590/s0103-05822014000400016 · Cited by 34 · see citing works
Gilbert, R., Murphy, N. A., Krueger, A. B., Ludwig, A., & Efron, T. Y. (2013) · International Journal of Disability Development and Education · doi:10.1080/1034912x.2013.812189 · Cited by 32 · see citing works
Martins, F., Massetti, T., Crocetta, T. B., Lopes, P. B., da Silva, A., Figueiredo, E. F., de Abreu, L. C., da Silva, T. D., & Monteiro, C. B. D. M. (2019) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s184510 · Cited by 32 · see citing works
“However, it should be noted that VR as an intervention for individuals with CP is relatively new, and although research is rapidly evolving, its benefits and limitations have not been extensively researched.(13,18) In systematic literature reviews, Chen et al(9,19) examined the effect of VR function in children with C…”
BackgroundVeličković, P., & Milovanović, M. (2021) · Sensors · doi:10.3390/s21020321 · Cited by 32 · see citing works
“Different studies suggest that VR therapy had a positive impact on the therapeutic modality for people, as it indicates benefits in activity and participation, brain reorganization, motor skills or visual-spatial outcomes, and personal factors [4].”
BackgroundMotor learning through virtual reality in cerebral palsy - a literature review
Massetti, T., da Silva, T. D., Papa, D. C. R., Malheiros, S. R. P., Ré, A. H. N., Fávero, F. M., & Monteiro, C. B. D. M. (2014) · Medical Express · doi:10.5935/medicalexpress.2014.06.04 · Cited by 32 · see citing works
“Some authors have reviewed studies on cerebral palsy and VR; Snider et al.7 carried out a literature review observing the results of VR as a therapeutic modality for children with CP.”
BackgroundMethodInfluentialEffects of Virtual Reality in Children with Cerebral Palsy: A Systematic Review
Chiu, H., & Kuo, P.-W. (2015) · doi:10.6215/fjpt.pts1408241086 · Cited by 31 · see citing works
Gordon, A. M., & Okita, S. Y. (2010) · Technology and Disability · doi:10.3233/tad-2010-0302 · Cited by 31 · see citing works
“Snider and colleagues [94] recently reviewed and analyzed 13 studies of VR training in CP (all but two conducted by Professor Denise Reid at the Neurorehabilitation and virtual Reality Laboratory at the University of Toronto).”
InfluentialMastery motivation in adolescents with cerebral palsy
Majnemer, A., Shikako‐Thomas, K., Lach, L., Shevell, M. I., Law, M., & Schmitz, N. (2013) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2013.07.002 · Cited by 30 · see citing works
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“Some studies showed that VR-based rehabilitation facilitated perceptual training and task completion in a virtual environment similar to reality but with a higher predictability and activity control (19, 24, 25).”
BackgroundVirtual reality applications in neurorehabilitation
Weiss, P. L., Kizony, R., Feintuch, U., Rand, D., & Katz, N. (2014) · Cambridge University Press eBooks · doi:10.1017/cbo9780511995590.021 · Cited by 27 · see citing works
Impaired visually guided weight-shifting ability in children with cerebral palsy
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“Several studies have shown that VR technology has a positive effect on motor intervention for children with developmental disabilities [11,12].”
BackgroundReal-Time Static Gesture Recognition for Upper Extremity Rehabilitation Using the Leap Motion
Gieser, S. N., Boisselle, A., & Makedon, F. S. (2015) · Lecture notes in computer science · doi:10.1007/978-3-319-21070-4_15 · Cited by 25 · see citing works
Integrating New Technologies into the Treatment of CP and DCD
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“functional actions [63].”
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“The level of evidence which each study add to the literature was evaluated by modified Sackett scale which adapted to rank studies according to their PEDro scores [31].”
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Zondervan, D. K., Secoli, R., Darling, A. M., Farris, J., Furumasu, J., & Reinkensmeyer, D. J. (2015) · Assistive Technology · doi:10.1080/10400435.2015.1012607 · Cited by 18 · see citing works
- Authors
- Snider, L., Majnemer, A., & Darsaklis, V.
- Affiliations
- McGill University (CA)
- Corresponding author
- Snider, Laurie
- Venue
- Developmental Neurorehabilitation
- Publisher
- Informa UK Limited
- Published
- 2010-01
- Volume
- 13
- Issue
- 2
- Pages
- 120-128
- ISSN
- 1363-8491 (ISSN-L)
- 1751-8423
- 1751-8431
- OpenAlex
- W2068620558
- Cited by
- 211
- References
- 37
- Citations by year
- 2026: 2 · 2025: 11 · 2024: 8 · 2023: 11 · 2022: 13 · 2021: 14 · 2020: 13 · 2019: 18 · 2018: 16 · 2017: 13 · 2016: 13 · 2015: 10 · 2014: 22 · 2013: 18 · 2012: 16
- FWCI
- 2.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Developmental Neurorehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- McGill University Health Centre
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Cerebral Palsy and Movement Disorders
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Keywords
- virtual reality, cerebral palsy, children, motor capacity, neuroplasticity, visual perceptual skills, social participation (health and rehabilitation), rehabilitation, quality of evidence
- MeSH terms
- Brain, Cerebral Palsy, Child, Computer Simulation, Humans, Magnetic Resonance Imaging, Motivation, Motor Skills, Neuronal Plasticity, Self Concept, Social Behavior, User-Computer Interface, Visual Perception, Treatment Outcome
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