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Cited by 46Cerebral Palsy and Movement DisordersStroke Rehabilitation and RecoveryBotulinum Toxin and Related Neurological Disorders

Nintendo® Wii Therapy Improves Upper Extremity Motor Function in Children with Cerebral Palsy: A Systematic Review with Meta-Analysis

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Montoro-Cárdenas, Desirée, Cortés-Pérez, Irene, Ibancos-Losada, María, Zagalaz-Anula, Noelia, Obrero-Gaitán, Esteban, Osuna-Pérez, María·2022·International Journal of Environmental Research and Public Health
DOI 10.3390/ijerph191912343PMC PMC9566093
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Abstract

Background: Nintendo® Wii-based therapy (NWT) is a non-immersive virtual reality therapy used to recover upper extremity (UE) motor function in children with cerebral palsy (CP). We aimed primarily to elucidate the effectiveness of NWT in improving UE motor and functional impaired abilities in children with CP, compared to conventional therapy or no intervention. The secondary aim was to assess if NWT is more effective when used alone or combined with conventional therapy. Methods: A systematic review with meta-analysis was conducted from a bibliographic search in PubMed, Scopus, PEDro, Web of Science, and CINHAL, ending in October 2021, in accordance with PRISMA guidelines. We included randomized controlled trials that compared NWT vs. conventional therapy or no intervention in terms of their impact on different UE impaired abilities (grip strength, tip grip strength, UE dissociated movements, functional capacity in daily living activities, gross and fine motor dexterity, and grasping ability) in children with CP. Effect size was calculated with standardized mean difference (SMD) and its 95% confidence interval (95% CI). Results: Nine studies (276 participants) were included. NWT is more effective than conventional therapy at improving grip strength (SMD = 0.5, 95% CI 0.08, 0.91), tip grip strength (SMD = 0.95, 95% CI 0.3, 1.61), and grasping ability (SMD = 0.72, 95%CI 0.14, 1.3). NWT is more effective than conventional therapy at improving functional capacity in daily living activities (SMD = 0.83, 95% CI 0.07, 1.56). For fine manual dexterity, NWT was better than no intervention (SMD = 3.12, 95% CI 1.5, 4.7). Conclusions: Our results indicate that NWT is effective at improving various UE impaired motor skills in children with CP.

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  • Training with repetitive movements increases the connection of new neural pathways.

    “They determined that the use of VR technology induces neuroplasticity and causes changes in the cerebral cortex, as demonstrated by neuroimaging studies that were conducted in children with cerebral palsy, and that training with repetitive movements increases the connection of new neural pathways.”

    From Serious Game for Fine Motor Control Rehabilitation for Children With Epileptic Encephalopathy: Development and Usability Study (2023) · cites this paper as [47]

    The Discussion (page not provided) links repeated activities in Nintendo Wii therapy to activity-dependent plasticity and says repetitive exercises can influence corticospinal interactions and reorganize motor-control networks. It does not specifically say that repetitive movements increase connections between new neural pathways, so that mechanism is more specific than the source supports. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • The use of virtual reality technology induces neuroplasticity and causes changes in the cerebral cortex.

    “They determined that the use of VR technology induces neuroplasticity and causes changes in the cerebral cortex, as demonstrated by neuroimaging studies that were conducted in children with cerebral palsy, and that training with repetitive movements increases the connection of new neural pathways.”

    From Serious Game for Fine Motor Control Rehabilitation for Children With Epileptic Encephalopathy: Development and Usability Study (2023) · cites this paper as [47]

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Authors
Montoro-Cárdenas, D., Cortés-Pérez, I., Ibancos-Losada, M., Zagalaz-Anula, N., Obrero-Gaitán, E., & Osuna-Pérez, M.
Affiliations
Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain
ORCID
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2022-09-28
Volume
19
Issue
19
Pages
12343
ISSN
1660-4601 (ISSN-L)
DOI
10.3390/ijerph191912343
PMC
PMC9566093
OpenAlex
W4297486086
Cited by
46
References
79
Citations by year
2026: 6 · 2025: 18 · 2024: 10 · 2023: 10 · 2022: 2
FWCI
1.72
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Cerebral Palsy and Movement Disorders
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Health Sciences › Medicine › Neurology › Botulinum Toxin and Related Neurological Disorders
Keywords
virtual reality therapy, cerebral palsy, upper limb motor function, children, grip strength, grasping ability, fine motor dexterity, conventional therapy comparison, motor rehabilitation
MeSH terms
Stroke Rehabilitation, Activities of Daily Living, Cerebral Palsy, Child, Humans, Motor Skills, Upper Extremity

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