Augmented effects of a kinect-based virtual reality on constraint-induced movement therapy for upper extremity function in children with cerebral palsy: a randomized controlled trial

With limited randomized controlled trials and a lack of long-term follow-up in previous studies, this study aimed to investigate the augmented effects of Kinect-based virtual reality (VR) on constraint-induced movement therapy (CIMT) for enhancing upper extremity function in children with unilateral spastic cerebral palsy (CP). In this randomized controlled trial, 23 children with unilateral spastic CP (aged 2 to 12 years; Manual Ability Classification System [MACS] I–III or Mini-MACS I–III) were randomly assigned to either 12-week CIMT alone or CIMT combined with a customized Kinect-based VR (VRCIMT). Each session lasted 1.5 h, twice per week for 12 weeks. Outcome measures were assessed pre-treatment, post-treatment, and at the 3-month follow-up, using the Box and Block Test (BBT) as the primary outcome and ABILHAND-Kids and Goal Attainment Scale (GAS) scores as secondary outcomes. Generalized estimating equations were used to compare the effectiveness of VRCIMT relative to CIMT. The VRCIMT group exhibited significantly better BBT scores than the CIMT group at posttreatment ( p = 0.001), with this difference not persisting at the 3-month follow-up. VRCIMT exhibited greater improvements in ABILHAND-Kids at posttreatment ( p < 0.001) and follow-up ( p = 0.019). Improvements in GAS scores were significantly greater in the VRCIMT group at both posttreatment and follow-up (both p < 0.001). The customized Kinect-based VR system enhanced manual dexterity and abilities in daily activities immediately after CIMT, with sustained gains in abilities in daily activity at follow-up. These findings highlight its potential as a valuable adjunct for addressing upper extremity function in children with unilateral spastic CP. Trial registration : This trial was registered at ClinicalTrials.gov (NCT02039284) on November, 2017.