Table 1. Study characteristics.
| Study | Group | Number of participants | Types of Cerebral palsy |
Sex (M/F) |
Age Mean (SD) |
GMFCS Level | Duration | Outcome |
|---|---|---|---|---|---|---|---|---|
| Intervention | MACS Level | |||||||
| Reid & Campbell (2006) | Experimental | 19 Web-based VR |
Not reported | 12/7 | 9.68 (2.32) | level 1 (7), level 3 (7), level 4 (1), level 5 (4) |
90 min × 8 wk (Day: not reported) |
COPM QUEST SPPC |
| Not reported | ||||||||
| Control | 12 Standard care (PT or OT) |
Not reported | 8/4 | 9.33 (1.03) | level 1 (4), level 3 (5), level 5(3) |
Not reported | ||
| Not reported | ||||||||
| Rostami et al. (2012) | Experimental | 8 VR |
Spastic hemiplegia (8) | NR | 7.66(0.96) | Not reported | 90 min 3 d ×4 wk | BOTMP PMAL |
| Not reported | ||||||||
| Control | 8 CIMT |
Spastic hemiplegia (8) | NR | 8.33(1.45) | Not reported | 90 min 3 d ×4 wk | ||
| Not reported | ||||||||
| James et al. (2015) | Experimental | 51 Web-based VR |
Spastic hemiplegia (51) | 26/25 | 11.8 (2.4) | level 1 (20), level 2 (31) | 20–30 min 6 d ×20 wk | AHA AMPS COPM JTTHF MUUL TVPS-3 |
| level 1 (11), level 2 (39), level 3 (1) |
||||||||
| Control | 51 Standard care |
Spastic hemiplegia (50) | 25/25 | 11.10 (2.5) | level 1 (25), level 2 (25) | 20 wk (Duration: not reported) |
||
| level 1 (13), level 2 (37) | ||||||||
| Atasavun Uysal & Baltaci (2016) | Experimental | 12 Nintendo Wii + Traditional PT |
Spastic hemiplegia (12) | 8/4 | 9.13 (2.57) | level 1 (9), level 2 (3) | 30 min 2 d ×12 wk (VR) 45 min 2 d ×12 wk (Traditional PT) |
COPM PEDI PBS |
| level 1 (6), level 2 (2), level 3 (4) |
||||||||
| Control | 12 Traditional PT |
Spastic hemiplegia (12) | 2/10 | 10.11 (2.62) | level 1 (10), level 2 (2) | 45 min 2 d ×12 wk (Traditional PT) | ||
| level 1 (6), level 2 (3), level 3 (3) |
||||||||
| Acar et al. (2016) | Experimental | 15 Nintendo Wii (VR) + NDT |
Spastic hemiplegia (15) | 8/7 | 9.53 (3.04) | level 1 (6), level 2 (9) | 15 min 2 d ×6 wk (VR) 45 min 2 d ×6 wk (NDT) |
ABILHAND-Kids JTHFT QUEST WeeFIM |
| level 2 (range 1-3) | ||||||||
| Control | 15 NDT |
Spastic hemiplegia (15) | 6/9 | 9.73 (2.86) | level 1 (6), level 2 (9) | 45 min 2 d ×6 wk (NDT) | ||
| level 2 (range 1-3) | ||||||||
| Mitchell, Ziviani & Boyd (2016) | Experimental | 51 Web-based VR |
Spastic hemiplegia (51) | 26/25 | 11.3(2.4) | level 1 (21), level 2 (30) | 30 min 6 d ×20 wk | 6MWT Accelerometer Life-H MobQues28 MVPA FSA |
| level 1 (11), level 2 (38), level 3 (2) |
||||||||
| Control | 50 Standard care |
Spastic hemiplegia (50) | 26/24 | 11.4(2.6) | level 1 (25), level 2 (25) | 20 wk (Duration: not reported) |
||
| level 1 (13), level 2 (37) | ||||||||
| Tarakci et al. (2016) | Experimental | 15 Nintendo Wii (VR) + NDT |
Spastic hemiplegia (7) Spastic diplegia (5) Dyskinetic (3) |
10/5 | 10.46(2.69) | level 2 (range 1-3) | 20 min 2 d ×12 wk (VR) 30 min 2 d ×12 wk (NDT) |
10MWT 10SCT FRT STST TUG WeeFIM |
| level 1-3 (15) | ||||||||
| Control | 15 Balance training (BT) + NDT |
Spastic hemiplegia (7) Diplegia (7) Dyskinetic (1) |
9/6 | 10.53(2.79) | level 2 (range 1-2) | 20 min 2 d ×12 wk (BT) 30 min 2 d ×12 wk (NDT) |
||
| level 1-3 (15) | ||||||||
| Avcil et al. (2021) | Experimental | 15 Nintendo Wii (VR) + Leap motino controller (LMC) |
Spastic hemiplegia (8) Spastic diplegia (4) Dyskinetic (3) |
8/7 | 10.93(4.09) | level 1 (8), level 2 (4), level 3 (1), level 4 (2) |
60 min 3 d ×8 wk (VR) | CHAQ DEI MMDT Dynamometer |
| level 1 (2), level 2 (9), level 3 (4) |
||||||||
| Control | 15 NDT-based upper extremity rehabilitation |
Spastic hemiplegia (9) Spastic diplegia (2) Dyskinetic (4) |
9/6 | 11.07(3.24) | level 1 (3), level 2 (2), level 3 (6), level 4 (4) |
60 min 3 d ×8 wk (NDT) | ||
| level 1 (3), level 2 (8), level 3 (2), level 4 (2) |
||||||||
| Choi et al. (2021) | Experimental | 40 VR for upper-limb + OT |
Unilateral (15) Bilateral (25) |
19/21 | 5.33(1.54) | level 1 or level 2 (13) level 3 or level 4 (27) |
30 min 5 d ×4 wk (VR) 30 min 5 d ×4 wk (OT) |
3D motion MA-2 PEDI ULPRS |
| Not reported | ||||||||
| Control | 38 OT |
Unilateral spastic (19) Bilateral spastic (29) |
19/19 | 4.33(2.31) | level 1 or level 2 (16) level 3 or level 4 (22) |
60 min 5 d ×4 wk (OT) | ||
| Not reported | ||||||||
| Jha et al. (2021) | Experimental | 19 VR + PT (Balance) |
Bilateral spastic (19) | 14/5 | 8.94(1.92) | level 2 (17), level 3 (2) | 30 min 4 d ×6 wk (VR) 30 min 4 d ×6 wk (PT) |
GMFM-88 Kids-mini-Best PBS WeeFIM |
| level 1 (12), level 2 (7) | ||||||||
| Control | 19 PT (Balance) |
Bilateral spastic (19) | 9/10 | 8.72(1.68) | level 2 (16), level 3 (3) | 60 min 4 d ×6 wk (PT) | ||
| level 1 (10), level 2 (9) | ||||||||
| Wang et al. (2021) | Experimental | 9 Nintendo Wii (VR) + CIMT |
Spastic hemiplegia (9) | 3/6 | 8.55(2.09) | Not reported | 135 min 2 d ×4 wk (CIT) 135 min 2 d ×4 wk (VR) |
ABILHAND-Kids BOTMP EQ PMAL PSI-SF ToP |
| level 1 (3), level 2 (4) level 3 (2) |
||||||||
| Control | 9 CIMT |
Spastic hemiplegia (9) | 4/5 | 8.57(2.15) | Not reported | 135 min 2 d ×8 wk (CIT) | ||
| level 1 (3), level 2 (6) |
Notes.
- GMFCS
- Gross motor function classification scale
- MACS
- Manual ability classification;
- VR
- Virtual reality
- PT
- Physical therapy
- OT
- Occupational therapy
- COPM
- Canadian occupational performance
- QUEST
- Quality of upper extremity test
- SPPC
- Sefl-perception profile for children
- CIMT
- Constraint-induced movement therapy
- BOTMP
- Bruiniks-oseretsky test of motor proficiency
- PMAL
- Pediatric motor activity log
- AHA
- Assisting hand assessment
- AMPS
- Assessment of motor and process skills
- JTTHF
- Jebsen-taylor test of hand function
- MUUL
- Melbourne assessment of unilateral upper limb function
- TVPS-3
- Test of visual perceptual skills-3rd edition;
- PEDI
- Pediatric evaluation of disability inventory
- PBS
- Pediatric balance scale
- NDT
- Neurodevelopmental treatment
- ABILHAND-Kids
- WeeFIM, Functional independence measure for children
- 6MWT
- 6-minute walk test
- LIFE-H
- Reaction assessment of life habits recreational domain
- MobQues28
- Mobility questionnaire 28 item
- MVPA
- Moderate to vigorous physical activity
- NHS
- 10MWT, 10-meter walk test
- 10SCT
- 10-stair climbing test
- FRT
- Functional reach test
- STST
- Sit-to-stand test
- TUG
- Timed up and go test
- CHAQ
- Childhood health assessment questionnaire
- DEI
- Duruoz hand index
- MMDT
- Minnesota manual dexterity test
- ULPRS
- Upper limb physician’s rating scale
- EQ
- Engagement questionnaire
- PSI-SF
- Parenting stress index-short form
- Top
- Test of playfulness