Currently submitted to: JMIR Serious Games
Date Submitted: Aug 25, 2020
Open Peer Review Period: Aug 24, 2020 - Oct 19, 2020
(currently open for review)
Do virtual interventions in individuals with cerebral palsy make use of motor learning principles? A systematic review
Increasing evidence supports the use of virtual reality to improve upper limb motor functions in individuals with cerebral palsy. While virtual reality offers the possibility to include key components to promote motor learning, it remains unclear if and how motor learning principles are incorporated in the development of rehabilitation interventions using virtual reality.
To determine the extent to which motor learning principles are integrated in virtual reality interventions targeting upper limb function in individuals with cerebral palsy.
A systematic review was conducted according to the PRISMA guidelines. The search was done in 10 databases using the key words and variations ‘cerebral palsy’, ‘virtual reality’, ‘video game’ and ‘rehabilitation’. Studies were divided in 2 categories: commercial video games or custom virtual reality system. Study quality was assessed using the Downs and Black checklist.
The initial search yielded 1497 publications. A total of 26 studies from 30 publications were included, with most studies classified as ‘fair’ on the Downs and Black checklist. The majority of studies provided enhanced feedback, variable practice and used functionally-relevant and motivating virtual tasks. Dosage varied greatly (total training time ranging from 300-3360 minutes) with only 6 studies reporting the number of movement repetitions per session. The difficulty progression, the assessment of skills retention and transfer, were poorly incorporated, especially for the commercial video games.
Motor learning principles should be better integrated in the development of future virtual reality systems for optimal upper limb motor recovery in individuals with cerebral palsy. Clinical Trial: PROSPERO Registration: #151982
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