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      Efficacy of neurodevelopmental treatment combined with the Nintendo ® Wii in patients with cerebral palsy

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          Abstract

          [Purpose] The aim of this study was to investigate the efficiency of Nintendo ® Wii games in addition to neurodevelopmental treatment in patients with cerebral palsy. [Subjects and Methods] Thirty hemiparetic cerebral palsy patients (16 females, 14 males; mean age, 6–15 years) were included in the study and divided into two groups: a neurodevelopmental treatment+Nintendo Wii group (group 1, n=15) and a neurodevelopmental treatment group (group 2, n=15). Both groups received treatment in 45-minute sessions 2 days/week for six weeks. Use of the upper extremities, speed, disability and functional independence were evaluated using the Quality of Upper Extremity Skills Test, Jebsen Taylor Hand Function Test, ABILHAND-Kids test, and Pediatric Functional Independence Measure (self-care) before and after treatment. [Results] There were statistically significant improvements in all parameters for group 1 and group 2 (except quality of function) after six weeks of treatment. Intergroup analysis showed that group 1 was superior to group 2 in mean change differences in the Jebsen Taylor Hand Function Test. [Conclusion] Our results showed that neurodevelopmental treatment is effective for improving hand functions in hemiplegic cerebral palsy. To provide a enjoyable, motivational, safe, and effective rehabilitation program, the Nintendo ® Wii may be used in addition to neurodevelopmental treatment.

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          Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Surveillance of Cerebral Palsy in Europe (SCPE).

          (2000)
          Although cerebral palsy (CP) is the most common cause of motor deficiency in young children, it occurs in only 2 to 3 per 1000 live births. In order to monitor prevalence rates, especially within subgroups (birthweight, clinical type), it is necessary to study large populations. A network of CP surveys and registers was formed in 14 centres in eight countries across Europe. Differences in prevalence rates of CP in the centres prior to any work on harmonization of data are reported. The subsequent process to standardize the definition of CP, inclusion/exclusion criteria, classification, and description of children with CP is outlined. The consensus that was reached on these issues will make it possible to monitor trends in CP rate, to provide a framework for collaborative research, and a basis for services planning among European countries.
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            Motor learning elicited by voluntary drive.

            Silke Anders, Christoph Braun, Leonardo Cohen … (2003)
            Motor training consisting of voluntary movements leads to performance improvements and results in characteristic reorganizational changes in the motor cortex. It has been proposed that repetition of passively elicited movements could also lead to improvements in motor performance. In this study, we compared behavioural gains, changes in functional MRI (fMRI) activation in the contralateral primary motor cortex (cM1) and in motor cortex excitability measured with transcranial magnetic stimulation (TMS) after a 30 min training period of either voluntarily (active) or passively (passive) induced wrist movements, when alertness and kinematic aspects of training were controlled. During active training, subjects were instructed to perform voluntary wrist flexion-extension movements of a specified duration (target window 174-186 ms) in an articulated splint. Passive training consisted of wrist flexion- extension movements elicited by a torque motor, of the same amplitude and duration range as in the active task. fMRI activation and TMS parameters of motor cortex excitability were measured before and after each training type. Motor performance, measured as the number of movements that hit the target window duration, was significantly better after active than after passive training. Both active and passive movements performed during fMRI measurements activated cM1. Active training led to more prominent increases in (i) fMRI activation of cM1; (ii) recruitment curves (TMS); and (iii) intracortical facilitation (TMS) than passive training. Therefore, a short period of active motor training is more effective than passive motor training in eliciting performance improvements and cortical reorganization. This result is consistent with the concept of a pivotal role for voluntary drive in motor learning and neurorehabilitation.
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              Use of a low-cost, commercially available gaming console (Wii) for rehabilitation of an adolescent with cerebral palsy.

              Phyllis Guarrera-Bowlby, Karen Huhn, T J Filler … (2008)
              The purpose of this retrospective and prospective case report is to describe the feasibility and outcomes of using a low-cost, commercially available gaming system (Wii) to augment the rehabilitation of an adolescent with cerebral palsy. The patient was an adolescent with spastic diplegic cerebral palsy classified as GMFCS level III who was treated during a summer session in a school-based setting. The patient participated in 11 training sessions, 2 of which included other players. Sessions were between 60 and 90 minutes in duration. Training was performed using the Wii sports games software, including boxing, tennis, bowling, and golf. He trained in both standing and sitting positions. Three main outcome measures were used: (1) visual-perceptual processing, using a motor-free perceptual test (Test of Visual Perceptual Skills, third edition); (2) postural control, using weight distribution and sway measures; and (3) functional mobility, using gait distance. Improvements in visual-perceptual processing, postural control, and functional mobility were measured after training. The feasibility of using the system in the school-based setting during the summer session was supported. For this patient whose rehabilitation was augmented with the Wii, there were positive outcomes at the impairment and functional levels. Multiple hypotheses were proposed for the findings that may be the springboard for additional research. To the authors' knowledge, this is the first published report on using this particular low-cost, commercially available gaming technology for rehabilitation of a person with cerebral palsy.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Phys Ther Sci
                Journal ID (iso-abbrev): J Phys Ther Sci
                Journal ID (publisher-id): JPTS
                Title: Journal of Physical Therapy Science
                Publisher: The Society of Physical Therapy Science
                ISSN (Print): 0915-5287
                ISSN (Electronic): 2187-5626
                Publication date (Electronic): 31 March 2016
                Publication date (Print): March 2016
                Volume: 28
                Issue: 3
                Pages: 774-780
                Affiliations
                [1) ] Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Turkey
                [2) ] TEMAS Pediatric Therapy and Special Education Center, Turkey
                Author notes
                [* ]Corresponding author. Gönül Acar, Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University: Bölümü, E-5 Yanyol Üzeri, 34865 Cevizli, Kartal, İstanbul, Turkey. (E-mail: gonulacar34@ 123456gmail.com )
                Article
                Publisher ID: jpts-2015-866
                DOI: 10.1589/jpts.28.774
                PMC ID: 4842438
                PubMed ID: 27134357
                SO-VID: 885d4440-9dbf-4243-a7c3-0f4d54522972
                Copyright © 2016©by the Society of Physical Therapy Science. Published by IPEC Inc.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License.

                History
                Date received : 15 October 2015
                Date accepted : 25 November 2015
                Categories
                Subject: Original Article

                Keywords: cerebral palsy,virtual reality,nintendo® wii
                Data availability:
                Keywords: cerebral palsy, virtual reality, nintendo® wii

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