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Table 3 Studies outcomes

From: Effect of virtual reality on motor coordination in children with cerebral palsy: a systematic review and meta-analysis of randomized controlled trials

Study,
Year
Outcome measure ICF Results Cochrane Pedro Level of evidence Setting
B A P
Chen et al. [32]
2012
Taiwan
BOTMP   Gross motor function did not improved, however, muscle strength- especially knee flexors at different angular velocities- improved Poor quality 5 (moderate) 2a (limited) Home
Isokinetic Dynamometer   
Ramstrand and Lygnegåd [33]
2012
Sweden
Modified sensory organization test    No significant difference was observed between testing occasions for any of the balance measures investigated Poor quality 2 (low) 2b (limited) Home
Reactive balance   
Rhythmic weight shift   
Rostami et al. [34]
2012
Iran
PMAL   Improved quantity and quality of UE movements and speed and dexterity via CIMT in VR Poor quality 6 (moderate) 1b (strong) Laboratory
BOTM (subset 8)  
Druzibicki et al. [35]
2013
Poland
3D Temporo-spatial and kinematic gait analysis    There was no a statically difference between the baseline and post-intervention assessment. At the end of intervention, there was a slight improvement in walking speed in both groups. Improvement in the mean walking speed was not significantly different between the groups. Range of motion decreased slightly in both groups, and the difference between mean amounts of change was not significant. There was significant improvement in maximal range of flexion in the hip joint in the study. It was shown that with a decrease in the mean value of adduction in hip joint, the mean walking speed increased Poor quality 5 (moderate) 2a (limited)  
Chiu et al. [36]
2014
Taiwan
Joint Kinematics    Coordination, strength or hand function did not improve, however, hand function according to carers perception improved Poor quality 7 (high) 1b (strong) Home
Dynamometer   
Nine-hole peg test   
JTTHF   
Functional Use Survey   
Gilliaux et al. [37]
2015
Belgium
UE Kinematics    Improved UE kinematics and manual dexterity but functional activities and social participation did not improved Poor quality 5 (moderate) 2a (limited) Rehabilitation department
BBT   
QUEST   
Modified Ashworth Scale   
Hand-Held dynamometer   
Abilhand-Kids   
PEDI  
Life Habits   
James et al. [38]
2015
Australia
AMPS   Improvement in ADL motor and processing skills, occupation performance, goal attainment, visual processing and speed and dexterity of the dominant UE, however, impaired UE trended toward improvement Poor quality 7 (high) 1b (strong) Home
AHA   
JTTHF impaired UE   
JTTHF dominant UE   
MUUL  
COPM   
TVPS-3   
Greeco et al. [39]
2015
Brazil
3D Temporo-spatial and kinematic gait analysis    The experimental group had a better performance regarding gait velocity,cadence, gross motor function,independent mobility and motor evoked Potential Poor quality 5 (moderate) 2a (limited) Clinic
GMFM   
PEDI  
Motor evoked potential   
Zoccolillo et al. [40]
2015
Italy
QUEST    QUEST scores significantly improved only after VR intervention, while the Abilhand-­kids scores improved significantly after CT. Quantity of performed movements was three times higher in VGT than in CT. No significant changes in VMI scores occurred in both groups Poor quality 4 (low) 2a (limited) Clinic
Abilhand-Kids   
VMI   
Cho et al. [41]
2016
Korea
Digital manual muscle tester    GMFM (standing) Gait and balance improved significantly in VR treatment training group compared to treadmill training group Poor quality 6 (moderate) 1b (strong) Clinic
GMFM   
PBS   
Walking 10 MWT (speed)   
2 MWT (endur)   
Posturographic measures   
Acar et al. [42]
2016
Turkey
QUEST    Improved UE functions, speed, manual ability and independence level in ADL Poor quality 6 (moderate) 1b (strong) Clinic
JTTHF   
Abilhand-Kids   
WeeFIM-self-care   
Ürgen et al. [43]
2016
Turkey
GMFM    Both groups had significant improvements in the GMFM and GMPM scores, durations of single leg and tandem standing, and PBS. The intervention group had more significant improvements in the mean duration of the TUG test and number of jumping than the control group. However, When the groups were compared post-intervention, the GMFM, the GMPM and PEDI scores were similar Poor quality 8 (high) 1b (strong) Clinic
GMPM   
Standing duration on flat and soft surfaces with eyes open and eyes closed   
Single leg standing duration   
Tandem standing duration   
Number of jumping on single leg   
TUG   
PBS   
Failing status    
PEDI  
Bedair et al. [44]
2016
Egypt
PDMS-2    Improved hand skills and visual motor skills of UE Poor quality 6 (moderate) 1b (strong) Clinic
Abilhand-Kids   
Uysal and Baltaci [45]
2016
Turkey
PEDI   Self-care, mobility, PEDI total, PBS and performance of COPM scores increased in the VR group after intervention. Self-care, mobility and total PEDI increased in the control group as well. However, there was no statistically significant difference found between the groups, except for PBS Poor quality 5 (moderate) 2a (limited) Clinic
PBS   
COPM   
Tarakci et al. [34]
2016
Turkey
FFRT    After the intervention, changes in balance scores and independence level in activities of daily living were significant in both groups. Statistically significant improvements were found in the Wii-based group compared with the control group in all balance tests and total WeeFIM score Poor quality 4 (low) 2a (limited) Rehabilitation unit
FSRT   
TGGT   
STST   
Wii Nintendo Fit Balance & Game Scores   
10 mWT   
10 sCT   
WeeFIM   
Wallard et al. [46]
2017
France
3D full-body kinematic gait analysis    Between-group comparison shows significant differences for head, shoulder, elbow, knee and ankle kinematics and GMFM. However, parameters for the thorax, pelvis and hip angles show no significant differences
No significant intragroup differences for the CG were shown in the terms of body kinematics and GMFM.On the other hand, significant differences are shown for intragroup comparison for TG for head, shoulder, elbow, knee and ankle and GMFM
Poor quality 6 (moderate) 1b (strong) Laboratory
GMFM   
Lazzari et al. [47]
2017
Brazil
Static balance Stabilometric evaluation COP "force plate"    Statically post-intervention & follow-up effects favoring the experimental group over the control group with regard to the PBS & TUGT & the area of oscillation of COP when standing on force plate Poor quality 8 (high) 1b (strong) Lab
Functional balance PBS   
Timed up and Go test   
Gatica Rojas et al. [48]
2017
Chile
Posturographic measures including COP sway area, standard deviation and velocity of COP    Wii therapy significantly reduced the COPsway and SDAP in the eyes-open condition
In Spastic hemiplegia, however, the effects wane after 2-4 h
Poor quality 6 (moderate) 1b (strong) Rehabilitation unit
Sajan et al. [49]
2017
India
Static posturography     Improved postural control and balance, UE function, visual perceptual skills and functional mobility Poor quality 7 (high) 1b (strong) Clinic
PBS    
BBT    
QUEST    
TVPS-3    
walking speed and distance    
  1. BOTMP burininks osteretsky test of motor proficiency, PMAL pediatric motor activity log, JTTHF Jebsen Taylor test of hand function, UE upper extremity, BBT box and blocks test, GMPM growth motor, QUEST quality of performance measure, upper extremity skills test, PEDI pediatric evaluation of disability inventory, AMPS Assessment of Motor and Process Scale, AHA assisting hand assessment, MUUL melbourne assessment of unilateral upper limb function, COMP Canadian occupational performance measure, TUG timed up and go test, FFRT functional forward reach test, FSRT functional sideway reach test, TGGT timed get up and go test, STST sit-to-stand test, 10 mWT 10 min walking test, 10s CT 10 s climbing test, GMFM growth motor functional measure, COP center of pressure, TVPS-2 test of visual and perceptual skills-2nd edition, PDMS-2 Peabody Developmental Motor Scale-2, WeeFIM-self-care functional independence measure, PBS Pediatric Balance Scale