Maintained Hand Function and Forearm Bone Health 14 Months After an In-Home Virtual-Reality Videogame Hand Telerehabilitation Intervention in an Adolescent With Hemiplegic Cerebral Palsy

Abstract

Virtual reality videogames can be used to motivate rehabilitation, and telerehabilitation can be used to improve access to rehabilitation. These uses of technology to improve health outcomes are a burgeoning area of rehabilitation research. So far, there is a lack of reports of long-term outcomes of these types of interventions. The authors report a 15-year-old boy with hemiplegic cerebral palsy and epilepsy because of presumed perinatal stroke who improved his plegic hand function and increased his plegic forearm bone health during a 14-month virtual reality videogame hand telerehabilitation intervention. A total of 14 months after the intervention ended, repeat evaluation demonstrated maintenance of both increased hand function and forearm bone health. The implications of this work for the future of rehabilitation in children with neurological disabilities are discussed in this article.

Keywords

cerebral palsy telerehabilitation virtual reality

References

Golomb MR , McDonald BC , Warden SJ , et al. In-home virtual reality videogame telerehabilitation in children with hemiplegic cerebral palsy improves hand function and forearm bone health, and induces functional brain changes: a pilot case series. Arch Phys Med Rehabil. 2010;91:1-8,e1.

Huber M. , Rabin B. , Docan C. , et al. Feasibility of modified remotely monitored in-home gaming technology for improving hand function in adolescents with cerebral palsy. IEEE Trans Inf Technol Biomed. 2010;14:526-534.

Golomb MR , Carvalho KS , Garg BP A 9-year-old boy with a history of large perinatal stroke, infantile spasms, and high academic achievement. J Child Neurol. 2005;20:444-446.

Golomb MR , Barkat-Masih M. , Rabin B. , et al. Eleven months of home virtual reality telerehabilitation-lessons learned. Paper presented at: Virtual Rehabilitation International Conference; June 29-July 2, 2009; Haifa, Israel.

Asher IE Jebsen hand function test. In: Occupational Therapy Assessment Tools: An Annotated Index. 2nd ed. Bethesda, MD: American Occupational Therapy Association ; 1996:154.

Bryanton C. , Bosse J. , Brien M. , et al. Feasibility, motivation, and selective motor control: virtual reality compared to conventional home exercise in children with cerebral palsy . Cyberpsychol Behav. 2006;9:123-128.

Bartlett DJ , Palisano RJ A multivariate model of determinants of motor change for children with cerebral palsy. Phys Ther. 2000; 80:598-614.

Majnemer A. , Shevell M. , Law M. , et al. Participation and enjoyment of leisure activities in school-aged children with cerebral palsy. Dev Med Child Neurol. 2008;50:751-758.

Horgan JS Reaction-time and movement-time of children with cerebral palsy: under motivational reinforcement conditions. Am J Phys Med. 1980 ;59:22-29.

10.

Anderson J. , Hinojosa J. , Strauch C. Integrating play in neurodevelopmental treatment . Am J Occup Ther. 1987;41:421-426.

11.

Reid DT Benefits of a virtual play rehabilitation environment for children with cerebral palsy on perceptions of self-efficacy: a pilot study. Pediatr Rehabil. 2002;5:141-148.

12.

Deutsch JE , Borbely M. , Filler J. , et al. Use of a low-cost, commercially available gaming console (Wii) for rehabilitation of an adolescent with cerebral palsy. Phys Ther. 2008;88:1196-1207.

13.

Indiana First Steps Web site. https://www.infirststeps.com/ matrix/default.asp. Accessed July 02, 2008.

14.

Kentucky First Steps Web site. http://chfs.ky.gov/dph/firststeps.htm . Accessed July 2, 2008.

15.

Missouri First Steps Web site. http://www.eikids.com/mo/matrix/ . Accessed July 2, 2008.

16.

Washington State First Steps Web site. http://fortress.wa.gov/dshs/maa/firststeps/. Accessed July 2, 2008.

17.

Bingham SC , Beatty PW Rates of access to assistive equipment and medical rehabilitation services among people with disabilities. Disabil Rehabil. 2003;25:487-490.

18.

Binks JA , Barden WS , Burke TA , Young NL What do we really know about the transition to adult-centered health care? A focus on cerebral palsy and spina bifida. Arch Phys Med Rehabil. 2007;88:1064-1073.

19.

Lin PP , Henderson RC Bone mineralization in the affected extremities of children with spastic hemiplegia . Dev Med Child Neurol. 1996;38:782-786.

20.

Leet AI , Mesfin A. , Pichard C. , et al. Fractures in children with cerebral palsy. J Pediatr Orthop. 2006;26:624-627.

21.

Mathiowitz V. , Weimer D. , Federman S. Grip and pinch strength: Norms for 6-19 year olds. Am J Occ Ther. 1986;40:705-711.