Virtual Reality Training Using Wii Fit in Children With Cerebral Palsy (VR in CP)

April 16, 2026 updated by: Ziauddin University

EFFECTS OF VIRTUAL REALITY TRAINING USING WII FIT ON BALANCE, GROSS MOTOR FUNCTION, AND AGILITY IN CHILDREN WITH CEREBRAL PALSY -A RANDOMIZED CONTROLLED TRIAL

The goal of this clinical trial is to determine whether virtual reality (VR) training using the Nintendo Wii Fit can improve balance, gross motor function, and agility in children aged 7-14 years with spastic cerebral palsy (GMFCS Levels I-II). The main questions it aims to answer are:

Does Wii Fit-based VR training improve balance more than conventional physiotherapy?

Does VR training enhance gross motor skills such as standing, walking, running, and jumping?

Does VR training improve agility in children with cerebral palsy?

Does VR training increase enjoyment and engagement during therapy?

Researchers will compare Wii Fit-based VR training with conventional physiotherapy to determine which approach leads to greater improvements in motor function.

Participants will:

Attend 18 sessions over 6 weeks (3 sessions per week).

Perform either VR-based exercises using the Wii Fit Balance Board or traditional physiotherapy exercises.

Complete pre- and post-intervention assessments using the Pediatric Balance Scale, GMFM-88 (domains D and E), BOT-2 agility subtest, and the PACES enjoyment scale.

This study aims to explore a fun, cost-effective, and engaging rehabilitation strategy that may improve functional independence and overall quality of life for children with cerebral palsy.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

This clinical trial aims to evaluate the effects of virtual reality training using the Nintendo Wii Fit on balance, gross motor function, agility, and enjoyment in children with spastic cerebral palsy. Cerebral palsy commonly affects motor control, posture, coordination, and mobility, and children often require long-term physiotherapy to improve their functional independence. While traditional physiotherapy is effective, many children struggle with motivation, participation, and engagement during repetitive therapeutic exercises. Virtual reality-based interventions are emerging as a fun, interactive, and affordable way to increase motivation and enhance motor learning in pediatric rehabilitation.

In this study, children aged 7 to 14 years with spastic cerebral palsy (GMFCS Levels I-II) will be randomly assigned to either Wii Fit-based virtual reality training or conventional physiotherapy. The intervention will last 6 weeks, with sessions held three times per week. The virtual reality group will perform selected Wii Fit games that specifically target balance, coordination, strength, motor planning, and agility. These include Table Tilt, Balance Bubble, Perfect 10, Super Hula Hoop, Obstacle Course, Ultimate Obstacle Course, Ski Jump, and Basic Step. Each session consists of a warm-up phase, 20 minutes of Wii Fit gameplay, and a cool-down period. Game difficulty will progressively increase as the child's performance improves, while therapists will ensure safety and provide encouragement.

The control group will receive conventional physiotherapy, which includes strengthening exercises, gait training, dynamic and static balance tasks, and functional task-oriented activities. Both groups will receive an equal number of sessions with similar session duration to ensure fairness in comparison.

Outcome measures include the Pediatric Balance Scale (balance), GMFM-88 domains D and E (standing, walking, running, jumping), BOT-2 Running Speed and Agility Subtest (agility), and the Physical Activity Enjoyment Scale. Assessments will be conducted before and after the 6-week intervention by trained assessors who are blinded to group allocation.

This study aims to address the lack of comprehensive research evaluating the combined effects of virtual reality on multiple motor skills in children with cerebral palsy, particularly in Pakistan. By comparing Wii Fit training with conventional physiotherapy, the study seeks to determine whether VR offers a more engaging, motivating, and effective rehabilitation option. If successful, the findings may support the use of low-cost, accessible virtual reality tools in pediatric therapy settings to improve functional outcomes, engagement, and quality of life for children with cerebral palsy.

Study Type

Interventional

Enrollment (Estimated)

56

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Ghulam Sakina Awan, MPhil in Physical Therapy
  • Phone Number: 5 021-36629251
  • Email: Ghulam.18567@zu.edu.pk

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • ● Children aged 7 to 14 years

    • Diagnosed cases of spastic diplegic CP, characterized by bilateral lower limb involvement
    • Classified under GMFCS levels I to II.
    • Having mild to moderate spasticity on Modified Ashworth Scale (MAS) scores ranging from 1, +1 or 2
    • Mild level intellectual disability according to their health records
    • Medically stable with no acute illness or uncontrolled comorbidities
    • No major changes in medication or therapy planned during the study period.

Exclusion Criteria:

  • ● Orthopedic surgery or botulinum toxin injections in the past 16 months

    • Hearing or visual impaired .
    • Uncontrolled epilepsy or seizures
    • Severe attention deficits or psychological issues interfering with task engagement such as attention deficit hyperactivity disorder (ADHD), Autism Spectrum Disorder (ASD) will be excluded from the study .

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Virtual Reality Group
Participants in this group will receive Wii Fit-based virtual reality training using the Nintendo Wii Fit Balance Board. Each session will include a warm-up, 20 minutes of structured Wii Fit gameplay, and a cool-down. The selected games target balance, coordination, strength, and agility, such as Table Tilt, Balance Bubble, Perfect 10, Super Hula Hoop, Obstacle Course, Ultimate Obstacle Course, Ski Jump, and Basic Step. Difficulty levels will progress gradually based on the participant's performance. Sessions will be conducted three times per week for six weeks (total 18 sessions), supervised by a physiotherapist. No additional physiotherapy exercises will be given during the intervention period.
Device: Experimental Group
Participants in this group will receive Wii Fit-based virtual reality training using the Nintendo Wii Fit Balance Board. Each session will include a warm-up, 20 minutes of structured Wii Fit gameplay, and a cool-down. The selected games target balance, coordination, strength, and agility, such as Table Tilt, Balance Bubble, Perfect 10, Super Hula Hoop, Obstacle Course, Ultimate Obstacle Course, Ski Jump, and Basic Step. Difficulty levels will progress gradually based on the participant's performance. Sessions will be conducted three times per week for six weeks (total 18 sessions), supervised by a physiotherapist. No additional physiotherapy exercises will be given during the intervention period.
Placebo Comparator: Conventional Physical Therapy
Participants assigned to the control group will receive routine physiotherapy commonly used for children with cerebral palsy. This includes strengthening exercises, stretching, balance training, gait training, coordination tasks, and functional activity practice. Each session will follow the same overall duration and format as the intervention group (warm-up, 20-minute main exercise phase, and cool-down). Sessions will also be conducted three times per week for six weeks (total 18 sessions), supervised by a physiotherapist. No virtual reality activities will be provided.
Behavioral: control group
Participants assigned to the control group will receive routine physiotherapy commonly used for children with cerebral palsy. This includes strengthening exercises, stretching, balance training, gait training, coordination tasks, and functional activity practice. Each session will follow the same overall duration and format as the intervention group (warm-up, 20-minute main exercise phase, and cool-down). Sessions will also be conducted three times per week for six weeks (total 18 sessions), supervised by a physiotherapist. No virtual reality activities will be provided.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Gross Motor Skills
Time Frame: Baseline
Gross Motor Skills measured via GMFM-88 (domains D and E)
Baseline
Balance
Time Frame: Baseline
Balance measured via Pediatric Balance Scale (PBS)
Baseline
Agility
Time Frame: Baseline
Agility using the running speed and agility subset of Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2)
Baseline
Agility
Time Frame: 6 weeks
Agility using the running speed and agility subset of Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2)
6 weeks
Balance
Time Frame: 6 weeks
Balance measured via Pediatric Balance Scale (PBS)
6 weeks
Gross Motor Skills
Time Frame: 6 weeks
Gross Motor Skills measured via GMFM-88 (domains D and E)
6 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Level of enjoyment
Time Frame: 6 weeks
Level of enjoyment using the Physical Activity Enjoyment Scale (PACES)
6 weeks
Level of enjoyment
Time Frame: Baseline
Level of enjoyment using the Physical Activity Enjoyment Scale (PACES)
Baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ziauddin University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

April 25, 2026

Primary Completion (Estimated)

July 15, 2026

Study Completion (Estimated)

August 15, 2026

Study Registration Dates

First Submitted

April 16, 2026

First Submitted That Met QC Criteria

April 16, 2026

First Posted (Actual)

April 23, 2026

Study Record Updates

Last Update Posted (Actual)

April 23, 2026

Last Update Submitted That Met QC Criteria

April 16, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 10980825GSPT (Other Identifier: Ziauddin University)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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