Effect of virtual reality versus conventional physiotherapy on upper extremity function in children with obstetric brachial plexus injury

S El-Shamy, R Alsharif, S El-Shamy, R Alsharif

Abstract

Objectives: The objective was to evaluate the effects of virtual reality versus conventional physiotherapy on upper extremity function in children with obstetric brachial plexus injury.

Methods: Forty children with Erb's palsy were selected for this randomized controlled study. They were assigned randomly to either group A (conventional physiotherapy program) or group B (virtual reality program using Armeo® spring for 45 min three times/week for 12 successive weeks). Mallet system scores for shoulder function and shoulder abduction, and external rotation range of motion (ROM) were obtained; shoulder abductor, and external rotators isometric strength were evaluated pre-and post-treatment using Mallet scoring system, standard universal goniometer, and handheld dynamometer.

Results: The results of this study indicate that the children in both groups showed improvement in shoulder functions post-treatment with greater improvements in group B. The abduction muscle strength after treatment was 8.53 and 11.3 Nm for group A and group B, respectively. The external rotation muscle strength after treatment was 5.88 and 7.45 Nm for group A and group B, respectively.

Conclusions: The virtual reality program is a significantly more effective than conventional physiotherapy program in improving the upper extremity functions in children with obstetric brachial plexus injury.

Conflict of interest statement

The authors have no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the study.
Figure 2
Figure 2
Armeo® Spring System.

References

    1. Andersen J, Watt J, Olson J, Van Aerde J. Perinatal brachial plexus palsy. Pediatr Child Health. 2006;11:93–100.
    1. Hoeksma AF, ter Steeg AM, Nelissen RG, van Ouwerkerk WJ, Lankhorst GJ, de Jong BA. Neurological recovery in obstetric brachial plexus injuries: an historical cohort study. Dev Med Child Neurol. 2004;46(2):76–83.
    1. Zafeiriou DI, Psychogiou K. Obstetrical brachial plexus palsy. Pediatr Neurol. 2008;38:235–242.
    1. Santamato A, Panza F, Ranieri M, Fiore P. Effect of botulinum toxin type A and modified constraint-induced movement therapy on motor function of upper limb in children with obstetrical brachial plexus palsy. Childs Nerv Syst. 2011;12(27):2187–2192.
    1. Yang LJ, Anand P, Birch R. Limb preference in children with obstetric brachial plexus palsy. Pediatr Neurol. 2005;33(1):46–49.
    1. Duff SV, Gordon AM. Learning of grasp control in children with hemiplegic cerebral palsy. Dev Med Child Neurol. 2003;45(11):746–757.
    1. Shumway-Cook A, Hutchinson S, Kartin D, Price R, Woollacott M. Effect of balance training on recovery of stability in children with cerebral palsy. Dev Med Child Neurol. 2003;45(9):591–602.
    1. Strömbeck C, Krumlinde-Sundholm L, Remahl S, Sejersen T. Long-term follow-up of children with obstetric brachial plexus palsy I: functional aspects. Dev Med Child Neurol. 2007;49:198–203.
    1. Dodds SD, Wolfe SW. Perinatal brachial plexus palsy. Curr Opin Pediatr. 2000;12(1):40–47.
    1. Vaz DV, Mancini MC, do Amaral MF, de Brito Brandão M, de França Drummond A, da Fonseca ST. Clinical changes during an intervention based on constraint-induced movement therapy principles on use of the affected arm of a child with obstetric brachial plexus injury: a case report. Occup Ther Int. 2010;17(4):159–167.
    1. Sisto SA, Forrest GF, Glendinning D. Virtual reality applications for motor rehabilitation after stroke. Top Stroke Rehabil. 2002;8(4):11–23.
    1. Nelles G, Jentzen W, Jueptner M, Müller S, Diener HC. Arm training induced plasticity in stroke studied with serial positron emission tomography. Neuroimage. 2001;13:1146–1154.
    1. Small S, Solodkin A. Review: The neurobiology of stroke rehabilitation. Neuroscientist. 1998;4:426–434.
    1. Liepert J, Bauder H, Wolfgang HR, Miltner WH, Taub E, Weiller C. Treatment-induced cortical reorganization after stroke in humans. Stroke. 2000;31(6):1210–1216.
    1. Broeren J, Bjorkdahl A, Pascher R, Rydmark M. Virtual reality and haptics as an assessment device in the post acute phase after stroke. Cyber Psychol Behav. 2002;25:207–211.
    1. Cramer S C, Bastings E P. Mapping clinically relevant plasticity after stroke. Neuropharmacology. 2000;39:842–851.
    1. Crosbie JH, Lennon S, Basford JR, McDonough SM. Virtual reality in stroke rehabilitation: Still more virtual than real. Disabil Rehabil. 2007;29(14):1139–1146.
    1. Galvin J, McDonald R, Catroppa C, Anderson V. Does intervention using virutal reality improve upper limb function in children with neurological impairment: A systematic review of the evidence. Brain injury. 2011;25(5):435–442.
    1. Snider L, Majnemer A, Darsaklis V. Virtual reality as a therapeutic modality for children with cerebral palsy. Dev Neurorehabil. 2010;13(2):120–128.
    1. Dinomais M, Veaux F, Yamaguchi T, Richard P, Richard I, Nguyen S. A new virtual reality tool for unilateral cerebral palsy rehabilitation: two single-case studies. Dev Neurorehabil. 2013;16(6):418–422.
    1. Sunderland SA. Classification of peripheral nerve injuries producing loss of function. Brain. 1951;74:491–516.
    1. Bae DS, Waters PM, Zurakowski D. Reliability of three classification systems measuring active motion in brachial plexus birth palsy. J Bone Joint Surg Am. 2003;85-a(9):1733–1738.
    1. de Luna Cabrai JR, Crepaldi BE, de Sambuy MTC, da Costa AC, Abdouni YA, Chakkour I. Evaluation of upper-limb function in patients with obstetric palsy after modified Sever-L'Episcopo procedure. Rev Bras Ortop. 2012;47(4):451–454.
    1. Levangie PK, Norkin CC. Joint structure and function: A Comprehensive Analysis. 5th Edition. Philadelphia, PA: F.A. Davis Company; 2011.
    1. Kilber MJ, Hanney WJ. The Reliability and concurrent validity of shoulder mobility measurements using a digital inclinometer and goniometer. A technical report. Ant J Sports Phys Ther. 2012;7(3):306–313.
    1. Brochard S, Alter K, Damiano D. Shoulder strength profiles in children with and without brachial plexus palsy. Muscle Nerve. 2014;50(1):60–66.
    1. Hébert LJ, Maltais DB, Lepage C, Saulnier J, Crête M. Hand-Held Dynamometry Isometric Torque Reference Values for Children and Adolescents. Pediatr Phys Ther. 2015;27(4):414–423.
    1. Ibrahim AI, Hawamdeh ZM, Alsharif AA. Evaluation of bone mineral density in children with perinatal brachial plexus palsy: effectiveness of weight bearing and traditional exercises. Bone. 2011;49:499–505.
    1. HOCOMA. Armeo®user manual [CD-ROM] Hocoma AG: 2008.
    1. Klobucka S, Kralovicova M, Ziakova E. A functionally robot-assisted therapy upper limb. Rehabilitation and Physical Medicine. 2010;17:164–168.
    1. Sladekova N, Kresanek J. Case report of a patient with cerebral palsy using non-robotic equipment for re-education movements of paretic upper limb. Prz Med Uniw Rzesz Inst Leków. 2014;1:115–118.
    1. Padyšaková H, Repková A, Sládeková N, Žiaková E, Pacek O, Musilová E, Klobucka S. Re-Education Movements of the Paretic Upper Extremity in Children age by Using Non-robotic Equipment. European Journal of Medicine. 2015;8(2):106–114.
    1. Kahn LE, Zygman ML, Rymer WZ, Reinkensmeyer DJ. Robot assisted reaching exercise promotes arm movement recovery in chronic hemiparetic stroke: a randomized controlled pilot study. J Neuroeng Rehabil. 2006;3:12.
    1. Lo AC, Guarino PD, Richards LG, Haselkorn JK, Wittenberg GF, Federman DG, et al. Robot-assisted therapy for long-term upper-limb impairment after stroke. N Engl J Med. 2010;362:1772–1783.
    1. Lum PS, Burgar CG, Van der Loos M, Shor PC, Majmundar M, Yap R. MIME robotic device for upper-limb neurorehabilitation in subacute stroke subjects: a follow-up study. J Rehabil Res Dev. 2006;43:631–642.
    1. Lum PS, Burgar CG, Shor PC, Majmundar M, Van der Loos M. Robot-assisted movement training compared with conventional therapy techniques for the rehabilitation of upper-limb motor function after stroke. Arch Phys Med Rehabil. 2002;83:952–959.
    1. Fasoli SE, Krebs HI, Hogan N. Robotic technology and stroke rehabilitation: translating research into practice. Top Stroke Rehabil. 2004;11(4):11–9.
    1. Brokaw EB, Murray T, Nef T, Lum PS. Retraining of interjoint arm coordination after stroke using robot-assisted time-independent functional training. J Rehabil Res Dev. 2011;48:299–316.
    1. Damiano DL. Activity, activity, activity: Rethinking our physical therapy approach to cerebral palsy. Phys Ther. 2006;86:1534–1540.
    1. Ketelaar M, Vermeer A, Hart H, van Petegem-van Beek E, Helders PJ. Effects of a functional therapy program on motor abilities of children with cerebral palsy. Phys Ther. 2001;81:1534–1545.
    1. Magill R, Anderson R. Motor Learning and Control: Concepts and Applications. 10th Edition. North Ryde: NSW McGraw-Hill; 2014.
    1. You SH, Jang SH, Kim YH, Kwon YH, Barrow I, Hallett M. Cortical reorganization induced by virtual reality therapy in a child with hemiparetic cerebral palsy. Dev Med Child Neurol. 2005;47:628–635.
    1. Lotze M, Braun C, Birbaumer N, Anders S, Cohen LG. Motor learning elicited by voluntary drive. Brain. 2003;126(4):866–872.
    1. Papavasiliou AS. Management of motor problems in cerebral palsy: a critical update for the clinician. European journal of pediatric neurology. 2009;13(5):387–396.
    1. Brutsch K, Schuler T, Koenig A, Zimmerli L, Koeneke SM, Lunenburger L, et al. Influence of virtual reality soccer game on walking performance in robotic assisted gait training for children. Journal of Neuroengineering and Rehabilitation. 2010;7:15.
    1. Brooks BM. Route Learning in a Case of Amnesia: A Preliminary Investigation into the Efficacy of Training in a Virtual Environment. Neuropsychol Rehabil. 1999;9(1):63–76.
    1. Chen YP, Kang LJ, Chuang TY, Doong JL, Lee SJ, Tsai MW, Jeng SF, Sung WH. Use of virtual reality to improve upper-extremity control in children with cerebral palsy: a single-subject design. Phys Ther. 2007;87:1441–1457.
    1. Kwakkel G, Kollen BJ, Krebs HI. Effects of robot-assisted therapy on upper limb recovery after stroke: a systematic review. Neurorehabil Neural Repair. 2008;22(2):111–121.
    1. Ladenheim B, Altenburger P, Cardinal R, Monterroso L, Dierks T, Mast J, Krebs HI. The effect of random or sequential presentation of targets during robot-assisted therapy on children. NeuroRehabil. 2013;33(1):25–31.
    1. 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(3):141–148.

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren