Effect of Biofeedback-Enhanced Exergaming, Exergaming Alone, and Traditional Physical Therapy on Motor Function, Adherence, and Engagement in Children With Cerebral Palsy: A RCT

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The trial is looking for children aged 6 to 12 with cerebral palsy who can walk and use their hands fairly well. It compares video-game exercise, with or without live body feedback, to usual physical therapy.

Életkor

6 to 12 years

Nem

Boys and girls

A betegség stádiuma

Cerebral palsy of the spastic diplegia, spastic hemiplegia or mild ataxia type. Gross Motor Function Classification System (GMFCS) Level I or II, and Manual Ability Classification System (MACS) Level I or II. The child must be able to stand and do basic movements with no help or minimal help.

Biomarker vagy leletérték

A score at or above the 25th percentile (T-score ≥ 40) on the NIH Toolbox Picture Sequence Memory Test (PSMT), a memory test. The child must be able to follow simple two-step commands.

A részvétel fő kizáró okai

• GMFCS Level III or higher, or MACS Level III or higher
• Severe uncorrected vision or hearing problems that would get in the way of playing the games
• Uncontrolled epilepsy or another nerve condition that rules out active movement
• Serious behaviour or attention problems that prevent taking part in game tasks
• Taking part in another treatment trial that may interfere

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• 6 és 12 év között vagy?IgenNem

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Cerebral Palsy (CP) accounts for approximately 0.9% of the global disease burden and affects 2.4-4% of children under 5 years old, with associated developmental and coordination impairments. Pediatric physical therapy aims to enhance independence and quality of life; however, maintaining adherence to conventional treatment remains a major challenge due to its repetitive and monotonous nature, leading to reduced motivation and limited functional progress.

A vizsgálat 3 csoportja

• exergamingA vizsgált kezelés

  The exergaming program will use Kinect Adventures (River Rush, Reflex Ridge) to train balance, agility, and trunk control; Kinect Sports to improve lower-limb activation, hand-eye coordination, and bilateral movements; Just Dance Kids for rhythmic stepping; and Kinect Party/Happy Action Theater to encourage free movement. Optional MIRA Rehab modules may target posture and agility. Sessions will be held three times per week for twelve weeks, starting with a light warm-up, followed by 20-30 minutes of targeted exergames, and ending with a cool-down. Game difficulty will progressively increase, and therapists will track progress through scores and completion times.

• biofeedback-enhanced exergamingA vizsgált kezelés

  This group will perform the same exergaming activities as the exergaming group, with the added integration of real-time multimodal biofeedback to enhance motor learning. The frequency and duration of sessions will be identical to the exergaming group. Participants will receive on-screen visual guides that indicate whether their movements are being performed correctly, along with auditory feedback through performance-linked cues such as pitch changes or sound alerts prompting postural adjustments. Optional vibration alerts from wearable devices may also be used to correct improper posture. The biofeedback system will incorporate surface EMG (Delsys Trigno) to assess bilateral muscle activity during gameplay, and motion tracking through the Microsoft Kinect SDK (v2 or Azure) to capture and analyze joint movements, posture, and detailed ranges of motion.

• traditional physical therapyMár használt kezelés, összehasonlításként

  Children in this group will receive standard physical therapy to improve gross motor function, especially balance and mobility. Sessions will be held three times per week for twelve weeks, lasting 30-45 minutes. The protocol includes a 5-minute warm-up, 12-15 minutes of strengthening for hip, knee, and ankle muscles, 8-10 minutes of balance training using wobble boards or foam, and 8-10 minutes of functional mobility tasks such as sit-to-stand and stair practice, followed by a 2-5 minute cool-down. Therapists will follow standardized instructions, and treatment fidelity will be monitored through checklists, with 10% of sessions audited monthly.