Comparative Study of Effects of Motor-Sensing-Input-Based Game and Conventional Rehabilitation on Gait and Balance in Children with Spastic Diplegic Cerebral Palsy: A Randomized Controlled Trial

Research Objectives: To study the effects of motor-sensing-input-based game on gait and balance function in spastic diplegic cerebral palsy.

Design: Randomized-controlled trial, assessor-blinded. Subjects were randomized into 2 groups. Intervention group received gait and balance training with motor-sensing-input-based game or WeSmile. Control group received conventional rehabilitation. Both were trained twice a week, for 8 weeks. Outcomes were evaluated at baseline, after training for 4 and 8 weeks at the end of the program.

Setting: Sri Sangwan school, Nonthaburi, Thailand

Participants: 10 Children with spastic diplegia cerebral palsy with impaired gait and balance.

Interventions: WeSmile, sensory-input based-game developed by research team, aims to improve gait and balance in cerebral palsy. WeSmile uses Kinect V2.0, skeletal tracking or motion capture using an RGB camera, infrared projector, and detector, to analyze the player’s movement and translate that movement onto the screen. The player will appear on the screen as cartoon character and move coordinately.

Main Outcome Measures: gait speed (m/s), Cadence (step/min), Stride length (m), Step length (m), Pediatric Balance scale, GMCFS, Balance path length with eyes opened and closed (mm), Balance surface area with eyes opened (mm 2 ) and Balance surface area with eyes closed (mm 2).

Results: After 8 weeks of training, gait speed in intervention group increased significantly 0.071 (p-value=0.043). While the balance parameters in control group increased or worsen significantly, including balance path length with eyes opened 7.860 (p-value=0.043), balance path length with eyes closed 13.390 (p-value=0.043), balance surface area with eye opened 6.013 (p-value=0.043) and eyes closed 8.902 (p-value=0.043). In the between-group comparison, the balance surface area with eyes opened at 8th week in the intervention group was significantly better (p- value=0.028). No adverse event was found in both groups.

Conclusions: Preliminary report reveals that the motor- sensing-input-based game was safe and feasible in gait and balance in children with spastic diplegia cerebral palsy aged 7-12 years old with GMFCS 1-3.

Author(s) Disclosures: This research was supported by Ratchadaphiseksomphot Endowment Fund, Chulalongkorn University.
We declare no conflict of interest regarding the publication of this research.