Development and Feasibility of a Kinect-Based Constraint-Induced Therapy Program in the Home Setting for Children With Unilateral Cerebral Palsy

Hao-Ling Chen; Szu-Yu Lin; Chun-Fu Yeh; Ren-Yu Chen; Hsien-Hui Tang; Shanq-Jang Ruan; Tien-Ni Wang

doi:10.3389/fbioe.2021.755506

Development and Feasibility of a Kinect-Based Constraint-Induced Therapy Program in the Home Setting for Children With Unilateral Cerebral Palsy

Front Bioeng Biotechnol. 2021 Oct 26:9:755506. doi: 10.3389/fbioe.2021.755506. eCollection 2021.

Authors

Hao-Ling Chen^{1

2}, Szu-Yu Lin², Chun-Fu Yeh², Ren-Yu Chen², Hsien-Hui Tang³, Shanq-Jang Ruan⁴, Tien-Ni Wang^{1

2}

Affiliations

¹ Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.
² School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
³ Department of Industrial and Commercial Design, National Taiwan University of Science and Technology, Taipei, Taiwan.
⁴ Department of Electronic and Computer Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan.

Abstract

Introduction: Cerebral palsy (CP) is the leading cause of childhood-onset physical disability. Children with CP often have impaired upper limb (UL) function. Constraint-induced therapy (CIT) is one of the most effective UL interventions for children with unilateral CP. However, concerns about CIT for children have been repeatedly raised due to frustration caused by restraint of the child's less-affected UL and lack of motivation for the intensive protocol. Virtual reality (VR), which can mitigate the disadvantages of CIT, potentially can be used as an alternative mediator for implementing CIT. Therefore, we developed a VR-based CIT program for children with CP using the Kinect system. Aims: The feasibility of the Kinect-based CIT program was evaluated for children with unilateral CP using a two-phase study design. Materials and Methods: In phase 1, ten children with unilateral CP were recruited. To confirm the achievement of the motor training goals, maximal UL joint angles were evaluated during gameplay. To evaluate children's perceptions of the game, a questionnaire was used. In phase 2, eight children with unilateral CP were recruited and received an 8 weeks Kinect-based CIT intervention. Performance scores of the game and outcomes of the box and block test (BBT) were recorded weekly. Results: In phase 1, results supported that the design of the program was CIT-specific and was motivational for children with unilateral CP. In phase 2, game performance and the BBT scores began showing stable improvements in the fifth week of intervention. Conclusion: It suggested the Kinect-based CIT program was beneficial to the motor function of the affected UL for children with unilateral CP. According to the results of this feasibility study, larger and controlled effectiveness studies of the Kinect-based CIT program can be conducted to further improve its clinical utility. Clinical Trial Registration: ClinicalTrials.gov, NCT02808195; Comparative effectiveness of a Kinect-based unilateral arm training system vs. CIT for children with CP.

Keywords: cerebral palsy; children; constraint-induced therapy; upper limb; virtual reality.

Associated data

ClinicalTrials.gov/NCT02808195