Comparison of the effects of fully immersive virtual reality applications on functional capacity in children with cerebral palsy

Introduction: Damage to the central nervous system occurs due to Cerebral Palsy (CP). This damage affects the use of the lower extremities and trunk, causing limitations in motor function, functional capacity and balance, and restricting the child's participation in society. Purpose: To compare and examine the effects of treadmill and bicycle exercise training approaches combined with fully immersive virtual reality on functional capacity, balance and walking in patients diagnosed with CP. Method: 36 children with CP, aged between 12-18, participated in the study and the participants were randomly assigned to the Combined Treadmill with Virtual Reality (CTVR) and Combined Cycling with Virtual Reality (CCVR) groups. Participants were given twice a week for 8 weeks; 40 minutes of aerobic exercise training was given at an intensity between 60% and 80% of the maximum heart rate. The CTVR group received aerobic exercise training with a treadmill combined with immersive virtual reality glasses. The CCVR group received aerobic exercise training with a stationary bike combined with immersive virtual reality glasses. Before and after treatment, evaluations were made with the 6 Minute Walk Test (6MWT), Gross Motor Function Measure – 88 (GMFM-88) (Modules D and E), Pediatric Balance Scale (PDS), 10 Meter Walk Test (10MWT), Timed Up and Go Test (TUG) and Timed Up and Down Test (TUD). In all analyses, p<0.05 value was considered statistically significant. Results: A statistically significant difference was observed in favor of the CTVR group in the 6MWT and TUG results (p<0.001, p=0.022, respectively). After treatment, a statistically significant difference was observed in the 6MWT, 10MWT and TUG results in the CTVR group (p<0.001, p=0.038, p=0.045, respectively). In the CCVR group, no statistically significant difference was observed in any outcome measure (p>0.05). Conclusion: From two different trainings combined with fully immersive virtual reality in children with CP; Treadmill training has been shown to be more effective than bicycle training in improving functional capacity and functional mobility parameters.