The effect of virtual reality games on changing the center of gravity location in children with adolescent idiopathic scoliosis

Background: Virtual Reality Games (VRG) use technology for game-based feedback and motivation. Studies demonstrated its impact on center of gravity location and postural alignment. Objective: To investigate the VRG's effects on changing the center of gravity location in children with AIS. Also, to investigate its effect on postural parameters and body image. Method: 28 participants with AIS were divided into two groups by stratified randomization. Group 1 underwent VRG for 6 weeks (3 times/week), while Group 2 was on the Waitlist. Centre of gravity, spinal posture, postural symmetry, posture and deformity perception were assessed using the "Physiosoft Balance System", "PostureScreen Mobile", "Anterior Trunk Symmetry Index (ATSI)" and "Posterior Trunk Symmetry Index (POTSI)" and "Walter Reed Visual Assessment Scale (WRVAS)". Before and after 6 weeks of the trial, these evaluations were done. Results: Both groups' baseline characteristics were similar (p >0.05). At the study's conclusion, the control group showed no significant changes (p >0.05), contrasting significant changes on the VRG group except for X axis with eyes open (p≤0.05); With ES =1.10 for Y axis with eyes open and 1.23 with eyes close, and ES=0.21 for X axis with eyes close. Additionally, participants' baseline postural parameters exceeded those of healthy individuals. While no changes were in the control group's PSM parameters and WRVAS scores (p>0.05), the VRG had a large effect size improvement (p≤0.05). Comparatively, the VRG group exhibited favorable changes in PSM's posterior and left and WRVAS scores (p≤0.05). The postural symmetry scores improved in the VRG group; with ES for ATSI= 0.5 and POTSI=0.45. But no superiority was found in favor of VRG (p>0.05). Conclusion: VRG effectively changed the center of gravity location, particularly in the Y axis in AIS with mild curvature. However, frontal plane's changes required a longer time. Also, VRG improved postural parameters and body image. But had no significant effects on frontal postural symmetry.