The feasibility of virtual reality application in children with neuromuscular disease and investigation of the effectiveness of virtual reality and biofeedback applications on the functional levels of children with neuromuscular disease

Neuromuscular diseases (NMD) are a heterogeneous group of diseases in which the primary problem is in the peripheral nervous system consisting of anterior horn cells, peripheral nerve, neuromuscular junction and muscles. NMH causes progressive loss of muscle and nerve functions. Although the most common NMD in the pediatric population is muscular dystrophies (MD), spinal muscular atrophy (SMA) is one of the most common types of NMD in childhood. Despite scientific developments, a treatment method has not yet been developed for MD and SMA. Therefore, symptomatic treatments are recommended in standard care publications recommended for cases with MD and SMA. Physiotherapy and rehabilitation practices are at the center of symptomatic treatment. It is stated that regular exercise can be effective in increasing the life expectancy and quality of life of patients. Recently, virtual reality applications are frequently used for rehabilitation purposes. Virtual reality enables the child to experience the activities that he may need in daily life in a three-dimensional environment similar to the real world and environment simulated by the computer. Electromyographic (EMG) biofeedback training is another method frequently used for rehabilitation purposes. This method is based on the method of converting myoelectric signals into visual and auditory stimuli. The myoelectric signals generated during the patient's muscle activity are converted into visual and auditory signals, allowing the patient to have an idea about their own muscle activity. Although the effectiveness of virtual reality and EMG biofeedback training has been shown in different populations, no study has been found in the literature examining the effectiveness of these two methods in cases with MD and SMA. However, in two studies, it was stated that patients with DMD could use EMG supported arm support and active wrist support. The aim of this study is to compare the effectiveness of virtual reality and biofeedback applications on the functional levels of children with neuromuscular disease. Twenty-four children aged 6-18 years, who were diagnosed with neuromuscular disease by a specialist doctor and whose ambulation continues, will be included in the study. Measurements will be made 3 times before the treatment, at the 6th week of the treatment and after the treatment.