In-Home Virtual Reality Videogame Telerehabilitation in Adolescents With Hemiplegic Cerebral Palsy

Meredith R. Golomb, Brenna C. McDonald, Stuart J. Warden, Janell Yonkman, Andrew J. Saykin, Bridget Shirley, Meghan Huber, Bryan Rabin, Moustafa AbdelBaky, Michelle E. Nwosu, Monica Barkat-Masih, Grigore C. Burdea

Research output: Contribution to journalArticle

122 Citations (Scopus)

Abstract

Golomb MR, McDonald BC, Warden SJ, Yonkman J, Saykin AJ, Shirley B, Huber M, Rabin B, AbdelBaky M, Nwosu ME, Barkat-Masih M, Burdea GC. In-home virtual reality videogame telerehabilitation in adolescents with hemiplegic cerebral palsy. Objective: To investigate whether in-home remotely monitored virtual reality videogame-based telerehabilitation in adolescents with hemiplegic cerebral palsy can improve hand function and forearm bone health, and demonstrate alterations in motor circuitry activation. Design: A 3-month proof-of-concept pilot study. Setting: Virtual reality videogame-based rehabilitation systems were installed in the homes of 3 participants and networked via secure Internet connections to the collaborating engineering school and children's hospital. Participants: Adolescents (N=3) with severe hemiplegic cerebral palsy. Intervention: Participants were asked to exercise the plegic hand 30 minutes a day, 5 days a week using a sensor glove fitted to the plegic hand and attached to a remotely monitored videogame console installed in their home. Games were custom developed, focused on finger movement, and included a screen avatar of the hand. Main Outcome Measures: Standardized occupational therapy assessments, remote assessment of finger range of motion (ROM) based on sensor glove readings, assessment of plegic forearm bone health with dual-energy x-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT), and functional magnetic resonance imaging (fMRI) of hand grip task. Results: All 3 adolescents showed improved function of the plegic hand on occupational therapy testing, including increased ability to lift objects, and improved finger ROM based on remote measurements. The 2 adolescents who were most compliant showed improvements in radial bone mineral content and area in the plegic arm. For all 3 adolescents, fMRI during grip task contrasting the plegic and nonplegic hand showed expanded spatial extent of activation at posttreatment relative to baseline in brain motor circuitry (eg, primary motor cortex and cerebellum). Conclusions: Use of remotely monitored virtual reality videogame telerehabilitation appears to produce improved hand function and forearm bone health (as measured by DXA and pQCT) in adolescents with chronic disability who practice regularly. Improved hand function appears to be reflected in functional brain changes.

Original languageEnglish (US)
Pages (from-to)1-8.e1
JournalArchives of physical medicine and rehabilitation
Volume91
Issue number1
DOIs
StatePublished - Jan 2010

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Cerebral Palsy
Hand
Forearm
Fingers
Occupational Therapy
Hand Strength
Articular Range of Motion
Bone and Bones
Health
Tomography
Magnetic Resonance Imaging
X-Rays
Telerehabilitation
Motor Cortex
Brain
Internet
Bone Density
Cerebellum
Reading
Arm

Keywords

  • Cerebral palsy
  • Child
  • Fiber optic technology
  • Hand
  • Hemiplegia
  • Internet
  • Perinatal care
  • Rehabilitation
  • Stroke
  • Video games

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

In-Home Virtual Reality Videogame Telerehabilitation in Adolescents With Hemiplegic Cerebral Palsy. / Golomb, Meredith R.; McDonald, Brenna C.; Warden, Stuart J.; Yonkman, Janell; Saykin, Andrew J.; Shirley, Bridget; Huber, Meghan; Rabin, Bryan; AbdelBaky, Moustafa; Nwosu, Michelle E.; Barkat-Masih, Monica; Burdea, Grigore C.

In: Archives of physical medicine and rehabilitation, Vol. 91, No. 1, 01.2010, p. 1-8.e1.

Research output: Contribution to journalArticle

Golomb, MR, McDonald, BC, Warden, SJ, Yonkman, J, Saykin, AJ, Shirley, B, Huber, M, Rabin, B, AbdelBaky, M, Nwosu, ME, Barkat-Masih, M & Burdea, GC 2010, 'In-Home Virtual Reality Videogame Telerehabilitation in Adolescents With Hemiplegic Cerebral Palsy', Archives of physical medicine and rehabilitation, vol. 91, no. 1, pp. 1-8.e1. https://doi.org/10.1016/j.apmr.2009.08.153
Golomb, Meredith R. ; McDonald, Brenna C. ; Warden, Stuart J. ; Yonkman, Janell ; Saykin, Andrew J. ; Shirley, Bridget ; Huber, Meghan ; Rabin, Bryan ; AbdelBaky, Moustafa ; Nwosu, Michelle E. ; Barkat-Masih, Monica ; Burdea, Grigore C. / In-Home Virtual Reality Videogame Telerehabilitation in Adolescents With Hemiplegic Cerebral Palsy. In: Archives of physical medicine and rehabilitation. 2010 ; Vol. 91, No. 1. pp. 1-8.e1.
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KW - Stroke

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