Virtual Reality for upper limb rehabilitation in children with Cerebral Palsy: a feasibility study

Paediatric rehabilitation interventions are shifting from in-clinic methods to home-based approaches. Home-based approaches may extend training duration and reduce logistical constraints and travel time. Virtual reality (VR), known for its engaging nature, could be promising as a home-based intervention. While various VR systems have shown promising results, VR headsets with controllers have not yet been evaluated for the home-based training. This study aimed to assess the feasibility and effectiveness of a home-based VR intervention targeting upper limb function in children with unilateral Cerebral Palsy (uCP). Thirteen children with uCP (aged 10-18 years) participated in an 8-week intervention using a VR headset with controllers with six commercially available games that stimulate the use of the upper limb. Children were instructed to play for 30 minutes daily, leading to 210 minutes of weekly training. Adherence, defined as a percentage of trained time compared to recommended time, was used to assess the feasibility. Usability was assessed with the System Usability Scale (SUS). Effectiveness was evaluated by assessing upper limb function using the Melbourne assessment, Wall Arm Reaching Test (WART) and Range of Motion assessments before and after the intervention. Mean adherence rate during the 8-week intervention was 61% (128 minutes/week), peaking at 86% in the first week and gradually decreasing to 50% in the final week. Children rated the VR headset with controllers as user-friendly, with a mean SUS score of 74.6 (SD: 17.5). The Melbourne assessment significantly improved from a median of 22 (range: 12-32) to 26 (range: 16-33) (z = -2.85, p= 0.004, r=0.97) with a median improvement of 2 (range: 1-7); and the WART also exhibited a significant improvement from 21 (range: 13-36) to 28 (range: 13-37) (z = -2.22, p= 0.03, r=0.77) with a median improvement of 4.5 (range: -3-14). No significant changes were found in elbow extension or shoulder flexion. This study found that home-based rehabilitation using a VR headset and controllers with commercial games is a feasible approach for children with unilateral cerebral palsy, supported by good training intensity, system usability, and indications of improved upper limb function. This dataset contains adherence data, questionnaire data and efficacy data