Saudi Cultural Missions Theses & Dissertations
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Item Restricted The Effectiveness of Nintendo Wii Training in Improving the Hand Motor Functions of Children and Adolescents With Cerebral Palsy(2023-04-03) Alhenaky, Malak; Jones, UnaBackground: Cerebral palsy (CP) is one of the leading causes of disability among children. Most children and adolescents with CP have impaired hand motor function, which may significantly affect their functional independence and quality of life. Nintendo Wii is a commercial virtual reality (VR) system that is most widely utilised to improve hand motor function in children and adolescents with CP. Several systematic reviews have assessed the effects of training with various VR systems, which differ considerably in their characteristics, but none have focused on Nintendo Wii training (NWT). Aim: To determine the effectiveness of NWT in improving the hand motor functions of children and adolescents with CP. Methods: A comprehensive search was conducted in the CINAHL, AMED, EMBASE, Ovid Emcare, Medline via Ovid and Scopus databases. Only randomised controlled trials (RCTs) that assessed the effectiveness of NWT alone or in combination with conventional therapy (CT) in improving hand motor function, including manual dexterity, strength and hand grasp, in children and adolescents with CP were selected. Two independent reviewers evaluated the methodological quality of these studies and based on the results of a critical appraisal, chose which studies to include in the review. The quality of the studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. A narrative synthesis was performed to synthesise the data. Results: Five RCTs with a total of 192 participants were included in the review. Three studies were of high quality; the others were of moderate quality. In the included studies, the NWT-CT combination improved grip strength, pinch strength and hand grasp. These improvements were greater than those found with the CT alone. Regarding the effect of NWT on manual dexterity, only the studies that included Tennis and Boxing games showed clinically relevant improvements. Conclusion: Due to the limited number of included studies and their several methodological limitations, insufficient evidence is available to draw definitive conclusions about the effectiveness of NWT in improving the hand motor functions of children and adolescents with CP. Further high-quality studies with larger sample sizes and long-term follow-up are required.17 0