Immersive Virtual Reality in Cerebral Palsy

Abstract

Abstract Cerebral palsy (CP) is the most common childhood physical disability. Immersive virtual reality (iVR) provides an enriching and motivational environment to conduct goal-oriented tasks with visual, auditory and haptic feedback, which are key pillars in CP rehabilitation. However, very little research has been undertaken on iVR in CP physiotherapy. This thesis aimed to explore the novel applications of iVR in CP physiotherapy and rehabilitation.

This thesis is composed of four studies. The first study (Chapter 2) synthesises available evidence for virtual reality interventions in upper limb motor function in CP, highlighting a lack of data surrounding the use of iVR in CP. The second study (Chapter 3) reveals the results of survey of clinicians involved in management of CP, showing that the utilisation of VR in paediatric physiotherapy clinics is limited (n = 6, out of 81). Multiple facilitators and barriers for VR implementation in clinical practice were identified in this study. The third and fourth studies (Chapters 4 and 5) investigated the usability of an iVR circle drawing task to measure upper-limb motor performance in typically-developing children (n = 36) and children with CP (n = 9). Participants in both studies reported high levels of usability, acceptability, ease of use, and confidence with the iVR circle drawing task. No adverse effects associated with iVR use were reported for any participants. In addition, the iVR circle drawing task captured differences between the movement kinematics of the dominant and non-dominant hands, indicating that iVR circle drawing is a viable tool to capture the upper-limb motor performance of children with and without CP.

In summary, the studies presented in this thesis offer original and important insights into the role of iVR in CP clinical diagnostics. This PhD thesis supports the future development of iVR as an assessment tool and its clinical applications in paediatric physiotherapy care.