A utilização da realidade virtual na estimulação da função manual em crianças com paralisia cerebral: uma revisão sistemática

Pereira, Kharinni Uchôa; Silva, Michelle Zampar; Pfeifer, Luzia Iara

Acessibilidade / Reportar erro

Brasil

Revista Paulista de Pediatria

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLE • Rev. paul. pediatr. 41 • 2023 • https://doi.org/10.1590/1984-0462/2023/41/2021283 copiar

A utilização da realidade virtual na estimulação da função manual em crianças com paralisia cerebral: uma revisão sistemática

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo

Objetivo:

Identificar na literatura nacional e internacional o uso da realidade virtual no desenvolvimento de habilidades manuais de crianças com paralisia cerebral.

Métodos:

Revisão sistemática realizada nas bases de dados United States National Library of Medicine (PubMed), Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) e no Sistema Online de Busca e Análise de Literatura Médica (Ovid Medline) utilizando as palavras-chave “paralisia cerebral”, “realidade virtual”, “terapia ocupacional”, “criança”, “atividades diárias/ atividades cotidianas”, em inglês e português. A qualidade metodológica dos artigos selecionados foi avaliada pela Physiotherapy Evidence Database (escala PEDro).

Resultados:

Foram selecionados 228 estudos que incluíam crianças com paralisia cerebral em tratamento com exposição à realidade virtual para a melhora da função manual nas atividades diárias, sendo excluídos os que estavam fora da temática, os incompletos e os duplicados. Três juízes conduziram o processo de seleção dos trabalhos, incluindo 14 artigos na análise.

Conclusões:

Os achados sugerem que a terapia com realidade virtual tem contribuído para a melhora na função manual de crianças com paralisia cerebral, constituindo-se em recurso útil de intervenção coadjuvante potencializadora das terapias tradicionais.

Palavras-chave:
Paralisia cerebral; Realidade virtual; Mão; Desempenho físico funcional; Atividades diárias

Authors/year	Sample	PEDro scale
Acar et al.²⁹29. Acar G, Altun GP, Yurdalan S, Polat MG. Efficacy of neurodevelopmental treatment combined with the Nintendo(®) Wii in patients with cerebral palsy. J Phys Ther Sci. 2016;28:774-80. https://doi.org/10.1589/jpts.28.774 https://doi.org/10.1589/jpts.28.774... 2016	CP (30): (6-15 years)	7
Gerber et al.³⁴34. Gerber CN, Kunz B, van Hedel HJ. Preparing a neuropediatric upper limb exergame rehabilitation system for home-use: a feasibility study. J Neuroeng Rehabil. 2016;13:33. https://doi.org/10.1186/s12984-016-0141-x https://doi.org/10.1186/s12984-016-0141-... 2016	CP (13), neuropathy (1); ABI (1): (5-18 years)	2
Kirshner et al.³⁷37. Kirshner S, Weiss PL, Tirosh E. Differences in autonomic functions as related to induced stress between children with and without cerebral palsy while performing a virtual meal-making task. Res Dev Disabil. 2016;49-50:247-57. https://doi.org/10.1016/j.ridd.2015.11.025 https://doi.org/10.1016/j.ridd.2015.11.0... 2016	CP (15), TD (19): (12 years)	4
van Hedel et al.³⁵35. van Hedel HJ, Häfliger N, Gerber CN. Quantifying selective elbow movements during an exergame in children with neurological disorders: a pilot study. J Neuroeng Rehabil. 2016;13:93. https://doi.org/10.1186/s12984-016-0200-3 https://doi.org/10.1186/s12984-016-0200-... 2016	CP (15), Stroke (4), TBI (4), Encephalitis (2), others (9): (5-20 years)	2
Eckert et al.³³33. Eckert M, Gómez-Martinho I, Meneses J, Martínez JF. New approaches to exciting exergame-experiences for people with motor function impairments. Sensors (Basel). 2017;17:354. https://doi.org/10.3390/s17020354 https://doi.org/10.3390/s17020354... 2017	EG = CP (1), hypotonia (1), BMD (1), DMD (2), FSH (2), PPS (1): (5-50 years), CG/TD (8): (7-13 years)	3
Hung et al.¹⁷17. Hung JW, Chang YJ, Chou CX, Wu WC, Howell S, Lu WP. Developing a suite of motion-controlled games for upper extremity training in children with cerebral palsy: a proof-of-concept study. Games Health J. 2018;7:327-34. https://doi.org/10.1089/g4h.2017.0141 https://doi.org/10.1089/g4h.2017.0141... 2017	CP (13): (5-15 years)	3
Beretta et al.³¹31. Beretta E, Cesareo A, Biffi E, Schafer C, Galbiati S, Strazzer S. Rehabilitation of upper limb in children with acquired brain injury: a preliminary comparative study. J Healthc Eng. 2018;2018:4208492. https://doi.org/10.1155/2018/4208492 https://doi.org/10.1155/2018/4208492... 2018	Hemiplegia from severe brain injury (18): (4-8 years)	3
Biffi et al.³²32. Biffi E, Maghini C, Cairo B, Beretta E, Peri E, Altomonte D, et al. Movement velocity and fluidity improve after Armeo® spring rehabilitation in children affected by acquired and congenital brain diseases: an observational study. Biomed Res Int. 2018;2018:1537170. https://doi.org/10.1155/2018/1537170 https://doi.org/10.1155/2018/1537170... 2018	CP (21), ABI (22): (5-18 years)	3
Martins et al.³⁹39. Martins FP, Massetti T, Crocetta TB, Lopes PB, Silva AA, Figueiredo EF, et al. Analysis of motor performance in individuals with cerebral palsy using a non-immersive virtual reality task – a pilot study. Neuropsychiatr Dis Treat. 2019;15:417-28. https://doi.org/10.2147/NDT.S184510 https://doi.org/10.2147/NDT.S184510... 2019	EG/CP (10); CG/TD (10): (6-19 years)	4
Şahin et al.²⁸28. Şahin S, Köse B, Aran OT, Ağce ZB, Kayıhan H. The effects of virtual reality on motor functions and daily life activities in unilateral spastic cerebral palsy: a single-blind randomized controlled trial. Games Health J. 2020;9:45-52. https://doi.org/10.1089/g4h.2019.0020 https://doi.org/10.1089/g4h.2019.0020... 2020	EG/CP (30); CG/CP (30); (7-16 years)	9
Bortone et al.³⁰30. Bortone I, Barsotti M, Leonardis D, Crecchi A, Tozzini A, Bonfiglio L, et al. Immersive virtual environments and wearable haptic devices in rehabilitation of children with neuromotor impairments: a single-blind randomized controlled crossover pilot study. J Neuroeng Rehabil. 2020;17:144. https://doi.org/10.1186/s12984-020-00771-6 https://doi.org/10.1186/s12984-020-00771... 2020	CP or DD (8): (18 years)	8
Daoud et al.³⁶36. Daoud MI, Alhusseini A, Ali MZ, Alazrai R. A game-based rehabilitation system for upper-limb cerebral palsy: a feasibility study. Sensors (Basel). 2020;20:2416. https://doi.org/10.3390/s20082416 https://doi.org/10.3390/s20082416... 2020	EG/CP (6): (10 years or +) CG/TD (20): (18 years or +)	4
Leal et. al.⁴⁰40. Leal AF, Silva TD, Lopes PB, Bahadori S, Araújo LV, Costa MV, et al. The use of a task through virtual reality in cerebral palsy using two different interaction devices (concrete and abstract) – a cross-sectional randomized study. J Neuroeng Rehabil. 2020;17:59. https://doi.org/10.1186/s12984-020-00689-z https://doi.org/10.1186/s12984-020-00689... 2020	EG/CP (28); CG/TD (28); (6-15 years)	4
MacIntosh et al.³⁸38. MacIntosh A, Desailly E, Vignais N, Vigneron V, Biddiss E. A biofeedback-enhanced therapeutic exercise video game intervention for young people with cerebral palsy: a randomized single-case experimental design feasibility study. PLoS One. 2020;15:e0234767. https://doi.org/10.1371/journal.pone.0234767 https://doi.org/10.1371/journal.pone.023... 2020	CP (19): (8-18 years)	2

Authors	Virtual reality equipment	Games
Acar et al.²⁹29. Acar G, Altun GP, Yurdalan S, Polat MG. Efficacy of neurodevelopmental treatment combined with the Nintendo(®) Wii in patients with cerebral palsy. J Phys Ther Sci. 2016;28:774-80. https://doi.org/10.1589/jpts.28.774 https://doi.org/10.1589/jpts.28.774...	Nintendo Wii	Tennis, baseball and boxing.
Gerber et al.³⁴34. Gerber CN, Kunz B, van Hedel HJ. Preparing a neuropediatric upper limb exergame rehabilitation system for home-use: a feasibility study. J Neuroeng Rehabil. 2016;13:33. https://doi.org/10.1186/s12984-016-0141-x https://doi.org/10.1186/s12984-016-0141-...	YouGrabber® system, portable version	Exergames and Hamster Splash
Kirshner et al.³⁷37. Kirshner S, Weiss PL, Tirosh E. Differences in autonomic functions as related to induced stress between children with and without cerebral palsy while performing a virtual meal-making task. Res Dev Disabil. 2016;49-50:247-57. https://doi.org/10.1016/j.ridd.2015.11.025 https://doi.org/10.1016/j.ridd.2015.11.0...	IREX 2D Camera Tracking VR System	Meal-Maker Virtual Environment
van Hedel et al.³⁵35. van Hedel HJ, Häfliger N, Gerber CN. Quantifying selective elbow movements during an exergame in children with neurological disorders: a pilot study. J Neuroeng Rehabil. 2016;13:93. https://doi.org/10.1186/s12984-016-0200-3 https://doi.org/10.1186/s12984-016-0200-...	YouGrabber® system	Airplane game
Eckert et al.³³33. Eckert M, Gómez-Martinho I, Meneses J, Martínez JF. New approaches to exciting exergame-experiences for people with motor function impairments. Sensors (Basel). 2017;17:354. https://doi.org/10.3390/s17020354 https://doi.org/10.3390/s17020354...	Blender Game Engine Platform with Kinect Sensor	The Ladder, The Boat, Whack-a-Mole and The Paper-Bird
Hung et al.¹⁷17. Hung JW, Chang YJ, Chou CX, Wu WC, Howell S, Lu WP. Developing a suite of motion-controlled games for upper extremity training in children with cerebral palsy: a proof-of-concept study. Games Health J. 2018;7:327-34. https://doi.org/10.1089/g4h.2017.0141 https://doi.org/10.1089/g4h.2017.0141...	Computer with Scratch software and Kinect2Scratch software + Kinect/Windows Sensor;	Howell; Hungry Shark and Hungry Ant
Beretta et al.³¹31. Beretta E, Cesareo A, Biffi E, Schafer C, Galbiati S, Strazzer S. Rehabilitation of upper limb in children with acquired brain injury: a preliminary comparative study. J Healthc Eng. 2018;2018:4208492. https://doi.org/10.1155/2018/4208492 https://doi.org/10.1155/2018/4208492...	Armeo®Spring	Armeo®Spring (game)
Biffi et al.³²32. Biffi E, Maghini C, Cairo B, Beretta E, Peri E, Altomonte D, et al. Movement velocity and fluidity improve after Armeo® spring rehabilitation in children affected by acquired and congenital brain diseases: an observational study. Biomed Res Int. 2018;2018:1537170. https://doi.org/10.1155/2018/1537170 https://doi.org/10.1155/2018/1537170...	Armeo®Spring	Vertical capture
Martins et al.³⁹39. Martins FP, Massetti T, Crocetta TB, Lopes PB, Silva AA, Figueiredo EF, et al. Analysis of motor performance in individuals with cerebral palsy using a non-immersive virtual reality task – a pilot study. Neuropsychiatr Dis Treat. 2019;15:417-28. https://doi.org/10.2147/NDT.S184510 https://doi.org/10.2147/NDT.S184510...	Computer with webcam	Real task: timing. Virtual task: MoveHero
Şahin et al.²⁸28. Şahin S, Köse B, Aran OT, Ağce ZB, Kayıhan H. The effects of virtual reality on motor functions and daily life activities in unilateral spastic cerebral palsy: a single-blind randomized controlled trial. Games Health J. 2020;9:45-52. https://doi.org/10.1089/g4h.2019.0020 https://doi.org/10.1089/g4h.2019.0020...	Computer + Microsoft Kinect v 1.0t sensor;	Aerial challenge; boxing coach; wall break; Jet run; super kick
Bortone et al.³⁰30. Bortone I, Barsotti M, Leonardis D, Crecchi A, Tozzini A, Bonfiglio L, et al. Immersive virtual environments and wearable haptic devices in rehabilitation of children with neuromotor impairments: a single-blind randomized controlled crossover pilot study. J Neuroeng Rehabil. 2020;17:144. https://doi.org/10.1186/s12984-020-00771-6 https://doi.org/10.1186/s12984-020-00771...	Equipment VERA	Moneybox and Marble; Labyrinth game
Daoud et al.³⁶36. Daoud MI, Alhusseini A, Ali MZ, Alazrai R. A game-based rehabilitation system for upper-limb cerebral palsy: a feasibility study. Sensors (Basel). 2020;20:2416. https://doi.org/10.3390/s20082416 https://doi.org/10.3390/s20082416...	Computer + Kinect sensor for Windows v2	Collect stars
Leal et. al.⁴⁰40. Leal AF, Silva TD, Lopes PB, Bahadori S, Araújo LV, Costa MV, et al. The use of a task through virtual reality in cerebral palsy using two different interaction devices (concrete and abstract) – a cross-sectional randomized study. J Neuroeng Rehabil. 2020;17:59. https://doi.org/10.1186/s12984-020-00689-z https://doi.org/10.1186/s12984-020-00689...	Computer with touchscreen + Kinect sensor	Verification limit
MacIntosh et al.³⁸38. MacIntosh A, Desailly E, Vignais N, Vigneron V, Biddiss E. A biofeedback-enhanced therapeutic exercise video game intervention for young people with cerebral palsy: a randomized single-case experimental design feasibility study. PLoS One. 2020;15:e0234767. https://doi.org/10.1371/journal.pone.0234767 https://doi.org/10.1371/journal.pone.023...	ICP	ICP game

Authors	Intervention period	Session time
Acar et al.²⁹29. Acar G, Altun GP, Yurdalan S, Polat MG. Efficacy of neurodevelopmental treatment combined with the Nintendo(®) Wii in patients with cerebral palsy. J Phys Ther Sci. 2016;28:774-80. https://doi.org/10.1589/jpts.28.774 https://doi.org/10.1589/jpts.28.774...	Twice a week for six weeks	45’ (GNW 15’ + routine 30’ ND); and routine GND
Gerber et al.³⁴34. Gerber CN, Kunz B, van Hedel HJ. Preparing a neuropediatric upper limb exergame rehabilitation system for home-use: a feasibility study. J Neuroeng Rehabil. 2016;13:33. https://doi.org/10.1186/s12984-016-0141-x https://doi.org/10.1186/s12984-016-0141-...	Two weeks (185 min ± 45 min); Three weeks with varying frequencies	1st meeting with standardized instruction for parents and patient (45’) + home training: 1st week. 5 days/week. for 30’ + 2nd week. with free time.
Kirshner et al.³⁷37. Kirshner S, Weiss PL, Tirosh E. Differences in autonomic functions as related to induced stress between children with and without cerebral palsy while performing a virtual meal-making task. Res Dev Disabil. 2016;49-50:247-57. https://doi.org/10.1016/j.ridd.2015.11.025 https://doi.org/10.1016/j.ridd.2015.11.0...	Single session	90’
van Hedel et al.³⁵35. van Hedel HJ, Häfliger N, Gerber CN. Quantifying selective elbow movements during an exergame in children with neurological disorders: a pilot study. J Neuroeng Rehabil. 2016;13:93. https://doi.org/10.1186/s12984-016-0200-3 https://doi.org/10.1186/s12984-016-0200-...	Single session	3 steps of 90’’: wide path, narrow 50%, narrow 80% + 30” gap between each step = total 330”
Eckert et al.³³33. Eckert M, Gómez-Martinho I, Meneses J, Martínez JF. New approaches to exciting exergame-experiences for people with motor function impairments. Sensors (Basel). 2017;17:354. https://doi.org/10.3390/s17020354 https://doi.org/10.3390/s17020354...	Single session OT run the four tested games	Not informed
Hung et al.¹⁷17. Hung JW, Chang YJ, Chou CX, Wu WC, Howell S, Lu WP. Developing a suite of motion-controlled games for upper extremity training in children with cerebral palsy: a proof-of-concept study. Games Health J. 2018;7:327-34. https://doi.org/10.1089/g4h.2017.0141 https://doi.org/10.1089/g4h.2017.0141...	Twice a week for 12 weeks	60’: VR (30’) + conventional 30” OT
Beretta et al.³¹31. Beretta E, Cesareo A, Biffi E, Schafer C, Galbiati S, Strazzer S. Rehabilitation of upper limb in children with acquired brain injury: a preliminary comparative study. J Healthc Eng. 2018;2018:4208492. https://doi.org/10.1155/2018/4208492 https://doi.org/10.1155/2018/4208492...	Ft: five times a week for four weeks CIMT: four times a week for four weeks VR: five times a week for four weeks	Ft: 45’ CIMT: at least 3 h/day VR: 45’
Biffi et al.³²32. Biffi E, Maghini C, Cairo B, Beretta E, Peri E, Altomonte D, et al. Movement velocity and fluidity improve after Armeo® spring rehabilitation in children affected by acquired and congenital brain diseases: an observational study. Biomed Res Int. 2018;2018:1537170. https://doi.org/10.1155/2018/1537170 https://doi.org/10.1155/2018/1537170...	Ft: 20 sessions for four weeks VR: 20 sessions for four weeks	Ft: 45’ VR: 45’
Martins et al.³⁹39. Martins FP, Massetti T, Crocetta TB, Lopes PB, Silva AA, Figueiredo EF, et al. Analysis of motor performance in individuals with cerebral palsy using a non-immersive virtual reality task – a pilot study. Neuropsychiatr Dis Treat. 2019;15:417-28. https://doi.org/10.2147/NDT.S184510 https://doi.org/10.2147/NDT.S184510...	Single session	8’
Şahin et al.²⁸28. Şahin S, Köse B, Aran OT, Ağce ZB, Kayıhan H. The effects of virtual reality on motor functions and daily life activities in unilateral spastic cerebral palsy: a single-blind randomized controlled trial. Games Health J. 2020;9:45-52. https://doi.org/10.1089/g4h.2019.0020 https://doi.org/10.1089/g4h.2019.0020...	Twice a week for eight weeks	45’
Bortone et al.³⁰30. Bortone I, Barsotti M, Leonardis D, Crecchi A, Tozzini A, Bonfiglio L, et al. Immersive virtual environments and wearable haptic devices in rehabilitation of children with neuromotor impairments: a single-blind randomized controlled crossover pilot study. J Neuroeng Rehabil. 2020;17:144. https://doi.org/10.1186/s12984-020-00771-6 https://doi.org/10.1186/s12984-020-00771...	VR: twice a week for four weeks + rest break of four weeks + traditional therapy twice a week for four weeks	15’
Daoud et al.³⁶36. Daoud MI, Alhusseini A, Ali MZ, Alazrai R. A game-based rehabilitation system for upper-limb cerebral palsy: a feasibility study. Sensors (Basel). 2020;20:2416. https://doi.org/10.3390/s20082416 https://doi.org/10.3390/s20082416...	180 sessions each group: CP: 12 OT 16 periods (10–15 sessions). TD: three periods (60 sessions)	A game session followed by a 2’ relaxation period
Leal et. al.⁴⁰40. Leal AF, Silva TD, Lopes PB, Bahadori S, Araújo LV, Costa MV, et al. The use of a task through virtual reality in cerebral palsy using two different interaction devices (concrete and abstract) – a cross-sectional randomized study. J Neuroeng Rehabil. 2020;17:59. https://doi.org/10.1186/s12984-020-00689-z https://doi.org/10.1186/s12984-020-00689...	Single session	30’ between acquisition phase, rest, retention phase; transfer phase.
MacIntosh et al.³⁸38. MacIntosh A, Desailly E, Vignais N, Vigneron V, Biddiss E. A biofeedback-enhanced therapeutic exercise video game intervention for young people with cerebral palsy: a randomized single-case experimental design feasibility study. PLoS One. 2020;15:e0234767. https://doi.org/10.1371/journal.pone.0234767 https://doi.org/10.1371/journal.pone.023...	Five times a week for four weeks	1st of 60’; + 3 OT 6 visits (20’–30’)

Sociedade de Pediatria de São Paulo R. Maria Figueiredo, 595 - 10o andar, 04002-003 São Paulo - SP - Brasil, Tel./Fax: (11 55) 3284-0308; 3289-9809; 3284-0051 - São Paulo - SP - Brazil
E-mail: rpp@spsp.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] *Corresponding author. E-mail: luziara@fmrp.usp.br (L. I. Pfeifer).