title: Use of virtual reality systems as proprioception method in cerebral palsy: clinical practice guideline.
abstract: BACKGROUND
  The limitations in performing functional activities in children and adolescents with cerebral palsy are important. The use of virtual reality systems is a new treatment approach that reinforces task-oriented motor learning. The purpose of this guide is to study the impact of the use of virtual reality systems in the improvement and acquisition of functional skills, and to evaluate the scientific evidence to determine the strength of recommendation of such interventions.
  
  
  METHODS
  All available full-text articles, regardless of their methodology, were included. The following data bases were consulted: PubMed (Medline), PEDro, EMBASE (OVID-Elsevier), Cochrane Library, Medline (OVID), CINAHL, ISI Web Knowledge. An assessment was made of methodological quality, the level of scientific evidence, and the strength of recommendations using the tools: Critical Review Form - Quantitative Studies and the Guidelines for Critical Review Form - Quantitative Studies and U.S. Preventive Services Task Force. Finally, we included 13 articles and 97 participants were recruited. We obtained significant improvements in outcome measures that assessed postural control and balance, upper limb function, the selective joint control, and gait.
  
  
  CONCLUSIONS
  The guide has some limitations: the limited number of patients enrolled, clinical diversity and age range, as well as the methodological quality of existing trials. Virtual reality is a promising tool in the treatment of children with cerebral palsy. There is strong scientific evidence of an acceptable recommendation for the use of virtual reality systems in the treatment of cerebral palsy.
authors.affiliation: Centro de Terapia Integral del Niño, Momo, Madrid, España.
authors.forename: E
authors.initials: E
authors.lastname: Monge Pereira
authors.affiliation: Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, España. Electronic address: francisco.molina@urjc.es.
authors.forename: F
authors.initials: F
authors.lastname: Molina Rueda
authors.affiliation: Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, España.
authors.forename: I M
authors.initials: IM
authors.lastname: Alguacil Diego
authors.affiliation: Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Cano de la Cuerda
authors.affiliation: Departamento de Aplicaciones Biomédicas, Centro de Investigación aplicada Vicomtech-IK4, San Sebastián, España.
authors.forename: A
authors.initials: A
authors.lastname: de Mauro
authors.affiliation: Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, España; Servicio de Rehabilitación y Medicina Física, Hospital Universitario de Fuenlabrada, Madrid, España.
authors.forename: J C
authors.initials: JC
authors.lastname: Miangolarra Page
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D003198:Computer Simulation; D055317:Evidence-Based Practice; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D009048:Motor Skills; D004856:Postural Balance; D011434:Proprioception; D014584:User-Computer Interface