title: The effects of virtual reality-based bilateral arm training on hemiplegic children's upper limb motor skills.
abstract: BACKGROUND
  Hemiplegic cerebral palsy is a neurological symptom appearing on the unilateral arm and leg of the body that causes affected upper/lower limb muscle weakening and dysesthesia and accompanies tetany and difficulties in postural control due to abnormal muscle tone, and difficulties in body coordination.
  
  
  OBJECTIVE
  The purpose of this study was to examine the impact of virtual reality-based bilateral arm training on the motor skills of children with hemiplegic cerebral palsy, in terms of their upper limb motor skills on the affected side, as well as their bilateral coordination ability.
  
  
  METHODS
  The research subjects were three children who were diagnosed with hemiplegic cerebral palsy. The research followed an ABA design, which was a single-subject experimental design. The procedure consisted of a total of 20 sessions, including four during the baseline period (A1), 12 during the intervention period (B), and four during the baseline regression period (A2), For the independent variable bilateral arm training based on virtual reality, Nintendo Wii game was played for 30 minutes in each of the 12 sessions. For the dependent variables of upper limb motor skills on the affected side and bilateral coordination ability, a Wolf Motor Function Test (WMFT) was carried out for each session and the Pediatric Motor Activity Log (PMAL) was measured before and after the intervention, as well as after the baseline regression period. To test bilateral coordination ability, shooting baskets in basketball with both hands and moving large light boxes were carried out under operational definitions, with the number of shots and time needed to move boxes measured. The results were presented using visual graphs and bar graphs.
  
  
  RESULTS
  The study's results indicated that after virtual reality-based bilateral arm training, improvement occurred in upper limb motor skills on the affected sides, and in bilateral coordination ability, for all of the research subjects. Measurements of the effects of sustained therapy after completion of the intervention, during the baseline regression period, revealed that upper limb motor skills on the affected side and bilateral coordination ability were better than in the baseline period for all subjects.
  
  
  CONCLUSIONS
  This study confirmed that for children with hemiplegic with cerebral palsy, bilateral arm training based on virtual reality can be an effective intervention method for enhancing the upper limb motor skills on the affected side, as well as bilateral coordination ability.
authors.affiliation: Department of Occupational Therapy, The Graduate School, Yonsei University, Kangwon-do, Republic of Korea.
authors.forename: Ji-Hye
authors.initials: JH
authors.lastname: Do
authors.affiliation: Department of Occupational Therapy, College of Health Science, Yonsei University, Kangwon-do, Republic of Korea.
authors.forename: Eun-Young
authors.initials: EY
authors.lastname: Yoo
authors.affiliation: Department of Occupational Therapy, College of Health Science, Yonsei University, Kangwon-do, Republic of Korea.
authors.forename: Min-Ye
authors.initials: MY
authors.lastname: Jung
authors.affiliation: Department of Occupational Therapy, College of Health Science, Yonsei University, Kangwon-do, Republic of Korea.
authors.forename: Hae Yean
authors.initials: HY
authors.lastname: Park
mesh_terms: D001490:Basketball / Q000523:psychology; D002547:Cerebral Palsy / Q000503:physiopathology / Q000534:rehabilitation; D002648:Child; D002675:Child, Preschool; D003198:Computer Simulation; D005260:Female; D007839:Functional Laterality; D006429:Hemiplegia / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D009043:Motor Activity; D009048:Motor Skills; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D016896:Treatment Outcome; D034941:Upper Extremity; D018910:Video Games
keywords: Bilateral arm training; hemiplegic cerebral palsy; virtual reality