title: Effectiveness of virtual reality rehabilitation for children and adolescents with cerebral palsy: an updated evidence-based systematic review.
abstract: BACKGROUND
  The use of virtual reality systems in the motor rehabilitation of children with cerebral palsy is new, and thus the scientific evidence for its effectiveness needs to be evaluated through a systematic review.
  
  
  OBJECTIVE
  To provide updated evidence-based guidance for virtual reality rehabilitation in sensory and functional motor skills of children and adolescents with cerebral palsy.
  
  
  METHODS
  PubMed, PEDro, Web of Science, OTseeker, PsycINFO and Cochrane Library were searched from their earliest records up to 1 June, 2016.
  
  
  METHODS
  Two reviewers applied the population intervention comparison outcome (PICO) question to screen the studies for this review.
  
  
  METHODS
  Information on study design, subjects, intervention, outcome measures and efficacy results were extracted into a pilot-tested form. Method quality was assessed independently by two reviewers using the Downs and Black checklist.
  
  
  RESULTS
  Thirty-one studies included 369 participants in total. Best evidence synthesis was applied to summarize the outcomes, which were grouped according to International Classification of Functioning, Disability and Health. Moderate evidence was found for balance and overall motor development. The evidence is still limited for other motor skills.
  
  
  CONCLUSIONS
  This review uncovered additional literature showing moderate evidence that virtual reality rehabilitation is a promising intervention to improve balance and motor skills in children and adolescents with cerebral palsy. The technique is growing, so long-term follow-up and further research are required to determine its exact place in the management of cerebral palsy. Systematic review registration number PROSPERO 2015:CRD42015026048.
authors.affiliation: Biomedical Instrumentation Division, CSIR-Central Scientific Instruments Organization, Chandigarh, India. Electronic address: depakroshanblu@gmail.com.
authors.forename: D K
authors.initials: DK
authors.lastname: Ravi
authors.affiliation: Biomedical Instrumentation Division, CSIR-Central Scientific Instruments Organization, Chandigarh, India.
authors.forename: N
authors.initials: N
authors.lastname: Kumar
authors.affiliation: Department of Paediatric Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: P
authors.initials: P
authors.lastname: Singhi
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009048:Motor Skills; D053580:Muscle Strength; D004856:Postural Balance; D011187:Posture; D018910:Video Games; D000076142:Virtual Reality
keywords: Cerebral palsy; Rehabilitation; Review; Virtual reality