Cerebral palsy (CP) is the most common cause of motor disability in childhood, affecting approximately 2 out of every 1000 children. About 90% of deformities in CP occur in the ankle and foot region, with foot equinus being the most frequently observed deformity, requiring targeted interventions to enhance both the strength and the selective motor control of the ankle dorsiflexor muscles. Recent research has enlightened the potential of passive/active robotic devices coupled with gamification, and of music applied in clinical practice. Additionally, resource constraints and limited access to centre-based therapy services underlined the importance of complementary home-based programs to allow intensive and repetitive training outside of the clinic. Therefore, the present study aims to merge all the innovative tools of serious games (SGs), virtual reality (VR), music, and integration of robotic devices to realize an accessible and enjoyable ankle dorsiflexion home-rehabilitation system, adapted to the needs of children with CP. The developed system underwent validation in a testing phase with ten participants, comprised of a group of five healthy children, a CP-affected adult, and a target group of four children with CP aged 6 to 12 years old. Sessions, each lasting approximately 45 minutes, revealed varied improvement in ankle range of motion (ROM), with modest increments up to 8°. Positive outcomes were observed for participants with null or mild cognitive disability, suggesting the system's potential suitability for CP-affected children up to Gross Motor Function Classification System (GMFCS) level IV. In conclusion, the study indicates enthusiastic acceptance of the developed system by children with CP, suggesting potential improvements in ankle dorsiflexion and overall quality of life through its long-term use, alongside conventional training, for motivating home exercises.
La paralisi cerebrale infantile (PCI) è la causa di disabilità motoria più comune nell'infanzia, che si verifica in circa 2 su 1000 bambini. Approssimativamente il 90% delle deformità nella PCI interessano la regione di caviglia e piede, ed il piede equino rappresenta la deformità più comune, richiedendo interventi mirati per migliorare sia la forza che il controllo motorio selettivo dei muscoli dorsi-flessori della caviglia. Recenti studi hanno messo in luce il potenziale dei dispositivi robotici passivi/attivi uniti alla gamification, e della musica applicata nella pratica clinica. Inoltre, limitazioni economiche e accesso limitato ai servizi terapeutici denotano l'importanza di programmi complementari da svolgere a casa per consentire un esercizio intensivo e frequente al di fuori della clinica. Pertanto, questo studio mira ad unire le potenzialità di serious games (SGs), realtà virtuale (VR), musica ed integrazione di dispositivi robotici per realizzare un sistema accessibile e divertente per la riabilitazione della dorsi-flessione della caviglia, adatto alle esigenze dei bambini con PCI. Il sistema sviluppato è stato testato con dieci partecipanti, tra cui un gruppo di cinque bambini sani, un adulto affetto da PCI, ed un gruppo sperimentale di quattro bambini con PCI di età compresa tra 6 e 12 anni. Le sessioni, ciascuna della durata di circa 45 minuti, hanno rilevato vari miglioramenti nel range of motion (ROM) della caviglia, con lievi incrementi fino a 8°. Esiti positivi sono stati osservati per i partecipanti con disabilità cognitiva assente o lieve, suggerendo una possibile idoneità del sistema per bambini affetti da PCI fino ad un livello IV nel Gross Motor Function Classification System (GMFCS). In conclusione, il sistema sviluppato è stato accettato con entusiasmo da parte dei bambini con PCI, e lo studio ha indicato la possibilità di miglioramenti nella dorsi-flessione della caviglia e nella qualità di vita complessiva attraverso un uso a lungo termine, affiancato alla terapia convenzionale, per incentivare gli esercizi riabilitativi da svolgere a casa.
Ankle home-rehabilitation system for children with Cerebral Palsy: music themed virtual reality game development and 3D-printed device integration
Padilla Neira, Sara
2022/2023
Abstract
Cerebral palsy (CP) is the most common cause of motor disability in childhood, affecting approximately 2 out of every 1000 children. About 90% of deformities in CP occur in the ankle and foot region, with foot equinus being the most frequently observed deformity, requiring targeted interventions to enhance both the strength and the selective motor control of the ankle dorsiflexor muscles. Recent research has enlightened the potential of passive/active robotic devices coupled with gamification, and of music applied in clinical practice. Additionally, resource constraints and limited access to centre-based therapy services underlined the importance of complementary home-based programs to allow intensive and repetitive training outside of the clinic. Therefore, the present study aims to merge all the innovative tools of serious games (SGs), virtual reality (VR), music, and integration of robotic devices to realize an accessible and enjoyable ankle dorsiflexion home-rehabilitation system, adapted to the needs of children with CP. The developed system underwent validation in a testing phase with ten participants, comprised of a group of five healthy children, a CP-affected adult, and a target group of four children with CP aged 6 to 12 years old. Sessions, each lasting approximately 45 minutes, revealed varied improvement in ankle range of motion (ROM), with modest increments up to 8°. Positive outcomes were observed for participants with null or mild cognitive disability, suggesting the system's potential suitability for CP-affected children up to Gross Motor Function Classification System (GMFCS) level IV. In conclusion, the study indicates enthusiastic acceptance of the developed system by children with CP, suggesting potential improvements in ankle dorsiflexion and overall quality of life through its long-term use, alongside conventional training, for motivating home exercises.| File | Dimensione | Formato | |
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2023_12_PadillaNeira_Thesis.pdf
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Descrizione: Final Thesis
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2023_12_PadillaNeira_Executive Summary.pdf
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Descrizione: Final Executive Summary
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https://hdl.handle.net/10589/215903