Effects of combined virtual reality assisted gait training and proprioceptive neuromuscular facilitation on motor function in children with spastic cerebral palsy: a randomized controlled trial.

In 30 seconds

This exploratory randomized controlled trial compared conventional rehabilitation, virtual reality (VR)-assisted gait training, and combined VR and proprioceptive neuromuscular facilitation (PNF) in 30 children with spastic cerebral palsy. Each group included 10 children, and the intervention lasted 12 weeks. All groups improved in functional outcomes. Significant group-by-time effects were reported for GMFM-88 dimension D, muscle tone, lower-limb Fugl-Meyer scores, and range of motion; the combined PNF + VR group showed the greatest improvements. Balance and bone mineral density did not show significant group-by-time effects.

Key findings

• Significant group-by-time effects occurred for GMFM-88D, Modified Ashworth Scale, lower-limb Fugl-Meyer Assessment, and range of motion (p < 0.05).
• The PNF + VR group showed the greatest improvements in outcomes with significant group-by-time effects.
• GMFM-88E improved significantly in the PNF + VR group in change-score comparisons, but its group-by-time interaction was not significant.
• No significant group-by-time effects were found for Berg Balance Scale or bone mineral density (p > 0.05).

Why it matters

The findings suggest that combining VR-assisted gait training with PNF may improve selected lower-limb motor outcomes beyond those seen with conventional rehabilitation or VR training alone. The results also distinguish outcomes that appeared responsive from balance and bone mineral density, for which no group-by-time effects were detected. This provides preliminary comparative evidence for rehabilitation approaches in children with spastic cerebral palsy.

What to keep in mind

This was an exploratory trial with 30 participants, only 10 per group, and a 12-week intervention; the abstract does not report longer-term outcomes.