Virtual Reality Training Using Wii Fit in Children With Cerebral Palsy
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Experimental Group, control group.
- Who it may be relevant to
- Registry conditions: Cerebral Palsy (CP), Virtual Reality, Balance, Gross Motor Function Classification System (GMFCS) Level I,II. Basic parameters: 7 years — 14 years · Female.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
EFFECTS OF VIRTUAL REALITY TRAINING USING WII FIT ON BALANCE, GROSS MOTOR FUNCTION, AND AGILITY IN CHILDREN WITH CEREBRAL PALSY -A RANDOMIZED CONTROLLED TRIAL
Overview
The goal of this clinical trial is to determine whether virtual reality (VR) training using the Nintendo Wii Fit can improve balance, gross motor function, and agility in children aged 7-14 years with spastic cerebral palsy (GMFCS Levels I-II). The main questions it aims to answer are: Does Wii Fit-based VR training improve balance more than conventional physiotherapy? Does VR training enhance gross motor skills such as standing, walking, running, and jumping? Does VR training improve agility in children with cerebral palsy? Does VR training increase enjoyment and engagement during therapy? Researchers will compare Wii Fit-based VR training with conventional physiotherapy to determine which approach leads to greater improvements in motor function. Participants will: Attend 18 sessions over 6 weeks (3 sessions per week). Perform either VR-based exercises using the Wii Fit Balance Board or traditional physiotherapy exercises. Complete pre- and post-intervention assessments using the Pediatric Balance Scale, GMFM-88 (domains D and E), BOT-2 agility subtest, and the PACES enjoyment scale. This study aims to explore a fun, cost-effective, and engaging rehabilitation strategy that may improve functional independence and overall quality of life for children with cerebral palsy.
Detailed description
This clinical trial aims to evaluate the effects of virtual reality training using the Nintendo Wii Fit on balance, gross motor function, agility, and enjoyment in children with spastic cerebral palsy. Cerebral palsy commonly affects motor control, posture, coordination, and mobility, and children often require long-term physiotherapy to improve their functional independence. While traditional physiotherapy is effective, many children struggle with motivation, participation, and engagement during repetitive therapeutic exercises. Virtual reality-based interventions are emerging as a fun, interactive, and affordable way to increase motivation and enhance motor learning in pediatric rehabilitation.
In this study, children aged 7 to 14 years with spastic cerebral palsy (GMFCS Levels I-II) will be randomly assigned to either Wii Fit-based virtual reality training or conventional physiotherapy. The intervention will last 6 weeks, with sessions held three times per week. The virtual reality group will perform selected Wii Fit games that specifically target balance, coordination, strength, motor planning, and agility. These include Table Tilt, Balance Bubble, Perfect 10, Super Hula Hoop, Obstacle Course, Ultimate Obstacle Course, Ski Jump, and Basic Step. Each session consists of a warm-up phase, 20 minutes of Wii Fit gameplay, and a cool-down period. Game difficulty will progressively increase as the child's performance improves, while therapists will ensure safety and provide encouragement.
The control group will receive conventional physiotherapy, which includes strengthening exercises, gait training, dynamic and static balance tasks, and functional task-oriented activities. Both groups will receive an equal number of sessions with similar session duration to ensure fairness in comparison.
Outcome measures include the Pediatric Balance Scale (balance), GMFM-88 domains D and E (standing, walking, running, jumping), BOT-2 Running Speed and Agility Subtest (agility), and the Physical Activity Enjoyment Scale. Assessments will be conducted before and after the 6-week intervention by trained assessors who are blinded to group allocation.
This study aims to address the lack of comprehensive research evaluating the combined effects of virtual reality on multiple motor skills in children with cerebral palsy, particularly in Pakistan. By comparing Wii Fit training with conventional physiotherapy, the study seeks to determine whether VR offers a more engaging, motivating, and effective rehabilitation option. If successful, the findings may support the use of low-cost, accessible virtual reality tools in pediatric therapy settings to improve functional outcomes, engagement, and quality of life for children with cerebral palsy.
Interventions
- Device Experimental Group
Participants in this group will receive Wii Fit-based virtual reality training using the Nintendo Wii Fit Balance Board. Each session will include a warm-up, 20 minutes of structured Wii Fit gameplay, and a cool-down. The selected games target balance, coordination, strength, and agility, such as Table Tilt, Balance Bubble, Perfect 10, Super Hula Hoop, Obstacle Course, Ultimate Obstacle Course, Ski Jump, and Basic Step. Difficulty levels will progress gradually based on the participant's perform - Behavioral control group
Participants assigned to the control group will receive routine physiotherapy commonly used for children with cerebral palsy. This includes strengthening exercises, stretching, balance training, gait training, coordination tasks, and functional activity practice. Each session will follow the same overall duration and format as the intervention group (warm-up, 20-minute main exercise phase, and cool-down). Sessions will also be conducted three times per week for six weeks (total 18 sessions), sup
Primary outcome measures
- Gross Motor Skills [Time frame: Baseline]
- Balance [Time frame: Baseline]
- Agility [Time frame: Baseline]
- Agility [Time frame: 6 weeks]
- Balance [Time frame: 6 weeks]
- Gross Motor Skills [Time frame: 6 weeks]
Secondary outcome measures (2)
- Level of enjoyment [Time frame: 6 weeks]
- Level of enjoyment [Time frame: Baseline]
Eligibility criteria
Inclusion criteria
- ● Children aged 7 to 14 years
- Diagnosed cases of spastic diplegic CP, characterized by bilateral lower limb involvement
- Classified under GMFCS levels I to II.
- Having mild to moderate spasticity on Modified Ashworth Scale (MAS) scores ranging from 1, +1 or 2
- Mild level intellectual disability according to their health records
- Medically stable with no acute illness or uncontrolled comorbidities
- No major changes in medication or therapy planned during the study period.
Exclusion criteria
- ● Orthopedic surgery or botulinum toxin injections in the past 16 months
- Hearing or visual impaired .
- Uncontrolled epilepsy or seizures
- Severe attention deficits or psychological issues interfering with task engagement such as attention deficit hyperactivity disorder (ADHD), Autism Spectrum Disorder (ASD) will be excluded from the study .
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Double blind
- Primary purpose
- Treatment
Study locations
Center list to be confirmed — check the primary protocol.
Publications
- Venema DM, Skinner AM, Nailon R, Conley D, High R, Jones KJ. Patient and system factors associated with unassisted and injurious falls in hospitals: an observational study. BMC Geriatr. 2019 Dec 11;19(1):348. doi: 10.1186/s12877-019-1368-8. PMID 31829166
- Paul S, Nahar A, Bhagawati M, Kunwar AJ. A Review on Recent Advances of Cerebral Palsy. Oxid Med Cell Longev. 2022 Jul 30;2022:2622310. doi: 10.1155/2022/2622310. eCollection 2022. PMID 35941906
- Ziab H, Saleh S, Talebian S, Olyaei G, Mazbouh R, Sarraj AR, Hadian MR. Effectiveness of virtual reality training compared to balance-specific training and conventional training on balance and gross motor functions of children with cerebral palsy: A double blinded randomized controlled trial. J Pediatr Rehabil Med. 2024 Sep;17(3):353-368. doi: 10.3233/PRM-220120. PMID 39150837
- Esculier JF, Vaudrin J, Beriault P, Gagnon K, Tremblay LE. Home-based balance training programme using Wii Fit with balance board for Parkinsons's disease: a pilot study. J Rehabil Med. 2012 Feb;44(2):144-50. doi: 10.2340/16501977-0922. PMID 22266676
- Deutsch JE, Borbely M, Filler J, Huhn K, Guarrera-Bowlby P. Use of a low-cost, commercially available gaming console (Wii) for rehabilitation of an adolescent with cerebral palsy. Phys Ther. 2008 Oct;88(10):1196-207. doi: 10.2522/ptj.20080062. Epub 2008 Aug 8. PMID 18689607
- Damiano DL. Activity, activity, activity: rethinking our physical therapy approach to cerebral palsy. Phys Ther. 2006 Nov;86(11):1534-40. doi: 10.2522/ptj.20050397. PMID 17094192
- Chidi-Egboka NC, Jalbert I, Golebiowski B. Smartphone gaming induces dry eye symptoms and reduces blinking in school-aged children. Eye (Lond). 2023 May;37(7):1342-1349. doi: 10.1038/s41433-022-02122-2. Epub 2022 Jun 6. PMID 35668140
- Chen Y, Fanchiang HD, Howard A. Effectiveness of Virtual Reality in Children With Cerebral Palsy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Phys Ther. 2018 Jan 1;98(1):63-77. doi: 10.1093/ptj/pzx107. PMID 29088476
Identifiers
NCT: NCT07547644 · 10980825GSPT · 10980825GSPT