Enhancing visual-spatial skills using virtual rehabilitation lead to improving balance in children with cerebral palsy
Hosseini S. A. PhD in Ergonomy. Associated Prof. Pediatric Neurorehabilitation Research Center.University of Social Welfare and Rehabilitation Sciences. Tehran. Iran
Pishyareh E. PhD in Cognitive Neuroscience. Occupational Dept. University of Social Welfare and Rehabilitation Sciences. Tehran. Iran
Haghgoo H. A. PhD in Medical Neuroscience. Occupational Dept. University of Social Welfare and Rehabilitation Sciences. Tehran. Iran
Amini B. MSc. Occupational Therapy. Occupational Dept. University of Social Welfare and Rehabilitation Sciences. Tehran. Iran
Rehabilitation in virtual space is defined as using Virtual Reality (VR) and Virtual Environments (VE) in the fields of rehabilitation. Because of exciting nature of rehabilitation in virtual space, it can increase in patient’s interest and motivation to follow therapeutic programs. In sensory integration approach, visual system lies in sensory-motor category which provides powerful and optimal sources for prediction, anticipation, selection, and developed motor patterns in cooperation with brain stem related structures. On the other side, visual system is under control by occulomotor and superior colliculus for its motor action and is connected to the cerebral cortex via widespread relationship with cerebellum and basal ganglia. In motor cortex, an specialized part is devoted to visual motor and frontal eye field which indicates its important role in motor function. Linking these systems by a sensory –motor system – visual system- is basis for multimodal skills (cognitive, developmental, perceptual, sensory and motor) such as depth perception, motor programming and planning, sequencing,prediction& anticipating, eye hand &foot coordination, environment manipulation, motor activity level, and body position& posture in different states according to environmental conditions. Numerous studies have done on specifications and different aspects of visual system such as visual-spatial which have an important role in neuro-occupation approaches in treatment plane. Accordingly, researches have shown that children who suffer from deficiencies in visual-spatial processing, have also problems in balance and body posture. In the present study, 3 boys with diplegia spastic cerebral palsy were studied. They were right handed, in the first and second school grades and were able to walk independently, while have no appropriate and normal pattern such as knee flex and hip flex patterns. They were evaluated using Balance Master machine before and after intervention. They received virtual rehabilitation for 3 days per week, and 15 min each session immediately after current occupational therapy for 2 months. Intervention included using Wii machine and participates in balance games while standing on force plate of machine.
Balance on one foot was examined to evaluate sway velocity and weight shifting with two dimensions including speed on motion axis and direction control. Results have shown significant differences in static balance in subjects during two tasks including standing on one foot with open and closed eyes, and weigh shifting test (forward and backward).
Keywords: Balance master machine, cerebral palsy, dynamic balance, static balance, virtual

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