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.
● 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
● 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 .
Parallel
Experimental Group
DeviceParticipants 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 performance. Sessions will be conducted three times per week for six weeks (total 18 sessions), supervised by a physiotherapist. No additional physiotherapy exercises will be given during the intervention period.
control group
BehavioralParticipants 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), supervised by a physiotherapist. No virtual reality activities will be provided.
Gross Motor Skills
Gross Motor Skills measured via GMFM-88 (domains D and E)
Balance
Balance measured via Pediatric Balance Scale (PBS)
Agility
Agility using the running speed and agility subset of Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2)
Agility
Agility using the running speed and agility subset of Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2)
Level of enjoyment
Level of enjoyment using the Physical Activity Enjoyment Scale (PACES)
Level of enjoyment
Level of enjoyment using the Physical Activity Enjoyment Scale (PACES)
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