Reactive Balance Training vs Virtual Reality in Hemiplegic Cerebral Palsy

NCT07401108 | Active Not Recruiting

• 1 other identifier: P.T.REC/012/005531
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled study compared the effects of Wii Balance Board training versus reactive balance training on balance control and functional abilities in children with spastic hemiplegic cerebral palsy. Sixty children aged 6-10 years (GMFCS levels I-II, mild spasticity) were randomly assigned to either a Wii-based balance training group or a reactive balance training group. Both groups received a conventional physical therapy program three times per week for eight weeks, with an additional 30 minutes of the assigned balance intervention per session. Balance and functional abilities were assessed before and after treatment using the HUMAC Balance System, Pediatric Balance Scale, Functional Reach Test, and Timed Up and Down Stairs test. The study aimed to evaluate and compare the effectiveness of both interventions in improving balance control and functional performance in this population.

Conditions

Hemiplegic Cerebral Palsy

Keywords

Virtual Reality; Hemiplegic Cerebral Palsy; Wii Balance Board; Reactive Balance Training

Outcome Measures

Primary Outcomes (2)

• Limits of stability scores

  The Humac Balance System will be used for assessment of balance through limits of stability (LOS) scores. Higher scores indicate better dynamic balance control

  From enrollment to the end of treatment at 8 weeks

• center of pressure scores

  The Humac Balance System will be used for assessment of balance through center of pressure (COP) scores. Lower values indicate better posture control

  From enrollment to the end of treatment at 8 weeks

Secondary Outcomes (2)

• Functional reach test scores

  From enrollment to the end of treatment at 8 weeks

• Timed up-and-down-stairs test scores

  From enrollment to the end of treatment at 8 weeks

Study Arms (2)

Virtual reality using Wii Balance Board

EXPERIMENTAL

The Wii Balance Board is a non-immersive virtual reality (VR) rehabilitation tool that has been widely used in physical therapy to assess and train balance and postural control. It is a force-platform-based device equipped with four pressure sensors (anterior-posterior and medial-lateral) that detect changes in body weight distribution and shifts in the center of pressure (CoP). These data are transmitted in real time to the Nintendo Wii console, where body movements are translated into visual feedback displayed on a screen, allowing users to interact with virtual environments and game-based tasks.

Device: Virtual reality

Reactive Balance training

EXPERIMENTAL

Participants will undergo structured reactive balance training that will consist of three sessions per week over an eight-week period. In Reactive balance training we will use different types of perturbations: External perturbations, Internal perturbation and combination of them. Training will last about 30 minutes.

Other: Reactive Balance Training

Interventions

Virtual reality DEVICE

Participants will undergo a structured balance training program utilizing the Wii Balance Board. The program will consist of three training sessions per week over an eight-week period. The first two weeks will focus on guided exercises with manual assistance and verbal instructions, ensuring that the children are comfortable and correctly performing the exercises. As the participants progress, the manual guidance will be gradually reduced, and verbal instructions alone will be provided for the remaining four weeks of training.

Also known as: Wii Balance Board

Virtual reality using Wii Balance Board

Reactive Balance Training OTHER

In reactive balance training, each session will include 3-4 of the following five core exercises: lean and release, push/pull, reaching with unexpected perturbation, weight shifting on unstable surfaces, and trip/slip simulation. Exercises will be divided into 2-3 blocks, with 6-8 perturbations in each block and short rest periods between blocks (1-2 min), for a total of 30-40 perturbations per session.

Also known as: Perturbation- Based Training

Reactive Balance training

Eligibility Criteria

• Age: 6 Years - 10 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Hemiplegic children between 6-10 years old.
• Both genders will be included.
• Their motor function will be between level I and II according to Gross Motor Function Classification System (GMFCS) .
• The degree of spasticity for these children will range from grade 1 to 1+ according to the Modified Ashworth Scale .
• They will be able to follow instructions during evaluation and treatment procedures

You may not qualify if:

• Cardiovascular or respiratory disorders.
• Undergone musculoskeletal surgery or botulinum toxin injection in the lower limbs in past six months
• Musculoskeletal problems or fixed deformities in the spine and/or lower extremities
• unstable seizures
• Visual or hearing impairment

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Wahet nour elahayah

Al Mansurah, Daqahlyia, 35511, Egypt

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: lecturer

Study Record Dates

• First Submitted: January 5, 2026
• First Posted: February 10, 2026
• Study Start: May 24, 2025
• Primary Completion: February 23, 2026
• Study Completion: May 15, 2026
• Last Updated: February 10, 2026

Record last verified: 2026-02

Locations

EG (1)