Virtual Reality Training Using Wii Fit in Children With Cerebral Palsy

NCT07547644 | Not Yet Recruiting

• 1 other identifier: 10980825GSPT
• Study Type: interventional
• Target: 56
• Locations: 0 countries
• Sites: N/A

Brief Summary

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.

Conditions

Cerebral Palsy (CP); Virtual Reality; Balance; Gross Motor Function Classification System (GMFCS) Level I,II; Gross Motor Functions; Agility

Keywords

cerebral palsy; virtual reality; balance; GMFM

Outcome Measures

Primary Outcomes (6)

• Gross Motor Skills

  Gross Motor Skills measured via GMFM-88 (domains D and E)

  Baseline

• Balance

  Balance measured via Pediatric Balance Scale (PBS)

  Baseline

• Agility

  Agility using the running speed and agility subset of Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2)

  Baseline

• Agility

  Agility using the running speed and agility subset of Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2)

  6 weeks

• Balance

  Balance measured via Pediatric Balance Scale (PBS)

  6 weeks

• Gross Motor Skills

  Gross Motor Skills measured via GMFM-88 (domains D and E)

  6 weeks

Secondary Outcomes (2)

• Level of enjoyment

  6 weeks

• Level of enjoyment

  Baseline

Study Arms (2)

Virtual Reality Group

EXPERIMENTAL

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 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.

Device: Experimental Group

Conventional Physical Therapy

PLACEBO COMPARATOR

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), supervised by a physiotherapist. No virtual reality activities will be provided.

Behavioral: control group

Interventions

Experimental Group DEVICE

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 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.

Virtual Reality Group

control group BEHAVIORAL

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), supervised by a physiotherapist. No virtual reality activities will be provided.

Conventional Physical Therapy

Eligibility Criteria

• Age: 7 Years - 14 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• ● 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.

You may not qualify if:

• ● 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 .

Sponsors & Collaborators

• Ziauddin University: lead

Related Publications (12)

• 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 RESULT

• 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 RESULT

• 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 RESULT

• 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 RESULT

• 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 RESULT

• 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 RESULT

• 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 RESULT

• 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 RESULT

• Bonnechere B, Jansen B, Omelina L, Van Sint Jan S. The use of commercial video games in rehabilitation: a systematic review. Int J Rehabil Res. 2016 Dec;39(4):277-290. doi: 10.1097/MRR.0000000000000190.

  PMID: 27508968 RESULT

• Behm DG, Chaouachi A. A review of the acute effects of static and dynamic stretching on performance. Eur J Appl Physiol. 2011 Nov;111(11):2633-51. doi: 10.1007/s00421-011-1879-2. Epub 2011 Mar 4.

  PMID: 21373870 RESULT

• Bekteshi S, Monbaliu E, McIntyre S, Saloojee G, Hilberink SR, Tatishvili N, Dan B. Towards functional improvement of motor disorders associated with cerebral palsy. Lancet Neurol. 2023 Mar;22(3):229-243. doi: 10.1016/S1474-4422(23)00004-2. Epub 2023 Jan 16.

  PMID: 36657477 RESULT

• Anttila H, Autti-Ramo I, Suoranta J, Makela M, Malmivaara A. Effectiveness of physical therapy interventions for children with cerebral palsy: a systematic review. BMC Pediatr. 2008 Apr 24;8:14. doi: 10.1186/1471-2431-8-14.

  PMID: 18435840 RESULT

MeSH Terms

Conditions

Cerebral Palsy

Interventions

Control Groups

Condition Hierarchy (Ancestors)

Brain Damage, Chronic; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases

Intervention Hierarchy (Ancestors)

Epidemiologic Research Design; Epidemiologic Methods; Investigative Techniques; Research Design; Methods

Central Study Contacts

Ghulam Sakina Awan, MPhil in Physical Therapy

CONTACT

021-36629251; Ghulam.18567@zu.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: This study follows a double-blinded randomized controlled trial design to compare the effects of Wii Fit-based virtual reality training with conventional physiotherapy in children with spastic cerebral palsy. The model includes two parallel groups with equal allocation and uses a simple random sampling technique through sealed-envelope randomization. A total of 56 participants aged 7-14 years, diagnosed with spastic diplegic cerebral palsy and classified under GMFCS Levels I-II, will be recruited from rehabilitation centers and hospitals in Karachi. Participants will be randomly assigned to one of two groups: Intervention Group - Wii Fit-based virtual reality training Control Group - Conventional physiotherapy Both groups will receive 18 supervised sessions over 6 weeks, consisting of a warm-up, a 20-minute core intervention, and a cool-down. The intervention group will perform structured Wii Fit games targeting balance, gross motor function, strength, coordination, and agility. Th

Study Record Dates

• First Submitted: April 16, 2026
• First Posted: April 23, 2026
• Study Start: April 25, 2026
• Primary Completion (Estimated): July 15, 2026
• Study Completion (Estimated): August 15, 2026
• Last Updated: April 23, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share