Adaptive VR-based rehabilitation to prevent deterioration in adults with cerebral palsy

Cerebral palsy (CP) is a disabling life-long condition progressively impeding a patient's independence. Although incident rates are high, a clear understanding of the disease is missing. CP is characterized by several motor disorders and sensory or perceptive comorbidities. This multifaceted nature complicates proper diagnosis and hampers the search for possible treatments. During adolescence and adulthood, individuals with CP experience a drastic deterioration in gross motor control, independence, and quality of life. There is poor evidence that physical therapy promotes the retention of function through aging, and no clinical studies exist that explore the potential of VR-based training to prevent deterioration. In this pilot randomized controlled trial, we expose 14 adults with CP to the Rehabilitation Gaming System (RGS) and examine its usability, effectiveness, and acceptability. Our results show that the RGS difficulty adaptation algorithm automatically matches the patients' impairment level as captured by clinical scales (Barthel and Box & Blocks). The clinical effectiveness and acceptability of the RGS and conventional therapy were comparable. We conclude that VR-based physical therapy as an adjunct to usual treatment may be a promising approach for the prevention of deterioration in adolescents and adults with CP.