Children with cerebral palsy benefited from a riding simulator coupled with virtual reality

The system that combines tge horse-riding simulator with virtual reality.
The system that combines the horse-riding simulator with virtual reality. (A) shows the simulator with a safety harness and a head-mounted display (HMD) with controllers. During therapy (B and C), the target is hit by raising the arms, and obstacles are avoided by tilting the trunk laterally on a moving saddle. Images: Jung et al.

A horse-riding simulator coupled with virtual reality appears to be an effective therapeutic approach to help children with cerebral palsy, the findings of fresh research suggest.

Cerebral palsy is one of the most common physical disabilities in childhood. It is a disorder of movement and posture caused by non-progressive lesions in the developing brain.

Affected children have, to varying degrees, muscle weakness, tone abnormality, and motor-control impairment, causing abnormal posture and poor balance control. Rehabilitative treatments are given to improve the symptoms.

Yong Gi Jung and his fellow researchers at Sungkyunkwan University in South Korea noted that a systematic review had shown that horse-riding therapy for children with cerebral palsy is effective in improving balance and symmetry. It positively affects spasticity, gross motor function, and hand function.

While such riding therapy delivers benefits, it is not always available because of distance, weather, and cost.

The study team set out to evaluate the effect of a horse-riding simulator coupled with the use of virtual reality on gross motor function, balance control, and body composition in children with spastic cerebral palsy.

The robotic simulator used in the study, developed in Seoul, has the rider seated in a saddle. The simulator produces three-dimensional movements similar to the gait pattern of a horse.

Seventeen preschool and school-aged children with cerebral palsy were enrolled in the study. Ten of them were assigned to the group using the simulator coupled with the task-driven virtual reality experience, receiving 30 minutes of riding therapy twice a week for a total of 16 sessions. The youngsters also received their conventional physiotherapy.

Seven children in the control group were asked to perform home-based aerobic exercises twice a week for 8 weeks in addition to their conventional physiotherapy. Gross motor function and body composition in all the children were evaluated before the first session and after the last session using validated tools.

Gross motor function scores and body composition – skeletal muscle mass – improved significantly in the group using the simulator.

Discussing their findings, the authors said their research is the first to evaluate the improvement of body composition and motor performance in children with cerebral palsy by applying fully immersive virtual reality technology to a horse-riding simulator. Their findings, they said, have high clinical significance.

The combination of a riding simulator with virtual reality appears to be an effective adjunctive therapeutic approach to help children with cerebral palsy.

Children with cerebral palsy had been impacted by the Covid-19 pandemic, and were at high risk of respiratory complications from the disease, the authors noted. This required them to minimize visits to public places.

Unlike hippotherapy or other rehabilitation treatments, the use of a riding simulator and virtual reality does not require contact with many people. It can even be integrated into a home program as part of telerehabilitation.

The authors noted that motivation has been suggested to be an important factor in pediatric motor rehabilitation. Motivated children have better rehabilitation outcomes than unmotivated children, with the task-driven virtual reality technology in this experiment adding an enjoyable and rewarding extra dimension to the simulated riding.

It is expected that the simulator combined with virtual reality can produce similar effects to hippotherapy, they said. “However, further research comparing the effects of the horse-riding simulator with those of virtual reality and hippotherapy is needed.”

They continued: “Based on the clinical effects and technological advances demonstrated in this study, it can be expanded to various rehabilitation treatment fields and serve as a foundation to increase patient compliance and treatment efficacy.”

The study team comprised Jung, Hyun Jung Chang, Eun Sol Jo and Da Hye Kim, all from Sungkyunkwan University.

Jung, Y.G.; Chang, H.J.; Jo, E.S.; Kim, D.H. The Effect of a Horse-Riding Simulator with Virtual Reality on Gross Motor Function and Body Composition of Children with Cerebral Palsy: Preliminary Study. Sensors 2022, 22, 2903.

The study, published under a Creative Commons License, can be read here.

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