Effect of task-specific training in an augmented reality context on upper limb function and activities in children with spastic cerebral palsy: a randomized controlled trial

• Grant number: 25/02360-1
• Support Opportunities: Scholarships in Brazil - Doctorate
• Start date: August 01, 2025
• End date: June 30, 2027
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Nelci Adriana Cicuto Ferreira Rocha
• Grantee: Luana Pereira Oliveira Gonçalves
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil

Abstract

Children with Cerebral Palsy (CP) exhibit motor impairments, which are considered more complex in the upper limbs, as they lead to limitations in performing motor activities, particularly manual reaching and daily tasks. As an intervention, the literature has recommended combining techniques with task-specific training. In this case, task-specific training will be combined with augmented reality (AR), a technique that has shown positive effects. However, studies in this area are scarce and present important gaps that need to be addressed.Objective: To investigate the effects of a task-specific training protocol combined with augmented reality on upper limb function and activities in children diagnosed with spastic cerebral palsy.Methods: Thirty-eight children with spastic CP, classified at Gross Motor Function Classification System (GMFCS) levels I, II, and III and Manual Ability Classification System (MACS) levels I, II, and III, aged 6 to 13 years, will participate in the study. They will be randomized into two intervention groups (control group and experimental group). Primary outcomes will include the kinematics of manual reaching and upper limb activities assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Secondary outcomes will involve the identification of goals using the Canadian Occupational Performance Measure (COPM) and their achievement tracked through the Goal Attainment Scaling (GAS).The intervention will last for four consecutive weeks, with three weekly sessions of 1 hour and 20 minutes each, totaling 12 sessions and 16 hours of training. The experimental group (INTERACT protocol) will use augmented reality (AR) software games. The control group will receive conventional physiotherapy for the same duration and frequency as the experimental group, conducted at their regular clinics.Assessments will take place before the intervention, two weeks into training, and at the end of the four-week training period. Additionally, a two-month follow-up without training will be conducted to assess the retention of the evaluated outcomes.Data Analysis: Statistical tests will compare effects between groups (t-test or Mann-Whitney) and within groups across the three assessments (pre, post, and follow-up) using repeated-measures ANOVA or Friedman tests.Relevance: This study will contribute to advancing treatments for individuals with CP by integrating low-cost AR technology with task-specific training, a combination strongly recommended in the literature. (AU)