Development of a customized non immersive virtual reality system as a therapeutic tool for children with cerebral palsy

Abstract

This research explores the design, development, and evaluation of a customized non-immersive virtual reality (VR) system tailored for children with spastic diplegia CP. Central to the system is an interactive car racing game developed using the Unity Game Engine in collaboration with clinical therapists. The game utilizes wearable Inertial Measurement Unit (IMU) sensor modules to track natural body movements and translate them into real-time gameplay actions. The system provides visual, auditory, and measurement feedback, enhancing motivation and engagement while targeting key therapeutic objectives such as balance, coordination, motivation, and functional performance. The game environment incorporates adaptive difficulty levels and progressive challenges, allowing therapists to adjust parameters such as sensitivity, game speed, and task complexity to meet CP children s needs. These customizable features ensure the therapy remains accessible and challenging, fostering sustained engagement. A single-blinded randomized controlled trial was conducted with 32 participants (30 completing the study, mean age = 10.4 years). Participants were divided into two groups: one receiving 45 minutes of non-immersive VR therapy combined with 45 minutes of conventional therapy, and the other receiving 90 minutes of conventional therapy. Evaluations included the Pediatric Balance Scale (PBS) for balance, the Intrinsic Motivation Inventory (IMI) for motivation, and in-game metrics for coordination and functional performance. Results showed significant improvements in the experimental group compared to the control group. Post-intervention PBS scores revealed enhanced balance (p = 0.003). Motivation was notably higher in the experimental group, with increases in Interest/Enjoyment (p = 0.017) and Perceived Competence (p = 0.003). Functional performance metrics indicated improved coordination, evidenced by increased coins collected (p lt 0.001) and fewer collisions (p = 0.024). newline