Review Article

Effect of virtual reality therapy, combined with physiotherapy for improving motor proficiency in individuals with Down syndrome: A systematic review

Jessica Stander, Jennifer C. du Preez, Chantel Kritzinger, Natasha M. Obermeyer, Silke Struwig, Nikki van Wyk, Jessica Zaayman, Marlette Burger
South African Journal of Physiotherapy | Vol 77, No 1 | a1516 | DOI: https://doi.org/10.4102/sajp.v77i1.1516 | © 2021 Jessica Stander, Jennifer C. du Preez, Chantel Kritzinger, Natasha M. Obermeyer, Silke Struwig, Nikki van Wyk, Jessica Zaayman, Marlette Burger | This work is licensed under CC Attribution 4.0
Submitted: 23 July 2020 | Published: 20 May 2021

About the author(s)

Jessica Stander, Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Jennifer C. du Preez, Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Chantel Kritzinger, Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Natasha M. Obermeyer, Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Silke Struwig, Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Nikki van Wyk, Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Jessica Zaayman, Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Marlette Burger, Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa


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Abstract

Background: Individuals with Down syndrome may struggle with anticipatory postural adjustments, and adapt slower to motor tasks and environmental changes, due to decreased motor proficiency.

Objectives: To determine the effectiveness of virtual reality therapy (VRT), specifically Nintendo Wii, combined with physiotherapy or occupational therapy (OT) for improving motor proficiency in individuals with Down syndrome, compared to standard physiotherapy, OT or no intervention.

Method: Nine computerised databases were searched from inception to July 2020. Methodological quality of randomised controlled trials and quasi-experimental studies was appraised using the physiotherapy evidence database (PEDro) scale and the Joanna Briggs Institute Critical Appraisal Checklist for Case Reports.

Results: Two randomised controlled trials and four quasi-experimental studies were included, with an average PEDro score of 7.3. One included case study scored 5. This review included 345 participants. Motor proficiency includes balance, coordination, strength and agility. Agility showed a significant improvement after 5 (p = 0.01) or 24 (p < 0.01) weeks. Strength showed a significant improvement after a 6- (p = 0.000) or 24-week intervention (p < 0.05). Balance showed inconclusive results for adults, and significant improvement in children after 6 (p = 0.000), 8 (p < 0.05) or 24 (p < 0.003) weeks. One study (n = 155) showed that upper limb and bilateral coordination improved significantly after 24 weeks (p < 0.003).

Conclusion: Level II, III-1 and IV evidence suggested that VRT may be valuable to improve agility and strength in individuals with Down syndrome, and balance and coordination in children with Down syndrome.

Clinical implications: It may be beneficial to use VRT in addition to standard physiotherapy or OT interventions for improving motor proficiency in individuals with Down syndrome.


Keywords

virtual reality; rehabilitation; physiotherapy; occupational therapy; Down syndrome; motor proficiency

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