Effects of Augmented Reality Interventions on the Function of Upper Extremity and Balance in Children With Spastic Hemiplegic Cerebral Palsy: A Randomized Clinical Trial.

Objective: To determine the effects of augmented reality (AR) interventions on the function of the upper extremity (UE) and balance in children with spastic hemiplegic cerebral palsy (SHCP). Methods: In total, 30 children with SHCP, aged 6 to 12 years, were randomly divided into three interventional groups. Each group received an AR game, i.e., Balance It, Bubble Pop, or Scoop'd (WonderTree, Pakistan). The UE function and balance were assessed at the baseline and after 8 weeks of intervention through the Disability of Arm, Shoulder, and Hand (DASH) questionnaire and Pediatric Balance Scale (PBS), respectively. The mixed ANOVA was used to determine the combined with-in and between-the-groups differences in the function of the upper extremity. The Wilcoxon sign ranked test was used for with-in group changes, while the Kruskal Wallis test with the bonferroni correction post-hoc analysis was used to compare the groups in terms of balance. The data were analyzed by using SPSS version 21 and the level of significance was set at p < 0.05. Paired sample t-test and Wilcoxon signed-rank test was used for analyzing the changes in the total DASH and PBS scores within the groups, respectively. One-way ANOVA was used to determine the differences between the groups in the total DASH and PBS scores, while the Kruskal Wallis test was used for the differences between the groups in the PBS items. The data were analyzed by using SPSS version 21. Results: All the groups improved significantly in the total DASH and PBS scores post-intervention. A significant difference was determined in standing with one foot in front between Bubble Pop and Balance It groups (p = 0.03). The total score of PBS also showed a significant difference between Bubble Pop and Balance It groups (p = 0.02). Conclusion: The AR interventions used in this study were found to be effective in improving the UE function and balance of children with SHCP. The Balance It game showed more promising results in improving the balance as compared with the other games, however, no significant difference was determined between the three AR games in terms of the UE function of the participants.

Effects of Augmented Reality Intervention on the Range of Motion and Muscle Strength of Upper Extremity in Children with Spastic Hemiplegic Cerebral Palsy: A Randomized Clinical Trial.

Objective: To determine the effects of augmented reality (AR) interventions on the upper extremity's (UE's) range of motion (ROM) and muscle strength in children with spastic hemiplegic cerebral palsy (SHCP). Materials and Methods: Thirty children with SHCP, aged 6 to 12 years, were randomly divided into three interventional groups. Each group received an AR game that is, Balance It, Bubble Pop, or Scoop'd (WonderTree, Pakistan). The UE's ROM and muscle strength were assessed at the baseline and after 8 weeks of intervention through goniometer and manual muscle testing, respectively. Paired-sample t-test and Wilcoxon signed-rank test were used for analyzing the changes in ROM and muscle strength within the groups respectively. One-way analysis of variance (ANOVA) and Tukey's test were used for the differences in ROM, whereas the Kruskal-Wallis test was used for the differences in muscle strength, between the groups. Results: Within-group analysis revealed that all the groups significantly improved in ROM of the majority of joints and in the strength of various muscles of UE (P < 0.05). The elbow extension ROM was significantly different when a comparison was made between the interventional groups (P < 0.05). Balance It group showed more significant improvement in the elbow extension ROM as compared with the Scoop'd group. However, the comparison between the groups showed no significant difference in the muscle strength of UE (P > 0.05). Conclusion: The AR games intervention was beneficial and effective for improving the ROM of majority of the joints and strength of various muscles of UE in children with SHCP. Clinical Trial Registration number: NCT04171232.

Levels of physical activity and its association with antigravity muscles.

This study was conducted to determine the association of physical activity levels with the strength of antigravity muscles in medical students of Isra University, Islamabad. An analytical cross sectional survey was conducted on 200 medical students of Isra University, Islamabad, aged between 17-25 years. The International Physical Activity Questionnaire- Short Form 7 (IPAQ-SF-7) was used to determine the physical activity levels, while Manual Muscle Testing (MMT) was used for evaluating the strength of antigravity muscles. The mean age of the study participants was 21.27±1.784. Of the 200 participants, 155 (77.5%) were females and 45 (22.5%) were males. A significant association was found between physical activity levels and the antigravity muscles' strength (p<0.001). This study concluded that physical activity levels were significantly associated with the strength of the antigravity muscles in medical students.