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Abstract
Aims
To describe the nature of custom and non-custom virtual reality and active video game (VR/AVG) implementation within a Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) intervention program for children with hemiplegia.
Methods
Six children aged 8-11 years participated in a 10-day HABIT-ILE intervention (65 h; 6.5 planned VR/AVG hours). VR/AVG implementation details were recorded daily and summarized with descriptive statistics; active motor engagement was quantified as minutes of active game participation. Post-intervention interviews with interventionists were analyzed with qualitative content analysis.
Results
On average, participants received 79% of the planned VR/AVG dosage (314/400 planned minutes, range 214–400 min), of which the per-session active motor engagement average was 68% (27 min, SD 12 min). Participation involved equivalent amounts of custom (49%) and non-custom (51%) VR/AVG system use. Material and verbal adaptations facilitated alignment with HABIT-ILE principles. Interventionists identified type of task (gross versus fine motor), children’s perceived motivation, and VR/AVG attributes as factors influencing active motor engagement and alignment with HABIT-ILE principles.
Conclusions
Describing individual and technological challenges of VR/AVG integration within HABIT-ILE can advance knowledge about VR/AVG use in intensive interventions and identify directions for subsequent research.
Acknowledgments
We would like to thank the children and the students who participated in this study.
Disclosure Statement
No potential conflict of interest was reported by the author(s).
Additional information
Funding
Notes on contributors
Audrey Ferron
Audrey Ferron has graduated from a Bachelor of Science in physical activity (kinesiology) at the Université du Québec à Montréal in the spring 2023. Over the past year, she has integrated various research projects involving the integration of technology and virtual reality in pediatric rehabilitation at the Marie Enfant Rehabilitation Center (CRME) at the CHU Sainte-Justine. She will pursue her interest in research as a master’s student at the Université du Québec à Montréal in the fall 2023.
Maxime T. Robert
Maxime T. Robert is an assistant professor at Université Laval (Québec City, Canada). His research program ranges from the neuroanatomical and physiological studies to the optimization of rehabilitation interventions for individual with cerebral palsy to community-based programs. The components of his research program complement one another for the ultimate goal of improving the quality of life and social participation of children with physical disabilities. Throughout his research program, he includes the use of virtual reality as a motivating and valuable adjunct to therapy to promote motor recovery.
William Fortin
William Fortin has graduated from a Bachelor of Science in physical activity (kinesiology) at the Université du Québec à Montréal in the spring 2023. Throughout the past year, he has been involved in multiple research projects related to the integration of active video games and virtual reality in pediatric rehabilitation at the Marie Enfant Rehabilitation Center (CRME). He plans to continue his work as a kinesiologist, focusing on helping young adult struggling with mental health issues, including depression, anxiety, and schizophrenia.
Odette Bau
Odette Bau is a physiotherapist at Marie Enfant Rehabilitation Center (CRME) at the CHU Sainte-Justine in Montreal with extensive experience in the rehabilitation of children aged 0-17 years old with motor development issues, spinal cord injury, hemiplegia, stroke and concussions/head injuries. She has been a leading therapist in summer-camp intensive therapy programs and has specialized in the modified Constraint-Induced Movement Therapy (CIMT).
Marie-Claude Cardinal
Marie-Claude Cardinal is an occupational therapist at Marie Enfant Rehabilitation Center (CRME) at the CHU Sainte-Justine in Montreal. In over 30 years of experience working with children with cerebral palsy, she has been a leading therapist in summer-camp intensive therapy programs and has specialized in the modified Constraint-Induced Movement Therapy (CIMT).
Julie Desgagné
Julie Desgagné has been a special care counselor at Marie Enfant Rehabilitation Center (CRME) at the CHU Sainte-Justine for almost 20 years. She has extensive experience with children aged 0-17 with developmental issues, speech, and motor deficits.
Geoffroy Saussez
Dr Geoffroy Saussez graduated in Physiotherapy and Rehabilitation in 2015 and completed his studies with a Master in Motor Sciences at the Catholic University of Louvain, in Belgium. In 2021, he obtained his PhD at the Institute of Neurosciences (UCLouvain), focusing on the development and use of a virtual device designed to promote the application of the motor learning therapeutic ingredients in neurorehabilitation. Since September 2020, he is employed at the Haute Ecole Louvain en Hainaut (Montignies-sur-Sambre, Belgium) as a teacher and researcher in the department motor sciences. Dr Geoffroy Saussez also works with the Intensive Rehabilitation Foundation (IRF) for the organization and realization of HABIT-ILE camps, mainly in children with cerebral palsy. He also collaborates with the IRF for training on functional and intensive rehabilitation, such as HABIT-ILE.
Yannick Bleyenheuft
Dr Yannick Bleyenheuft is physiotherapist and Professor at the Institute of Neuroscience, UCLouvain, Belgium. She is Holder of the Chair for neurophysiological evidences in Intensive Neurorehabilitation (since 2014). Her research focuses on neuroplasticity and the development of new techniques to improve the motor function of children with neurological disorders. In this context, she notably developed HABIT-ILE (Hand and arm bimanual intensive training including lower extremities) and created the Motor Skill Learning and Intensive Neurorehabilitation lab. In addition to her research, Dr Bleyenheuft is involved in teaching neurorehabilitation in the physiotherapy cursus at the Faculty of Movement Sciences, UCLouvain, as well as intensive neurorehabilitation in continuing education. She is also involved in clinical practice, providing care to children with a wide range of neurological conditions. She is committed to improving the autonomy of children with disabilities and to transfer her theoretical and practical know-how in a patient-centered approach to care.
Danielle Levac
Dr Danielle Levac is a physiotherapist by training and an associate professor at the School of Rehabilitation in the Faculty of Medicine at the University of Montreal. She is a researcher at the CHU Sainte-Justine Research Center, where she is also the head of the musculoskeletal health, rehabilitation, and medical technologies research axis. Dr Levac directs the Laboratoire d‘innovations numériques, polytechniques et interactives en réadaptation pour enfants at the Technopole in pediatric rehabilitation at the Marie Enfant Children’s Rehabilitation Center, CHU Sainte-Justine. Her research focuses on the integration of virtual reality in pediatric rehabilitation.