Application of virtual reality-based sensorimotor intervention in motor skills for children with cerebral palsy

Riksma Nurahmi Rinalti Akhlan; Nita Nitiya Intan Tanbrin; Euis Heryati; Ranti Nur Fathiah; Destiyanti Wahyuni

doi:10.17509/jik.v22i2.76329

Abstract

This study explores virtual reality media's influence on improving children's walking ability with CP diplegia. Children with this condition often face challenges in daily mobility, which significantly impacts their quality of life. This study used a quantitative approach with a single-subject research method on one subject, selected from a population of 50 CP children using purposive random sampling. The research instruments included action tests and observations to measure gait ability and response to interventions. The results showed a significant improvement in walkability after the virtual reality intervention, compared to the pre- and post-intervention phases. Data analysis indicated that the technology effectively provided additional stimulus for developing motor skills and balance, significantly improving the Gross Motor Function Measure (GMFM) score. While the results are promising, the study highlights the need for further studies to measure the long-term impacts and address the challenges of accessibility, cost, and training in using these technologies. This research makes an essential contribution to the development of more effective and innovative rehabilitation interventions, offering great potential to improve the quality of life of children with CP diplegia.

Abstrak

Penelitian ini mengeksplorasi pengaruh penggunaan media virtual reality dalam meningkatkan kemampuan berjalan anak-anak dengan CP diplegia. Anak-anak dengan kondisi ini sering menghadapi tantangan dalam mobilitas sehari-hari, yang berdampak signifikan pada kualitas hidup mereka. Studi ini menggunakan pendekatan kuantitatif dengan metode single subject research pada satu subjek, dipilih dari populasi 50 anak CP menggunakan purposive random sampling. Instrumen penelitian meliputi tes perbuatan dan observasi untuk mengukur kemampuan berjalan dan respons terhadap intervensi. Hasil penelitian menunjukkan peningkatan signifikan dalam kemampuan berjalan setelah intervensi virtual reality, dibandingkan fase sebelum dan sesudah intervensi. Analisis data mengindikasikan bahwa teknologi ini efektif dalam memberikan stimulus tambahan bagi perkembangan keterampilan motorik dan keseimbangan, dengan peningkatan signifikan pada skor Gross Motor Function Measure (GMFM). Meskipun hasilnya menjanjikan, penelitian ini menyoroti perlunya studi lanjutan untuk mengukur dampak jangka panjang dan mengatasi tantangan aksesibilitas, biaya, serta pelatihan dalam penggunaan teknologi ini. Penelitian ini memberikan kontribusi penting dalam pengembangan intervensi rehabilitasi yang lebih efektif dan inovatif, menawarkan potensi besar untuk meningkatkan kualitas hidup anak-anak dengan CP diplegia.

Kata Kunci: bina gerak; cerebral palsy; intervensi sensorimotorik; virtual reality

Keywords:

cerebral palsy movement coaching sensorimotor intervention virtual reality

References

Airaksinen, M., Taylor, E., Gallen, A., Ilén, E., Saari, A., Sankilampi, U., Räsänen, O., Haataja, L. M., & Vanhatalo, S. (2023). Charting infants’ motor development at home using a wearable system: Validation and comparison to physical growth charts. EBioMedicine, 92(1), 1-12.

Alrashidi, M., Wadey, C. A., Tomlinson, R. J., Buckingham, G., & Williams, C. A. (2023). The efficacy of virtual reality interventions compared with conventional physiotherapy in improving the upper limb motor function of children with cerebral palsy: a systematic review of randomised controlled trials. Disability and Rehabilitation, 45(11), 1773-1783.

Al-Sowi, A. M., AlMasri, N., Hammo, B., & Al-Qwaqzeh, F. A.-Z. (2023). Cerebral palsy classification based on multi-feature analysis using machine learning. Informatics in Medicine Unlocked, 37(1), 1-2.

Anthes, C., García-Hernández, R. J., Wiedemann, M., & Kranzlmüller, D. (2016). State of the art of virtual reality technology. IEEE Aerospace Conference, 18(1), 1-19.

Ardini, R., & Safran, S. (2024). Pop-up book Putri Tujuh to improve the ability to read aloud. Inovasi Kurikulum, 21(4), 1955-1966.

Bell, J., Decker, B., Eichmann, A., Palkovich, C., & Reji, C. (2024). Effectiveness of virtual reality for upper extremity function and motor performance of children with cerebral palsy: A systematic review. The American Journal of Occupational Therapy, 78(2), 1-10.

Beveridge, L. A., Struthers, A. D., Khan, F., Jorde, R., Scragg, R., Macdonald, H. M., ... & d-pressure collaboration. (2015). Effect of vitamin D supplementation on blood pressure: A systematic review and meta-analysis incorporating individual patient data. Jama Internal Medicine, 175(5), 745-754.

Brien, M., Krishna, D., Ponnusamy, R., Cameron, C., Moineddin, R., & Coutinho, F. (2024). Motor development trajectories of children with cerebral palsy in a community-based early intervention program in rural South India. Research in Developmental Disabilities, 154(1), 1-12.

Buonocore, G., De Bernardo, G., De Falco, M., Menale, F., Giordano, M., & Lieto, A. Di. (2022). Perinatal ischemic stroke as a misunderstood cause of cerebral palsy: Literature review, future perspectives and forensic problems. Global Pediatrics, 29(1), 1-8.

Busboom, M., Corr, B., Reelfs, A., Trevarrow, M., Reelfs, H., Baker, S., Bergwell, H., Wilson, T. W., Moreau, N. G., & Kurz, M. J. (2022). Therapeutic lower extremity power training alters the sensorimotor cortical activity of individuals with cerebral palsy. Archives of Rehabilitation Research and Clinical Translation, 4(1), 1-9.

Chen, Y., Fanchiang, H. D., & Howard, A. (2018). Effectiveness of virtual reality in children with cerebral palsy: A systematic review and meta-analysis of randomized controlled trials. Physical Therapy, 98(1), 63-77.

Dabney, K. W., & Miller, F. (2012). Current approaches in cerebral palsy, a focus on gait problems: editorial comment. Clinical Orthopaedics and Related Research, 470(5), 1247-1248.

Degerstedt, F., Enberg, B., Ng, N., Keisu, B. I., & Björklund, M. (2025). Quality of life, physical activity, and social determinants in teenagers with cerebral palsy: A cross-sectional study in Sweden. Disability and Health Journal, 1(1), 1-7.

Diaz, J. H. (2020). Hypothesis: Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may increase the risk of severe COVID-19. Journal of Travel Medicine, 27(3), 1-2.

Flavián, C., Ibáñez-Sánchez, S., & Orús, C. (2019). The impact of virtual, augmented and mixed reality technologies on the customer experience. Journal of Business Research, 100(1), 547-560.

Garcia-Hernandez, N., Guzman-Alvarado, M., & Parra-Vega, V. (2021). Virtual body representation for rehabilitation influences on motor performance of cerebral palsy children. Virtual Reality, 25(3), 669-680.

Ghai, S., & Ghai, I. (2019). Virtual reality enhances gait in cerebral palsy: A training dose-response meta-analysis. Frontiers in Plant Science, 10(1), 236-245.

Gupta, R. (2001). Cerebral palsy: not always what it seems. Archives of Disease in Childhood, 85(5), 356-360.

Kavanagh, S., Luxton-Reilly, A., Wuensche, B., & Plimmer, B. (2017). A systematic review of virtual reality in education. Themes in Science and Technology Education, 10(2), 85-119.

Idris, M., Pramono, S. E., & Yulianto, A. (2025). The influence of using articulate storyline media on learning interest and results. Inovasi Kurikulum, 22(1), 235-248.

Iqbal, H. A. M., Zanudin, A., Sheng, H. W., Ahmad, M. A., & Nordin, N. A. M. (2024). Evaluating the effectiveness of virtual reality-based therapy as an adjunct to conventional rehabilitation in the management of adolescents with cerebral palsy: An intervention protocol. MethodsX, 13(1), 1-8.

Janzing, A. M., Eklund, E., De Koning, T. J., & Eggink, H. (2024). Clinical characteristics suggestive of a genetic cause in cerebral palsy: A systematic review. Pediatric Neurology, 153(1), 144-151.

Kilcioglu, S., Schiltz, B., Araneda, R., & Bleyenheuft, Y. (2023). Short- to long-term effects of virtual reality on motor skill learning in children with cerebral palsy: Systematic review and meta-analysis. JMIR Serious Games, 11(1), 1-10.

Kobesova, A., & Kolar, P. (2014). Developmental kinesiology: Three levels of motor control in the assessment and treatment of the motor system. Journal of Bodywork and Movement Therapies, 18(1), 23-33.

Kolezoi, A., Lepoura, A., Christakou, A., Chrysagis, N., Lalou, P., & Sakellari, V. (2025). The use of a virtual reality training system on gross motor function and balance in children with cerebral palsy: A multiple single-subject experimental report. Applied Sciences, 15(1), 443-457.

Komariah, M., Amirah, S., Abdurrahman, M. F., Handimulya, M. F. S., Platini, H., Maulana, S., Nugrahani, A. D., Mulyana, A. M., Qadous, S., Mediani, H. S., & Mago, A. (2024). Effectivity of virtual reality to improve balance, motor function, activities of daily living, and upper limb function in children with cerebral palsy: A systematic review and meta-analysis. Therapeutics and Clinical Risk Management, 20(1), 95-109.

Ladjar, Y. F. L., & Susanti, A. I. (2024). Effectiveness of technology in midwifery education for enhancing knowledge and clinical skills. Inovasi Kurikulum, 21(4), 1995-2008.

Lampropoulos, G., & Kinshuk. (2024). Virtual reality and gamification in education: A systematic review. Educational Technology Research and Development, 72(3), 1691-1785.

Lestari, S. (2018). Peran teknologi dalam pendidikan di era globalisasi. Edureligia: Jurnal Pendidikan Agama Islam, 2(2), 94-100.

Liu, C., Wang, X., Chen, R., & Zhang, J. (2022). The effects of virtual reality training on balance, gross motor function, and daily living ability in children with cerebral palsy: Systematic review and meta-analysis. JMIR Serious Games, 10(4), 1-32.

Lucas, B. R., Bowen, J., Morgan, C., Novak, I., Badawi, N., Elliott, E., Dwyer, G., Venkatesha, V., & Harvey, L. A. (2024). The best start trial: a randomised controlled trial of ultra-early parent-administered physiotherapy for infants at high risk of cerebral palsy or motor delay. Early Human Development, 198(1), 1-12.

McGrath, T. M., & Palmer, S. T. (2024). Integrated hip surveillance pathways for pain, function and quality of life in children with cerebral palsy: A systematic literature review. European Journal of Paediatric Neurology, 53(1), 166-173.

Mirzoev, T., Topp, S. M., Afifi, R. A., Fadlallah, R., Obi, F. A., & Gilson, L. (2022). Conceptual framework for systemic capacity strengthening for health policy and systems research. BMJ Global Health, 7(8), 1-7.

Monahan, T., McArdle, G., & Bertolotto, M. (2008). Virtual reality for collaborative e-learning. Computers & Education, 50(4), 1339-1353.

Mufti, A., Jain, S., Kochhar, K. P., Gulati, S., Wadhwa, S., Sikka, K., Saxena, R., & Alam, M. I. (2025). Primed low frequency repetitive transcranial magnetic stimulation rebalances cortical excitatory-inhibitory circuitry and improves functional outcomes in infantile cerebral palsy patients: A randomized controlled trial. Journal of Neurorestoratology, 13(1), 1-9.

Narayanan, U. G. (2015). Should children with cerebral palsy exercise?. Developmental Medicine & Child Neurology, 57(7), 597-598.

Ng, J. Y. Y., Jiang, S., Chan, C. H. S., & Ha, A. S. (2025). Assessing fundamental movement skills using the Test of Gross Motor Development (TGMD): Challenges and solutions to comparability and standardization. Sports Medicine and Health Science, 7(4), 299-301.

Nossa, R., Gagliardi, C., Panzeri, D., Diella, E., Maghini, C., Genova, C., Turconi, A. C., & Biffi, E. (2022). Could an immersive virtual reality training improve navigation skills in children with cerebral palsy? A pilot controlled study. Journal of Clinical Medicine, 11(20), 1-9.

Oskoui, M., Majnemer, A., Dagenais, L., & Shevell, M. I. (2013). The relationship between gross motor function and manual ability in cerebral palsy. Journal of Child Neurology, 28(12), 1646-1652.

Romero, B., Hoque, P., Robinson, K. G., Lee, S. K., Sinha, T., Panda, A., Shrader, M. W., Parashar, V., Akins, R. E., & Batish, M. (2024). The circular RNA circNFIX regulates MEF2C expression in muscle satellite cells in spastic cerebral palsy. Journal of Biological Chemistry, 300(12), 1-18.

Roostaei, M., Babaee, M., Alavian, S., Jafari, N., Rayegani, S. M., & Behzadipour, S. (2023). Effects of a multi-component virtual reality program on motor skills and functional postural control in children with hemiplegic cerebral palsy. Heliyon, 9(9), 1-10.

Salma, Y., & Fatmawati, F. (2019). Metode Drill dalam meningkatkan keterampilan membuat tas makrame untuk anak tunarungu di SLB Bina Bangsa. Golden Age: Jurnal Ilmiah Tumbuh Kembang Anak Usia Dini, 4(3), 27-34.

Sandran, N. G., Badawi, N., Gecz, J., & van Eyk, C. L. (2024). Cerebral palsy as a childhood-onset neurological disorder caused by both genetic and environmental factors. Seminars in Fetal and Neonatal Medicine, 29(2), 1-9.

Sharma, P., Gupta, M., & Kalra, R. (2023). Recent advancements in interventions for cerebral palsy - A review. Journal of Neurorestoratology, 11(3), 1-10.

Sharova, O., Smiyan, O., & Borén, T. (2021). Immunological effects of cerebral palsy and rehabilitation exercises in children. Brain, Behavior, and Immunity - Health, 18(1), 1-8.

Tobaiqi, M. A., Albadawi, E. A., Fadlalmola, H. A., & Albadrani, M. S. (2023). Application of virtual reality-assisted exergaming on the rehabilitation of children with cerebral palsy: A systematic review and meta-analysis. Journal of Clinical Medicine, 12(22), 1-32.

Todrani, M. (2022). Les recommandations de bonne pratique de la haute autorité de santé apportent un nouveau souffle à la paralysie cérébrale, mais quelles réponses apportent-elles aux familles?. Motricité Cérébrale, 43(2), 72-74.

Ulya, A., Muqtadiroh, F. A., & Muklason, A. (2021). Identifikasi faktor resistansi guru terhadap teknologi sebagai pendukung pembelajaran di Pondok Pesantren Salaf. Jurnal Nasional Teknologi dan Sistem Informasi, 7(1), 18-26.

Vilhelmsson, A., Rylander, L., Jöud, A., Lindh, C. H., Mattsson, K., Liew, Z., Guo, P., Ritz, B., Källén, K., & Thacher, J. D. (2023). Exposure to per- and polyfluoroalkyl substances in early pregnancy and risk of cerebral palsy in children. Science of The Total Environment, 899(1), 1-8.

Wahyu, E. (2013). Jarog Dance for children with special needs: Case study in the celebration of the international dance day in Surakarta. Harmonia: Journal of Arts Research and Education, 13(2), 100-109.

Wijnhoud, E. J., Bos, A. M. M. E., Buizer, A. I., & Beckerman, H. (2024). Aerobic fitness in children with cerebral palsy compared to typically developing peers: A systematic review and meta-analysis. Brazilian Journal of Physical Therapy, 28(6), 1-10.

Yosafat, F. (2024). Mengatasi gangguan motorik gerak dengan alat bantu (orthosis) dan layanan bina gerak (terapi fisik). Grab Kids: Journal of Special Education Need, 4(1), 1-9.