Virtual reality therapy simulates real life learning incorporating increased sensory input by the use of technology. Interaction with the 3D technology gives the participant feedback and corrections when performing activities with the computerized scenario.[1] Virtual reality is one of the most up-and-coming, promising modalities for rehabilitation. It has been used to increase impairments in stroke, traumatic brain injuries, cerebral palsy, and many more disorders. Several different modes of virtual reality are being used such as the X-box Kinect, Ipad, and the Nintendo Wii. Most research has been centered around the Nintendo Wii or Wii-Fit and has been deemed by some as “Wii habilitation.” [2] The Wii specifically is a computerized program that uses a hand held, wireless remote that is sensitive to the actions of the user and mimics their motions. [2] These therapies have been used to improve a number of different impairments.

What is Virtual Reality Therapy

Down Syndrome

Articles and References

• Significant improvements in balance and postural control [2]

• Improve neural plasticity• Increases motor proficiency [1]

• Visual-integrative abilities [1]

• Increased sensory integrative functions (i.e. sensory organizing) [1]

• Increased gross and fine motor function [1]

• Increased wayfinding behavior (cognitive mapping), sequencing abilities, and planning alternative strategies [2,3]

• Improvements in somatosensory control/ coordination between limbs and vision [2]

• Increased visuo-spatial short-term memory [3]

References

1. Wuang Y, Chiang C, Su C, Wang C. Effectiveness of virtual reality using Wii gaming technology in children with Down Syndrome. Research in Developmental Disabilities, 2011; 32: 312-321.

2. Rahman S. Efficacy of Virtual Reality-Based Therapy on Balance in Children with Down Syndrome. World Applied Sciences Journal. 2010; 10 (3): 254-261.

3. Courbois Y, Farran E, Lemahieu A, Blades M, Mengue-Topio H, Sockeel P. Wayfinding behavior in Down Syndrome: A study with virtual environments. Research in Developmental Disabilities. 2013; 34: 1825-1831.

4. Connolly B, Morgan S, Russell F, Fulliton W. A Longitudinal Study of Children with Down Syndrome Who Experienced Early Intervention Programming. Physical Therapy . 1993; 73:170-179.

5. Uyanik M, Bumin G, Kayihan H. Comparison of different therapy approaches in children with Down Syndrome. Pediatrics International. 2003; 45: 68-73.

Bellarmine University DPT Program

• Chromosomal anomaly in which an individual is born with an additional chromosome (21).[1]

• It is one of the leading causes of intellectual and developmental disabilities. [2]

• Research suggests that early intervention may be appropriate to increase cognition, adaptability and motor function presently and long term. [4]

• Research also suggests that multisensory stimulation may be indicated for individuals with down syndrome. They illustrate best outcomes with combined sensory integrative, vestibular stimulation and neurodevelopmental therapies. [5]

• Typical physical presentation • ligamentous laxity, • hypotonia, • decreased strength, • increased hip abduction and external rotation,• shoulder girdle instability. [2]

• Typical sensorimotor deficits are decreases in • balance, • protective responses, • and muscle movement therefore demonstrating a wide base of support

in different positions of sitting and standing. [2]

Trisha Counce, Student Physical TherapistVirtual Reality Therapy in Children with Down Syndrome

Benefits of Virtual Reality TherapyIn Children with DS

Conclusions

Virtual reality therapy holds promising outcomes in improving the impairments and limitations that are present in children with down syndrome. Due to its more recent integration as a treatment, there is limited evidence in order for a clinician to make a definite decision. Despite the limitations, research has been performed that analyzes the effectiveness of virtual reality compared to standard therapy for down syndrome. These studies have found significantly furthered improvements and benefits in balance, sensorimotor, musculoskeletal, and neuromuscular impairments in children with DS when compared to the control group. In addition this research illustrates the clinical importance of incorporating virtual therapy into your standard plan of care for children with DS. Overall, virtual reality intervention can lead to various increased benefits when used in conjunction with standard physical therapy for patients with down syndrome.

Figure 1. Tight Rope Walk game [2]

Figure 2. Penguin Slide game [2]