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Feasibility of a task-specific training protocol associated with augmented reality (INTERACT protocol) in children with spastic cerebral palsy: perspectives from children and caregivers

Grant number: 23/09570-6
Support Opportunities:Scholarships in Brazil - Scientific Initiation
Effective date (Start): November 01, 2023
Effective date (End): October 31, 2024
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Nelci Adriana Cicuto Ferreira Rocha
Grantee:Henrique Granado Jábali
Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil


Introduction and Hypothesis: Interventions with task-specific training have high evidence when applied in children with cerebral palsy (CP), and are sometimes associated with enjoyable therapies, such as virtual and augmented reality (AR). Protocols of this combination of therapies are still being created and developed for children with CP. Nonetheless, few studies verified the feasibility of these treatments. Objective: The objective of this study is to verify the feasibility of the INTERACT protocol of treatment in children with CP in recruitment, assessment, intervention, and satisfaction, based on caregiver's and children's perspectives. Materials and Methods: Cross-sectional study with a convenience sample. Children from 6 to 12 years with Gross Motor Classification System (GMFCS) levels I and II, diagnosed with CP, and spastic tonus classification will be randomized into a group for INTERACT and conventional physiotherapeutic treatment. Both groups will last twelve weeks, 2 days a week, lasting 60 minutes. The INTERACT will comprise the acronym IN -Individual, T - Task-specific, E - Environmental enrichment, with augmented reality R - augmented reality, in and ACT - Active Training way. In the INTERACT group, children will play jigsaw AR games with different themes in the virtual environment while doing sit-to -stand or stepping up and down tasks in the real environment. Control group will receive intervention following the same frequency and duration, but will receive common motor interventions without using AR in the clinics where they usually go. Children will be assessed regarding their postural control (force plate and markerless kinematics with cameras) during sit-to-stand and functional reaching. The motor capacity will be assessed using the Challenge Test, the motor performance using the Pediatric Evaluation of Disability Inventory - Computer Adaptive Test (PEDI-CAT), and motivation (Dimensions of Mastery Questionnaire). The study will have four outcomes: (a) Recruitment Viability, following the rates: (i) recruitment rate, (ii) adherence rate (b) Assessment Viability, as: (i) adherence, (ii) adverse events, (iii) assessment duration, (iv) assessment comprehension, (v) assessment execution, (vi) previous technology knowledge; (c) Intervention Viability, as: (i) adherence, (ii) adverse events, (iii) intervention duration, (iv) comprehension of the intervention, (v) intervention execution (d) Satisfaction of children based on: (i) satisfaction with the protocol. Relevance: This feasibility study is important to predict if a treatment will be beneficial to the target population before submitting a great quantity of individuals in the experiment. Moreover, as being a low cost protocol, it will be an innovation in the CP research field.

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