Augmented Biofeedback Training with Physical Therapy Improves Visual-Motor Integration, Visual Perception, and Motor Coordination in Children with Spastic Hemiplegic Cerebral Palsy: A Randomised Control Trial

Abstract

Aim: The aim of this study is to investigate the efficacy of combining augmented biofeedback training and standard therapy for improving visual-motor integration (VMI), visual perception (VP), and motor coordination (MC) in children with spastic cerebral palsy (CP).

Methods: Participants were 45 children, 5–8 years of age, with spastic hemiplegic CP. They were randomized into three groups: group A followed a 3-month specially designed program physical therapy intervention to facilitate VMI and VP. Group B received augmented biofeedback training. Group C received augmented biofeedback training and the physical therapy program provided to group A. The treatment sessions lasted 60 min, three times a week for three months. The Beery-Buktenica Developmental Test of VMI and its supplemental tests were used to evaluate the children before and after the program.

Results: After a 3-month treatment, standard scores and age equivalent scores for VMI, VP, and MC were significantly higher in group C compared with group A.

Conclusion: The combination of augmented biofeedback and physical therapy could be used to improve VMI, VP, and MC in children with spastic hemiplegic CP.

Keywords:

• Augmented biofeedback
• cerebral palsy
• hemiplegia
• Saudi children
• visual-motor integration
• visual perception

Acknowledgments

The completion of this study would not have been possible without the children and their parents who volunteered to participate. The authors would like to thank the therapists, administration and all staff members of the Disabled Children’s Association in Riyadh who helped and offered the location to perform this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Deanship of Scientific Research at Princess Nourah bint Abdulrahman University under grant no. 205-S-37.

Notes on contributors

Reem M. Alwhaibi

Reem M. Alwhaibi, Associate professor of pediatric physical therapy. Dean of preparatory year and supervisor of foundation year of health colleges. Got a Bachelor's degree in Physical Therapy from King Saud University, Riyadh, Saudi Arabia, Master's degree in Rehabilitation from Pittsburgh University, and PhD in Pediatric physical therapy from Newcastle-upon-tyne in 2019.

Reham S. Alsakhawi

Dr Reem has held many administrative and academic positions, translated 3 books, co-author 1 book, has two inventions and has 10 published articles. Dr Reham S. Alsakhswi, Assistant professor at college of health and rehabilitation sciences at Princess Nourah University. She got her bachelor degree in 2001, and her master in 2007, her PhD in 2012 all from Cairo University, college of physical therapy. She has 18 years teaching and clinical experience in pediatric physical therapy.

Safaa M. ElKholi

Dr Safaa M. Elkholi, Assistant professor in pediatric physical therapy, college of health and rehabilitation sciences at Princess Nourah University. She got her bachelor degree in 1999, and her master degree in 2006, and her PhD in 2011 all from college of physical therapy, Cairo University. She has 20 years of teaching and clinical experience in pediatric physical therapy. Currently she is the head of community services unit at college of health and rehabilitation sciences at Princess Nourah University.