A Virtual Reality Application for the Rehabilitation of Children with Cerebral Palsy
Resumo
The development of virtual environments to support rehabilitation for various diseases and special needs has gained significant attention in recent years. These environments offer numerous advantages for patients and healthcare professionals, including increased motivation and engagement among patients and the possibility of objective and personalized monitoring of the rehabilitation process for professionals. These benefits become even more relevant when the target audience is children, considering the difficulties related to concentration and understanding of the situation by such young patients, as well as the psychological and emotional burden that clinical environments often impose on minors. This paper presents the development and evaluation of an immersive VR application designed to support physical therapy in pediatric patients. Built in collaboration with physiotherapists, the system employs a “slideshow” metaphor to guide children through interactive narratives within a tropical forest environment. The solution prioritizes simplicity of use for professionals and engagement for young users while enabling therapists to observe and stimulate cervical and cognitive functions. Initial testing with children aged 3 to 17 revealed positive responses, particularly in cervical movement stimulation and interaction quality, although cognitive abilities significantly influenced engagement. The results demonstrate the potential of VR as an effective and adaptable therapeutic aid, paving the way for future expansions, allowing flexible creation of different narratives, and also targeting other diverse neuropsychomotor conditions.
Palavras-chave:
Virtual Reality, Rehabilitation, Physical Therapy, Cerebral Palsy
Referências
Ministerio da Saude. Diretrizes de atencao a pessoa com paralisia cerebral. Brasilia: Ministerio da Saude, 2014.
A. V. Prieto, F. C. da Silva, R. da Silva, J. A. T. Santos, and P. J. B. Gutierres Filho. A equoterapia na reabilitacao de individuos com paralisia cerebral: uma revisao sistematica de ensaios clinicos. Cadernos Brasileiros de Terapia Ocupacional, 26(1), 2018.
L. P. S. Santos and P. P. Martins. A intervencao da fisioterapia na paralisia cerebral. Revista Interdisciplinar Pensamento Cientifico, 6(3), 2020.
R. D. S. Dias, I. L. A. Sampaio, and L. S. Taddeo. Fisioterapia x wii: a introducao do ludico no processo de reabilitacao de pacientes em tratamento fisioterapico. Brazilian Symposium on Games and Digital Entertainment, 8, 2009, 34–37.
K. E. Laver, B. Lange, S. George, J. E. Deutsch, G. Saposnik, and M. Crotty. Virtual reality for stroke rehabilitation. Cochrane Database of Systematic Reviews, 11, 2017.
D. K. Ravi, N. Kumar, and P. Singhi. Effectiveness of virtual reality rehabilitation for children and adolescents with cerebral palsy: An updated evidence-based systematic review. Physiotherapy, 103(3), 245–258, 2017.
R. Tori, C. Kirner, and R. Siscoutto. Fundamentos e Tecnologia de Realidade Virtual e Aumentada. Editora SBC, 2006.
T. Baranowski, F. Blumberg, R. Buday, A. DeSmet, L. E. Fiellin, C. S. Green, P. M. Kato, A. S. Lu, A. E. Maloney, R. Mellecker et al. Games for health for children—current status and needed research. Games for Health Journal, 5(1), 1–12, 2016.
E. A. Keshner and P. L. Weiss. Virtual reality in physical rehabilitation: A new step to return to function. Journal of Neurologic Physical Therapy, 43(1), 1–2, 2019.
A. F. Brandao, M. P. Guimaraes, D. R. Dias, and J. R. Brega. Virtual and augmented reality for neurofunctional recovery and human movement analysis. Simposio de Realidade Virtual e Aumentada (SVR), SBC, 2022, 38–40.
J. F. O. Araujo, E. H. Ribeiro, M. P. Guimaraes, J. R. F. Brega, A. F. Brandao, and D. R. C. Dias. Immersive brain puzzle: A virtual reality application aimed at the rehabilitation of post-stroke patients. 16th Iberian Conference on Information Systems and Technologies (CISTI), IEEE, 2021, 1–6.
D. Strickland. Virtual reality for the treatment of autism. Virtual Reality in Neuro-Psycho-Physiology, 1997, 81–86.
R. S. Cavalcante, E. A. L. Junior, A. Cardoso, A. Soares, and G. M. de Lima. Development of a serious game for rehabilitation of upper limb amputees. 20th Symposium on Virtual and Augmented Reality (SVR), IEEE, 2018, 99–105.
C. Bryanton, J. Bosse, M. Brien, J. McLean, A. McCormick, and H. Sveistrup. Feasibility, motivation, and selective motor control: Virtual reality compared to conventional home exercise in children with cerebral palsy. CyberPsychology & Behavior, 9(2), 123–128, 2006.
E. W. Johnson. Visual analog scale (VAS). American Journal of Physical Medicine & Rehabilitation, 80(10), 717, 2001.
P. L. T. Weiss, E. Tirosh, and D. Fehlings. Role of virtual reality for cerebral palsy management. Journal of Child Neurology, 29(8), 1119–1124, 2014.
S. M. Glegg and D. Levac. Virtual reality for pediatric rehabilitation: A scoping review. Developmental Neurorehabilitation, 22(2), 129–146, 2019.
J. F. Thayer and G. J. Siegle. Neurovisceral integration in cardiac and emotional regulation. IEEE Engineering in Medicine and Biology Magazine, 21(4), 24–29, 2002.
R. W. Levenson. Blood, sweat, and fears: The autonomic architecture of emotion. Annals of the New York Academy of Sciences, 1000(1), 348–366, 2003.
J. Wentzel, A. Luz, M. E. Mott, and D. Vogel. Motionblocks: Modular geometric motion remapping for more accessible upper body movement in virtual reality. Proceedings of the 2025 CHI Conference on Human Factors in Computing Systems, 2025, 1–16.
H. Zhou, T. Kip, Y. Dong, A. Bianchi, Z. Sarsenbayeva, and A. Withana. Juggling extra limbs: Identifying control strategies for supernumerary multi-arms in virtual reality. Proceedings of the 2025 CHI Conference on Human Factors in Computing Systems, 2025, 1–16.
Q. Jin, S. Kawas, S. Arora, Y. Yuan, and S. Yarosh. Is your family ready for VR? Ethical concerns and considerations in children’s VR usage. Proceedings of the 23rd Annual ACM Interaction Design and Children Conference, 2024, 436–454.
H.-T. Jung, T. Park, N. Mahyar, S. Park, T. Ryu, Y. Kim, and S. I. Lee. Rehabilitation games in real-world clinical settings: Practices, challenges, and opportunities. ACM Transactions on Computer-Human Interaction (TOCHI), 27(6), 1–43, 2020.
T. W. Malone. Toward a theory of intrinsically motivating instruction. Cognitive Science, 5(4), 333–369, 1981.
R. S. S. Kramer and J. Y. Prior. Colour associations in children and adults. Quarterly Journal of Experimental Psychology, 72(8), 1977–1983, 2019.
P. Cipresso, I. A. C. Giglioli, M. A. Raya, and G. Riva. The past, present, and future of virtual and augmented reality research: A network and cluster analysis of the literature. Frontiers in Psychology, 9, 2086, 2018.
J. Byun and C. S. Loh. Audial engagement: Effects of game sound on learner engagement in digital game-based learning environments. Computers in Human Behavior, 46, 129–138, 2015.
R. J. Palisano, P. Rosenbaum, D. Bartlett, and M. H. Livingston. Gross motor function classification system: Expanded and revised. Developmental Medicine & Child Neurology, 50(10), 744–750, 2008.
K. R. Lohse, C. G. Hilderman, K. L. Cheung, S. Tatla, and H. F. M. Van der Loos. Virtual reality therapy for adults post-stroke: A systematic review and meta-analysis exploring virtual environments and commercial games in therapy. PLoS ONE, 9(3), e93318, 2014.
A. V. Prieto, F. C. da Silva, R. da Silva, J. A. T. Santos, and P. J. B. Gutierres Filho. A equoterapia na reabilitacao de individuos com paralisia cerebral: uma revisao sistematica de ensaios clinicos. Cadernos Brasileiros de Terapia Ocupacional, 26(1), 2018.
L. P. S. Santos and P. P. Martins. A intervencao da fisioterapia na paralisia cerebral. Revista Interdisciplinar Pensamento Cientifico, 6(3), 2020.
R. D. S. Dias, I. L. A. Sampaio, and L. S. Taddeo. Fisioterapia x wii: a introducao do ludico no processo de reabilitacao de pacientes em tratamento fisioterapico. Brazilian Symposium on Games and Digital Entertainment, 8, 2009, 34–37.
K. E. Laver, B. Lange, S. George, J. E. Deutsch, G. Saposnik, and M. Crotty. Virtual reality for stroke rehabilitation. Cochrane Database of Systematic Reviews, 11, 2017.
D. K. Ravi, N. Kumar, and P. Singhi. Effectiveness of virtual reality rehabilitation for children and adolescents with cerebral palsy: An updated evidence-based systematic review. Physiotherapy, 103(3), 245–258, 2017.
R. Tori, C. Kirner, and R. Siscoutto. Fundamentos e Tecnologia de Realidade Virtual e Aumentada. Editora SBC, 2006.
T. Baranowski, F. Blumberg, R. Buday, A. DeSmet, L. E. Fiellin, C. S. Green, P. M. Kato, A. S. Lu, A. E. Maloney, R. Mellecker et al. Games for health for children—current status and needed research. Games for Health Journal, 5(1), 1–12, 2016.
E. A. Keshner and P. L. Weiss. Virtual reality in physical rehabilitation: A new step to return to function. Journal of Neurologic Physical Therapy, 43(1), 1–2, 2019.
A. F. Brandao, M. P. Guimaraes, D. R. Dias, and J. R. Brega. Virtual and augmented reality for neurofunctional recovery and human movement analysis. Simposio de Realidade Virtual e Aumentada (SVR), SBC, 2022, 38–40.
J. F. O. Araujo, E. H. Ribeiro, M. P. Guimaraes, J. R. F. Brega, A. F. Brandao, and D. R. C. Dias. Immersive brain puzzle: A virtual reality application aimed at the rehabilitation of post-stroke patients. 16th Iberian Conference on Information Systems and Technologies (CISTI), IEEE, 2021, 1–6.
D. Strickland. Virtual reality for the treatment of autism. Virtual Reality in Neuro-Psycho-Physiology, 1997, 81–86.
R. S. Cavalcante, E. A. L. Junior, A. Cardoso, A. Soares, and G. M. de Lima. Development of a serious game for rehabilitation of upper limb amputees. 20th Symposium on Virtual and Augmented Reality (SVR), IEEE, 2018, 99–105.
C. Bryanton, J. Bosse, M. Brien, J. McLean, A. McCormick, and H. Sveistrup. Feasibility, motivation, and selective motor control: Virtual reality compared to conventional home exercise in children with cerebral palsy. CyberPsychology & Behavior, 9(2), 123–128, 2006.
E. W. Johnson. Visual analog scale (VAS). American Journal of Physical Medicine & Rehabilitation, 80(10), 717, 2001.
P. L. T. Weiss, E. Tirosh, and D. Fehlings. Role of virtual reality for cerebral palsy management. Journal of Child Neurology, 29(8), 1119–1124, 2014.
S. M. Glegg and D. Levac. Virtual reality for pediatric rehabilitation: A scoping review. Developmental Neurorehabilitation, 22(2), 129–146, 2019.
J. F. Thayer and G. J. Siegle. Neurovisceral integration in cardiac and emotional regulation. IEEE Engineering in Medicine and Biology Magazine, 21(4), 24–29, 2002.
R. W. Levenson. Blood, sweat, and fears: The autonomic architecture of emotion. Annals of the New York Academy of Sciences, 1000(1), 348–366, 2003.
J. Wentzel, A. Luz, M. E. Mott, and D. Vogel. Motionblocks: Modular geometric motion remapping for more accessible upper body movement in virtual reality. Proceedings of the 2025 CHI Conference on Human Factors in Computing Systems, 2025, 1–16.
H. Zhou, T. Kip, Y. Dong, A. Bianchi, Z. Sarsenbayeva, and A. Withana. Juggling extra limbs: Identifying control strategies for supernumerary multi-arms in virtual reality. Proceedings of the 2025 CHI Conference on Human Factors in Computing Systems, 2025, 1–16.
Q. Jin, S. Kawas, S. Arora, Y. Yuan, and S. Yarosh. Is your family ready for VR? Ethical concerns and considerations in children’s VR usage. Proceedings of the 23rd Annual ACM Interaction Design and Children Conference, 2024, 436–454.
H.-T. Jung, T. Park, N. Mahyar, S. Park, T. Ryu, Y. Kim, and S. I. Lee. Rehabilitation games in real-world clinical settings: Practices, challenges, and opportunities. ACM Transactions on Computer-Human Interaction (TOCHI), 27(6), 1–43, 2020.
T. W. Malone. Toward a theory of intrinsically motivating instruction. Cognitive Science, 5(4), 333–369, 1981.
R. S. S. Kramer and J. Y. Prior. Colour associations in children and adults. Quarterly Journal of Experimental Psychology, 72(8), 1977–1983, 2019.
P. Cipresso, I. A. C. Giglioli, M. A. Raya, and G. Riva. The past, present, and future of virtual and augmented reality research: A network and cluster analysis of the literature. Frontiers in Psychology, 9, 2086, 2018.
J. Byun and C. S. Loh. Audial engagement: Effects of game sound on learner engagement in digital game-based learning environments. Computers in Human Behavior, 46, 129–138, 2015.
R. J. Palisano, P. Rosenbaum, D. Bartlett, and M. H. Livingston. Gross motor function classification system: Expanded and revised. Developmental Medicine & Child Neurology, 50(10), 744–750, 2008.
K. R. Lohse, C. G. Hilderman, K. L. Cheung, S. Tatla, and H. F. M. Van der Loos. Virtual reality therapy for adults post-stroke: A systematic review and meta-analysis exploring virtual environments and commercial games in therapy. PLoS ONE, 9(3), e93318, 2014.
Publicado
30/09/2025
Como Citar
MENDES, Diego Caracas; RODRIGUES, Edson Coelho; FARIAS, Emanuel Bandeira; BARBOSA, Ícaro; GOMES, George A. M.; CAVALCANTE NETO, Joaquim Bento; VIDAL, Creto Augusto; LEITE JUNIOR, Antonio J. M..
A Virtual Reality Application for the Rehabilitation of Children with Cerebral Palsy. In: SIMPÓSIO DE REALIDADE VIRTUAL E AUMENTADA (SVR), 27. , 2025, Salvador/BA.
Anais [...].
Porto Alegre: Sociedade Brasileira de Computação,
2025
.
p. 484-493.
