Search

Virtual reality (VR)-based therapy has demonstrated potential in enhancing upper and lower limb functions, postural control, and balance. Despite its growing use, evidence regarding its impact on physical function and quality of life (QoL) in individuals with cerebral palsy (CP) remains scarce. This study protocol outlines a randomized controlled trial (RCT) designed to evaluate the efficacy of VR-based therapy as an adjunct to conventional therapy on physical function and QoL in adolescents with CP, as well as to explore the perceptions of participants and their caregivers regarding the intervention. This RCT will include 56 adolescents with CP, aged 10-17 years, who will be randomly assigned in a 1:1 ratio to either the intervention group (VR-based therapy) or the control group. Both groups will receive their usual conventional therapy, equated between groups. Additionally, the intervention group will receive VR therapy using the Xbox 360 Kinect, delivered twice weekly in 45- to 60-minute sessions for 12 weeks. Outcome measures will include the Gross Motor Function Measure-88, the 6-Minute Walk Test, handheld dynamometry, and the Paediatric Quality of Life Inventory. Assessments will be conducted at baseline, mid-intervention (week 6), and post-intervention (week 12). Qualitative data will be collected through semi-structured interviews with participants and caregivers after the 12-week program. Statistical analyses will be conducted on an intention-to-treat basis. Repeated measures ANOVA will be used to evaluate changes in physical function and QoL over time at baseline, mid- and post-intervention. The qualitative data from interviews will be analyzed using thematic analysis to identify key themes related to the experiences and perceptions of caregivers and participants.

BackgroundSpinal cord injury (SCI) is a devastating condition that often leads to significant impairments in physical function, leading to disability and mental health disorders. Hence, understanding the prevalence of SCI and the relationship between physical activity and mental health in individuals with SCI is crucial for informing rehabilitation strategies and optimizing outcomes. ObjectiveThis study aims to comprehensively analyze existing research on the link between physical activity and mental health and identify the level of physical activity and mental health status, the barriers to physical activity, and SCI’s impacts on psychological well-being in individuals with SCI. MethodsAn electronic search strategy will be used to identify prevalence studies published since 1993 in health-related databases such as PubMed, MEDLINE, COCHRANE Library, and Wiley Library using the following query: “Spinal Cord Injury” OR “Paraplegia” OR “Tetraplegia” AND “Physical Activity” OR “Exercise” AND “Mental Health” OR “Mental Illness” OR “Mental Disorder.” Bibliographies of primary studies and review articles meeting the inclusion criteria will be searched manually to identify further eligible studies. The risk of bias in the included studies will be appraised using the Joanna Briggs Institute checklist for prevalence studies by 2 review authors. Any disagreement will be resolved by reaching a consensus. ResultsFunding was received in October 2023, data collection will commence in July 2024, and the results are expected by 2025. We will summarize the selection of the eligible studies using a flowchart. The data from the studies will be extracted and tabulated. This scoping review will be published in a peer-reviewed journal in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. ConclusionsThis scoping review underscores the complex relationship between physical activity and mental health among individuals with SCI, highlighting the level of physical activity and mental health status, barriers to physical activity engagement, and psychological implications. Understanding these dynamics is crucial in devising tailored interventions aimed at enhancing mental well-being. This synthesis of evidence emphasizes the need for personalized strategies to promote physical activity, addressing unique challenges faced by this population to foster improved mental health outcomes and overall quality of life. Trial RegistrationOpen Science Framework osf.io/ugx7d; https://osf.io/ugx7d/ International Registered Report Identifier (IRRID)PRR1-10.2196/56081

IntroductionParkinson disease (PD), a neurodegenerative disorder that progresses over time, is steadily growing in number and prevalence worldwide. PD in Malaysia is expected to increase five-fold by 2040 from the existing estimate of 20,000 patients in 2018. Treatment program of PD in Malaysia is rather unstructured, and there is no known comprehensive PD family caregiver training program available to date. To ensure the quality of a program, it must be tested for feasibility, effectiveness and sustainability. This paper describes the protocol of a study that evaluates the effectiveness of a structured, comprehensive training program of family caregiver to persons with PD in comparison to usual care.Materials and methods–study protocolA total of 60 pairs of persons with PD of stage II and III, and their primary family caregiver will be recruited and allocated into either an experimental or a control group for 12 weeks of intervention. The experimental group will undergo initial training from multi-disciplinary healthcare providers and will be given a physical module containing weekly tasks that must be practised at home. While the control group will receive a usual care. Both groups will be assessed in terms of physical functions, functional mobility, quality of life (QoL), caregiver burden and knowledge using standardised assessment tools namely Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Timed Up and Go (TUG) test, Parkinson's Disease Questionnaire (PDQ-39), European Quality of Life five-dimensions (EQ-5D), Malay version of Zarit Burden Interview (MZBI) and Knowledge of Parkinson Disease Questionnaire (KPDQ). In addition, the feasibility and sustainability of the interventions will be evaluated, alongside its cost-effectiveness based on the average and incremental cost effectiveness ratio. All data will be analysed using descriptive and inferential statistics, particularly mixed model ANOVA.DiscussionThere is a significant gap in the literature pertaining family caregiver training programs for people with PD. Documented programs are lacking in term of comprehensiveness of content, application approach and the measurement of training outcomes including the program cost-effectiveness. The feasibility and effectiveness of such training program in a Malaysian setting also requires investigation due to differences in living environment, support system and population's perception. This study will assist to fulfil the existing literature gap and demonstrate the potential benefit of caregiver involvement in mediating the care and therapy for PD in the home setting. Optimum knowledge and skills gained through the training are expected to enhance the confidence and ability of the family caregivers and may possibly reduce their perceived caregiving burden.Protocol registrationThe protocol of this study is registered in the Australian-New Zealand Clinical Trial Registry (ANZCTR) with a registration number ACTRN12623000336684.