EFFECTIVENESS OF COMPUTER SIMULATION ON POSTURAL BALANCE IN CEREBRAL PALSY.- A SYSTEMIC REVIEW.

There is scarcity of literature stating the effective rehabilitation program to treat postural balance issues in CP. So this review was under taken to rule out the difference in the effectiveness of computer simulation and other rehabilitation or physical therapy interventions on postural balance in cerebral palsy children studied over the last 05 years. Goals-We set out to gain an overview of the evidence from randomized controlled trials on the improvement of postural balance in cerebral palsy children. A further aim was to estimate the relative efficacy of the various interventions, taking effect modifiers into account. All RCTs of parallel-group design and randomised crossover studies that compared computer simulations with other interventions were included. We combined comparable interventions and approaches into treatment categories. To refine the search strategy, we used filters like RCT’s articles for last 05 years, articles published in English language and articles with paediatric balance scale as a primary outcome to measure postural balance were included. Studies with no treatment focused on balance component, more than two computer simulation given at once, exoskeleton devices used without computer feedback system, control group deprived of and treatment. For risk of bias PEDRO scale was used Qualitative Synthesis For studies that did not provide sufficient quantitative data for the meta-analysis, the qualitative synthesis highlighted consistent improvements in postural balance due to computer simulation interventions. These interventions were generally well- received by participants, with few adverse effects reported.  Sensitivity Analysis-Sensitivity analyses excluding lower-quality studies confirmed the robustness of the findings, with minimal change in pooled effect sizes. This indicates the reliability and consistency of the results. Overall Effectiveness- The collective results from the included studies demonstrate that computer simulation interventions significantly improve postural balance in children with cerebral palsy. The pooled effect size of 0.85 indicates a large and clinically meaningful impact, highlighting the potential of these innovative rehabilitation tools. Intervention Types -Virtual Reality (VR), Gaming Balance Boards) Personalized Balance Games. The subgroup analysis revealed that younger children (ages 5-8) showed slightly larger improvements compared to older children. This suggests that early intervention might be more beneficial in enhancing postural balance, possibly due to greater neuroplasticity at a younger age. Quality of Studies The inclusion criteria ensured that only high-quality studies (PEDro score ≥ 6) were considered. The developed pedal switches can assist children with CP in training ankle dorsiflexion.