Virtual Reality for Motor Rehabilitation of Children with Down Syndrome: Systematic Review

Abstract
Background: Down syndrome is one of the most common genetic causes of developmental delays. Virtual reality is an innovative tool of rehabilitation based on computer technology. It has been applied in the rehabilitation of many developmental areas.
Aim of Study: To systematically review the available studies on the effect of virtual reality in motor rehabilitation of children with Down syndrome.
Patients and Methods: An electronic search was made in Cochrane (CENTRAL), Pedro, PubMed (MEDLINE), Google scholar and TRIP databases from July 2017 to July 2018, in addition to manual search in reference lists of the included studies. The inclusion criteria were: Published studies of any design which investigatethe effect of virtual reality on motor rehabilitation of children with Down syndrome, reviews studies were excluded. The outcome measures were: Balance, sensorimotor functions, coordination, strength andagility.Two independent reviewers assessed the methodological quality and extracted data from the included studies. Score differences were discussed between the two reviewers and disagreements were revealed by consultation with a third author until con-sensus was reached.
Results: A total number of 30 records, 7 of them were duplicated, 19 of them were excluded after screened the title and abstract. Only 4 articles met the inclusion criteria; 2 were randomized controlled trials, one was quasi-experimental study and one was case report. One study fulfills the criteria of high methodological quality; two studies were of moderate quality and one of weak quality. Descriptive analysis was performed as data extracted from the included studies heter-ogeneous.
Conclusion: Despite the few number of studies found and the heterogeneity present between its characteristics, the methodological quality of the included study gave moderate evidence regarding the effectiveness of virtual reality in motor rehabilitation of children with Down syndrome. Further well designed randomized controlled trials on the effectiveness of virtual reality on children with Down syndrome are necessary.