Effect of Immersive Virtual Reality-Based Dual-Task Training on Cognitive Function and Functional Mobility in Ambulatory Children with Pediatric Neurological Disorders
Authors
Institute of Physiotherapy, Srinivas University (India)
Institute of Physiotherapy, Srinivas University (India)
Article Information
DOI: 10.51584/IJRIAS.2026.11080141
Subject Category: Paediatrics
Volume/Issue: 11/8 | Page No: 1860-1866
Publication Timeline
Submitted: 2026-09-04
Accepted: 2026-09-09
Published: 2026-09-18
Abstract
Immersive virtual reality (IVR) is increasingly being explored in pediatric neurorehabilitation because it provides an interactive and controllable environment in which motor and cognitive demands can be manipulated simultaneously. Children with pediatric neurological disorders may experience limitations in executive functions, attention, visuospatial processing, postural control, gait and functional mobility. Conventional rehabilitation often trains these domains separately, whereas everyday activities require children to walk, balance, navigate obstacles and make decisions while attending to competing cognitive demands. Dual-task training (DTT) therefore offers a clinically relevant approach to reducing cognitive-motor interference. This literature review examines the rationale for combining IVR with DTT in ambulatory children with pediatric neurological disorders, with particular emphasis on cerebral palsy. A structured narrative search of PubMed/MEDLINE, Scopus, Web of Science, PEDro and Google Scholar was considered for peer-reviewed literature addressing pediatric neurological rehabilitation, virtual reality, immersive virtual reality, dual-task performance, executive function, gait, balance and functional mobility. Current evidence indicates that VR can improve balance, gross motor function and gait-related outcomes in children with cerebral palsy, while dual-task studies demonstrate that concurrent cognitive demands can reduce gait and postural performance. Recent evidence also suggests that DTT may improve balance, gross motor function and functional mobility. However, direct evidence specifically evaluating IVR-based DTT on both cognitive function and functional mobility remains limited. Future adequately powered trials should use standardized cognitive and mobility outcomes, individualized task progression and longer follow-up.
Keywords
Immersive virtual reality; Dual-task training; Cognitive function
Downloads
References
1. Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007;109:8-14. [Google Scholar] [Crossref]
2. Novak I, Morgan C, Adde L, Blackman J, Boyd RN, Brunstrom-Hernandez J, et al. Early, accurate diagnosis and early intervention in cerebral palsy: advances in diagnosis and treatment. JAMA Pediatr. 2017;171(9):897-907. [Google Scholar] [Crossref]
3. Novak I, McIntyre S, Morgan C, Campbell L, Dark L, Morton N, et al. A systematic review of interventions for children with cerebral palsy: state of the evidence. Dev Med Child Neurol. 2013;55(10):885-910. [Google Scholar] [Crossref]
4. Rathinam C, Mohan V, Peirson J, Skinner J. A systematic review of the effectiveness of virtual reality in the rehabilitation of children with cerebral palsy. Pediatr Phys Ther. 2014;26(3):334-345. [Google Scholar] [Crossref]
5. Ravi DK, Kumar N, Singhi P. Effectiveness of virtual reality rehabilitation for children and adolescents with cerebral palsy: an updated evidence-based systematic review. Physiotherapy. 2017;103(3):245-258. [Google Scholar] [Crossref]
6. Warnier N, Lambregts S, Van De Port I. Effect of virtual reality therapy on balance and walking in children with cerebral palsy: a systematic review. Dev Neurorehabil. 2020;23(8):502-518. doi:10.1080/17518423.2019.1683907. [Google Scholar] [Crossref]
7. Liu C, Wang X, Chen R, Zhang J. The effects of virtual reality training on balance, gross motor function, and daily living ability in children with cerebral palsy: systematic review and meta-analysis. JMIR Serious Games. 2022;10(4):e38972. doi:10.2196/38972. [Google Scholar] [Crossref]
8. Liu H, Hu Y, Li J, Chang Y. Effect of virtual reality on balance function in children with cerebral palsy: a systematic review and meta-analysis. Front Pediatr. 2022;10:864490. [Google Scholar] [Crossref]
9. Pazzaglia C, Imbriani C, Gatti A, et al. The role of immersive virtual reality interventions in pediatric cerebral palsy: a systematic review across motor and cognitive domains. Brain Sci. 2024;14(5):490. doi:10.3390/brainsci14050490. [Google Scholar] [Crossref]
10. Gagliardi C, Turconi AC, Biffi E, Maghini C, Marelli A, Cesareo A, et al. Immersive virtual reality to improve walking abilities in cerebral palsy: a pilot study. Ann Biomed Eng. 2018;46(9):1376-1384. [Google Scholar] [Crossref]
11. Carcreff L, Fluss J, Allali G, Valenza N, Aminian K, Newman CJ, et al. The effects of dual tasks on gait in children with cerebral palsy. Gait Posture. 2019;70:148-155. doi:10.1016/j.gaitpost.2019.02.014. [Google Scholar] [Crossref]
12. Ghai S, Ghai I, Effenberg AO. The effect of dual-task conditions on gait and balance performance in children with cerebral palsy: a systematic review and meta-analysis of observational studies. J Bodyw Mov Ther. 2021;26:448-462. doi:10.1016/j.jbmt.2020.12.011. [Google Scholar] [Crossref]
13. Meskers CGM, et al. Effects of dual tasking on postural and gait performances in children with cerebral palsy and healthy children. Gait Posture. 2019;74:43-49. [Google Scholar] [Crossref]
14. Peng B, Sun Q. Effects of dual-task training on gross motor function, balance, and gait in children with cerebral palsy: a systematic review and meta-analysis. Front Neurol. 2026;17:1769434. doi:10.3389/fneur.2026.1769434. [Google Scholar] [Crossref]
15. Büğüşan Oruç S, Elbasan B. Efficacy of dual task training for children with cerebral palsy: a randomized controlled trial. BMC Pediatr. 2026;26. doi:10.1186/s12887-026-07492-0. [Google Scholar] [Crossref]
16. de Melo G, et al. Effectivity of virtual reality to improve balance, motor function, activities of daily living, and upper limb function in children with cerebral palsy: a systematic review and meta-analysis. Children (Basel). 2024;11. [Google Scholar] [Crossref]
17. Chen YP, Lee SY, Howard AM. Effect of virtual reality on upper extremity function in children with cerebral palsy: a meta-analysis. Pediatr Phys Ther. 2014;26(3):289-300. [Google Scholar] [Crossref]
18. Holden MK. Virtual environments for motor rehabilitation: review. Cyberpsychol Behav. 2005;8(3):187-211. [Google Scholar] [Crossref]
19. Shumway-Cook A, Woollacott MH. Motor Control: Translating Research into Clinical Practice. 6th ed. Philadelphia: Wolters Kluwer; 2021. [Google Scholar] [Crossref]
20. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, DC: American Psychiatric Association Publishing; 2022. [Google Scholar] [Crossref]