The effectiveness of an individualised and adaptive game-based rehabilitation, iVision, on visual perception in cerebral visual impairment: A triple-blind randomised controlled trial

Background: Cerebral visual impairment (CVI) can negatively affect a child's functioning, emphasising the need for interventions to improve visual perception (VP), potentially translating into improved health-related quality of life (HRQOL).

Aims: Assessing the effectiveness of an adaptive individualised game-based rehabilitation, iVision, on VP, visual function, functional vision, and HRQOL.

Methods and procedures: Seventy-three children with CVI (3-12 performance age) were randomised into the adaptive individualised or the non-adaptive non-individualised group (3 sessions/week; 12 weeks). Primary outcome was change score (post-intervention - pre-intervention) of the lowest VP dimension. Key secondary outcomes included change score (post-intervention - pre-intervention) of visual function (reaction time to fixation in a preferential looking eye-tracking paradigm), functional vision (success rate in the adapted virtual toy box paradigm; total Flemish CVI questionnaire score), HRQOL (total scale score of the paediatric quality of life inventory 4.0 child self-report), and the lowest VP dimension change score (short-term follow-up - pre-intervention).

Outcomes and results: Both groups significantly improved on the primary outcome, maintaining at short-term. Between-group differences were not significant. No significant effect was found for other key secondary outcomes. Exploratory analyses revealed VP dimension improvements and clinically meaningful HRQOL improvements.

Conclusions and implications: Although children with CVI improved their VP and to some extent HRQOL, no differences were found between the groups.