systematic evaluation of the effect of rehabilitation of

Research ArticleSystematic Evaluation of the Effect of Rehabilitation of LowerLimb Function in Children with Cerebral Palsy Based on VirtualReality Technology

Chao Gao Yongli Wu Junting Liu Runhan Zhang and Manting Zhao

Cangzhou Central Hospital Cangzhou 061000 Hebei China

Correspondence should be addressed to Yongli Wu wuyonglistucpueducn

Received 30 December 2020 Revised 29 January 2021 Accepted 20 February 2021 Published 9 March 2021

Academic Editor Zhihan Lv

Copyright copy 2021 Chao Gao et al +is is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited

As times go by peoplersquos standard of living is constantly improving but the medical pressure exerted by children with cerebralpalsy is also increasing and the recovery of lower limb function in children with cerebral palsy after treatment has also gets peoplersquosattention Of course the relevant medical equipment is constantly improving especially the appearance of virtual realitytechnology which has played an extremely important role in restoring the lower extremities of children with cerebral palsy Inorder to study the role that virtual reality technology can play in children with cerebral palsy this article collects relevantinformation builds a case template and uses comprehensive quantification by investigating patients examining relevantdocuments and interviewing professionals With qualitative analysis a damage assessment matrix is created Experimental resultsprove that the use of virtual reality technology can improve the treatment efficiency of children with cerebral palsy by more than30 In terms of the rehabilitation effect of childrenrsquos lower limb function virtual reality technology is more targeted for thetreatment of children with far-reaching effects It is much higher than traditional treatment methods and the mobility of thechildrenrsquos lower limbs is restored by more than 80 +is shows that virtual reality technology can play an important role in therehabilitation of the lower limbs of children with cerebral palsy

1 Introduction

With the continuous improvement of my countryrsquos medicalservice system the rehabilitation of lower limb function inchildren with cerebral palsy has received more and moreattention [1] Sport rehabilitation is an important sector ofmedical rehabilitation and the most widely accepted work inthe social security system In the process of continuousimprovement of restoration services the restoration in-dustry based on virtual reality technology is moving towardsproduction industrialization and individualisation Virtualreality technology provides a great help for the rehabilitationof patients [2] Virtual reality technology can be traced backto the late 1980s It is a kind of comprehensivemanufacturing technology that has subverted the traditionalmanufacturing process and has a brand-new thinking modethat has gradually emerged since then It is based on software

technology machining technology and special processingtechnology micromolecular science and electrical andelectronic technology as its foundation Virtual realitytechnology is a revolution to traditional manufacturingtechnology and provides a new platform for its development[3] Compared with the traditional manufacturing tech-nology in the past virtual reality technology can not onlyrealize ldquofrom scratchrdquo and save a lot of time and labor [4] butalso carry out ldquopersonalized manufacturingrdquo to make theproduct unique At present the medical industry is generallyconcerned about virtual reality technology It has achievedgood results in the experimental demonstration of newproduct development rapid mold making and direct pro-duction of small batches of special complex parts bioen-gineering applications and the development of newmaterials [5] +is technology can quickly deliver abstractand complex ideas in design innovation It can be

HindawiJournal of Healthcare EngineeringVolume 2021 Article ID 6625604 11 pageshttpsdoiorg10115520216625604

constructed in a way to save materials and reduce energyconsumption It can use graphical or animated drawings toexpress the rapid process of manufacturing individualproducts and to show people in the future its tendency thesearch for differentiated and individualised products It canbe used in the form of graphical cases to show the functionsand functions of integrated design and optimised design andconstruction [6] +ere are also many domestic and foreignresearch studies on the role of virtual reality technology inthe rehabilitation of lower limb function of children withcerebral palsy

In order to evaluate the effect of virtual reality tech-nology on the rehabilitation of upper and lower limbs ofstroke patients Yang Yujie used computers to search majordatabases such as HowNet and Wanfang to research therelated literature and to systematically analyze literature datausing computer software He concluded that virtual realitytechnology has a significant effect on the rehabilitation ofupper limbs of stroke patients but it is not obvious for therehabilitation of patientsrsquo lower limbs [7] Cheng Xiuyananalyzed the application of virtual reality technology inmedical treatment especially in stroke patients and the useof virtual reality technology can allow patients to bettermaintain their recovery function It has designed experi-ments on the clinical data of the hospital in recent years andperformed virtual reality technology treatments on patientsfor several weeks Comparing the parameters of these skillswith patients undergoing traditional treatment methods it isconcluded that virtual reality technology can effectivelyimprove the patientrsquos lower extremity balance and is con-ducive to patient rehabilitation [8] Xu Lei in order toevaluate the impact of virtual reality technology on patientswith cerebral palsy created a three-dimensional gait analysissystem divided patients into groups and performed dif-ferent treatments on patients [9] After a certain treatmenttime the patientrsquos stride length stride frequency and otherimportant indicators for cerebral palsy patients are testedExperimental results prove that virtual reality technologyhas a good effect on the patientrsquos walking ability [10] +esestudies have improved the relevant reference role for thisarticle However due to insufficient samples of these studiestoo much emphasis on theories and unreasonable practicalschemes the research has too many variables and theconclusions are unconvincing

+is article analyzes the advantages and disadvantagesof the previous research and then proposes a model of therehabilitation efficacy of lower limb function in childrenwith cerebral palsy based on virtual reality technology+is article mainly describes the basic characteristics ofthe impairment of the ability of the lower limbs in chil-dren with cerebral palsy and the composition is describedin four aspects grid individual definition status andaction definition and interaction between individuals +esystem objectively assessed the clinical relevance of re-storing the function of the lower limbs in children withcerebral palsy explained the damage of children withcerebral palsy in patients and verified the role of virtualreality technology in the treatment of children with ce-rebral palsy

2 Rehabilitation Treatment Methods of LowerLimb Function in Children withCerebral Palsy

21 Virtual Reality Technology +e continuous develop-ment of virtual reality technology has deepened the con-notation of virtual practice In essence the practice of virtualreality technology is still transforming things in objectivereality into digital image symbols through photoelectric andother means and then expressing them in virtual space comeout [11] However difference from the usual virtual practiceis that the practice in virtual reality makes the practicesubject completely immersed in a virtual environment thatcan get real feelings and through sophisticated sensingtechnology people can obtain vision hearing touch andsmell that are the same as reality And the comprehensivefeeling of kinesthesia and then the motion tracker of variousparts of the human body will feedback the subjectrsquos feedbackinto the virtual space and cyclically interact [12]

Virtual reality technology has brought about changes inhuman working life entertainment and practical methodsAt the same time it also caused social problems such asexcessive leniency health effects violence and value ori-entation and the development of the field of philosophy wasborn +e traditional philosophy of technology tends tostudy the various social effects of technology but at the sametime the development of technology will also have an impacton the philosophy system Affected by virtual reality tech-nology branches of philosophical fields such as artificialintelligence philosophy virtual reality philosophy and ar-tificial life philosophy continue to appear +e philosophicalissues generated by virtual reality technology involve manyfields such as practical theory media theory epistemologyethics and sociology Its unique technical characteristics andpractical methods have produced different depths of utilityin multiple disciplines [13]

+e characteristics of virtual reality technology makephilosophers pay more attention to some traditional phil-osophical theories such as the study of ontology andthinking about the nature of the world Some brand-newphilosophical ideas have emerged at the historic moment Inview of the technical characteristics of virtual reality that canconstruct a brand-new virtual environment some scholarshave put forward the idea that ldquocomputingrdquo is the essence ofthe world For example the American philosopher Steinhartproposed digital metaphysics Zhai Zhenming a philosophyprofessor at Sun Yat-sen University in my country proposeda new ethics ldquoworld-making ethicsrdquo and so on Facing thecontinuous innovation of technology philosophical think-ing cannot stop but should lead and correct the newtechnology [14]

Since the advent of the Internet virtual practice hasattracted much attention+rough virtual practice mankindhas broken through material production practice socialpractice and scientific practice expanded the scope ofpractice increased the objects of knowledge and improvedthe practical ability +e development of virtual realitytechnology has added new vitality to virtual practice If

2 Journal of Healthcare Engineering

virtual practice is a practice that creates possibilities thenvirtual reality practice is a practice that transforms anypossibility into reality In the virtual environment anycondition becomes controllable and human beings are nolonger restricted by physiological natural and social factorsand get rid of the shackles of material conditions [15] +edigital symbols with bits as the unit abstract the originalconcrete things In reality the function of things is separatedfrom the material carrier of the thing and its function can beused alone anytime and anywhere without being restrictedby the material carrier +is is no exception for peopleVirtual reality pulls human senses and consciousness out ofthe body realizing truly beyond the limitations of time andspace For the application of virtual reality technology inmedical treatment we generally adopt the followingformula

x(k + 1) Ix(k) + Jv(k) k 1 2 (1)

+e quadratic performance indicators are as follows

K 1113944infin

k1x

i(k)Jx(k) + r

i(k)cJ1113960 1113961 (2)

where the weighting matrix Q is

Q 1

2a2r

minus 12b2

a2rminus1 p minus t1113888 1113889

minus 1

a2r

minus 1t2

+ 2 1 minus b2

1113872 1113873t1113960 1113961

Q 1

2a2r

minus 12b2

a2rminus1 t minus L1113888 1113889

minus 1

a2r

minus 1L2

+ 2 1 minus a2

1113872 1113873L1113960 1113961

(3)

Bring in the parameters and weighting matrix Q to get

2b2

a2r

minus1Ix minus t1113888 1113889Q 12

t2

+1 minus b

2

a2r

minus1 t (4)

Available through formula

Q2

+2 1 + b

21113872 1113873

a2r

minus1 Q +1 + b

21113872 1113873

2

a2r

minus11113872 1113873

2 Ix Q + t +1 minus b2

a2rminus1 Ix1113888 1113889

2

(5)

Virtual reality plays a huge role in military educationmedical treatment retail etc by virtue of its advantagesbeyond the limitations of time and space and physicalconditions technology is constantly advancing and virtualreality and reality are constantly merging +e continuousexploration of virtual reality will give mankind more gainsand progress+e highest level of virtual reality technology isto achieve human-machine symbiosis Humans can use self-awareness to directly control machines or complete actionsAt this time virtual reality can be an independent cyber-space or it can be a reality that is completely integrated withreality In the context the equipment can be head-mountedglasses or microimplanted chips When the human-com-puter interaction interface changes from a variety of two-dimensional static and abstract graphical user interfaces tovirtual reality three-dimensional dynamic and intuitivenatural interfaces the degree of human-computer

interaction is greatly improved and a new human-computerharmonious relationship will emerge as the times requireAnd this new human-computer relationship is also animportant direction of our scientific and technological de-velopment and the continuous prominence of the humansubject status to achieve the ultimate goal of virtual realitytechnology to meet the needs of all aspects of humans [16]

22 Rehabilitation Treatment of Cerebral Palsy in ChildrenCerebral palsy refers to the immature brain of the fetus orinfancy caused by various reasons resulting in movementdisorders postural disorders and some children withmentalretardation +e introduction of rehabilitation in China hasnot been long and various technologies are not very matureGenerally speaking training is aimed at the increase ofmuscle strength and the decrease of tension in childrenChildren with cerebral palsy need to recover for a longertime and have a slower ability to solve daily life Lower limbdysfunction usually leads to uncoordinated movementspoor balance ability and step abnormal state increased riskof falling etc About 13 to 12 of hemiplegic patients stillhave independent walking disorder after 3months which isone of the main reasons that affect the ability of daily livingof hemiplegic patients +is article consults relevant infor-mation and combines the training concept of Lekangclassrooms in the cityrsquos rehabilitation center introducesvirtual reality technology trains patients and combines thetwo to seek a more effective rehabilitation treatment methodfor children with cerebral palsy [17]

Abnormal body posture activity and imperfect motorfunction are the core manifestations of cerebral palsy andchildren with cerebral palsy have a certain degree of de-velopmental lag in physical posture and motor function dueto different degrees of disease If you want to understand thedegree of cerebral palsy in children with cerebral palsy it isnecessary to formulate a set of objective and scientificevaluation methods and evaluation standards [18]

At present sports rehabilitation is generally used torehabilitate children with cerebral palsy +e main aim is totrain children with functional tasks so that children withcerebral palsy can adapt to changes in the environment andskills learning in the training process can be used in real life+emain characteristics of the task-oriented training modelfirst according to the age of the child the degree of dys-function and the goals that the family members want toachieve a group of 4ndash6 people is used as a unit throughgroup training collective learning and motivation of chil-dren Inducing the ability to imitate and compete with eachother so that children can actively challenge difficultiesachieve interaction between individuals and other peopleand promote the normal development of personality [19]second the focus is to emphasize the initiative of childrenwith cerebral palsy Exercise rather than passive or pureauxiliary activities active learning can achieve greaterprogress and sense of accomplishment which is one of themanifestations of normal character development +e task-oriented training mode has the characteristics of intentionand rhythm Intentionalization means that in the training

Journal of Healthcare Engineering 3

process it is necessary to master the content of the trainingthat the child can complete +e language of the rehabili-tation therapist makes it conscious By guiding the child tobetter understand the therapistrsquos intentions he can completethe action more easily Rhythm strengthening is mainly tostrengthen the sense of rhythm in children which is of greatsignificance to the improvement of childrenrsquos motor func-tion and plays an important role in task-oriented training+rough intentional and rhythmic completion of training ithelps children with cerebral palsy to quickly restore normalmotor function [20] shown in Figure 1

For children to perform task-oriented training theguidance of the rehabilitation therapist is the key He mustbe familiar with the decomposition of an action and be ableto tell the children simply and clearly so that the childrencan understand and imitate+is training is not a procedureit is to practice a motor skill as an activity Rehabilitationtherapists need to analyze the movements One movementmay be broken down into several steps so that the child canperform it step by step and finally combine it [21] +e one-to-many training model of task-oriented training also solvesthe current problem of more children and fewer rehabili-tation therapists and appropriately reduces the pressure onrehabilitation therapists so that they can face their patientsin a better state to achieve twice the result with half the efforteffect +e work feature of task-oriented training is tomobilize all resources and abilities that can be mobilized notfor symptoms but to achieve goals +ese goals are deter-mined by social needs Task-oriented training can allowchildren to learn comprehensively not simply to traincertain muscle strength and reduce the tension of a certainmuscle but to learn how to complete an action a task suchas walking and transferring objects Use a task-orientedtraining system to promote the personality development ofchildren and master the ability of daily learning and life [22]In the process of motor learning for children with cerebralpalsy the rehabilitation therapist should explain to thechildren what they are learning and what their effects are+is can help the children rebuild their brain activities andintegrate their movements into their daily lives +e externalbehavior of children with cerebral palsy can also be im-proved [23]

23 Rehabilitation Effect Template Motor function evalua-tion plays an important role in the rehabilitation of childrenwith cerebral palsy On the one hand the evaluation resultscan reflect the degree of motor dysfunction in children inreal time On the other hand it can also assist in clinicaldiagnosis and guide the formulation of personalized reha-bilitation training programs At present clinically motorfunction scales are mainly used to evaluate childrenrsquos motorfunction and rehabilitation training effects but the currentpart of the assessment lacks quantitative evaluation stan-dards and the evaluation results mainly rely on the doctorrsquosexperience and subjective feelings [24 25] Rehabilitation

treatment is the main means to reduce the disability rateimprove the quality of life of patients and help patientsreturn to their families and society Recently some newrehabilitation treatment methods have been gradually ap-plied in clinical applications such as robot-assisted tech-nology virtual reality technology electromyographybiofeedback therapy weight loss walking training and re-petitive transcranial magnetic stimulation which haveachieved good results In this paper virtual reality tech-nology is used to parameterize the patientrsquos disease pre-vention and then transmit it to the data model +e datamodule receives the needs of users finds suitable resourcesthrough resource evaluation performs tasks and completesuser requests

In the current medical environment and actual reha-bilitation treatment how to understand and transform theexpectations and needs of users more comprehensively andhow to adapt the form structure and function of products tomeet the needs of users is the current focus Taking intoaccount the resources with the same service function theattributes of the resources are set according to user pref-erences and have certain scalability [26] calculated asfollows

Ua plowast bj

ilowast c + y minus 1113944

m

m1t (6)

In order to calculate the weight of patient attributes andensure the objectivity of the evaluation results we use theentropy weight method to determine the entropy value andentropy weight of each resource attribute [27]

t 1

ln x1113944

1

n1fnm lowast ln fnm

r 1 minus 1113936

xn1 znm

y minus 1113936mm1 t

fmn znm rnmminusuqm( )

1113936xn1 znm

1113944

x

m1wm 1

(7)

Set objective weights for each user attribute

d

1113944

x

m1wn lowast rnm minus uqm( 1113857

2

11139741113972

wn 1

1 + d rn uq( 1113857

(8)

From this the matching value Q can be obtained

Qδ rn d cos rn uq( 11138571113868111386811138681113868

1113868111386811138681113868ge δ1113966 1113967 (9)


Calculate the similarity between the resources in thematching resource setQ and the resources requested by the user

cos m(r uq) αlowast cos(r uq) +(1 minus α)lowast1m

1113944

m

n1δij (10)

+e simulation parameters are calculated as follows

F 1113936 qrprpn minus qrpm1113872 1113873 ququqn minus quq1113872 1113873

1113936nn1 qr minus quq1113872 1113873

2

1113936 ququqm minus quq1113872 11138732

1113970 (11)

3 Virtual Reality Technology in theRehabilitation of Lower Limb Function ofChildren with Cerebral Palsy

31ExperimentalPurpose +rough the follow-up investigationof the patients it was learned whether the pathology of childrenwith cerebral palsy and after treatment whether the effect ofrehabilitation of the lower limb function of children with cerebralpalsywas effectively controlled andwhether the control effectwasobvious To study the clinical characteristics and imaging ofchildren with cerebral palsy summarize and analyze the clinicalcharacteristics treatment and prognosis of children with cerebralpalsy and provide reference basis for the early diagnosis earlytreatment and prognosis of children with cerebral palsy

32 Experimental Analysis Objects By collecting the clinicaldata of children diagnosed with cerebral palsy in the inpatientdepartment of the Childrenrsquos Hospital of this province (genderage at diagnosis or diagnosis clinical symptoms and signs atadmission auxiliary examinations include seven respiratoryvirus antigen tests T lymphocyte subgroup tests and allergies)routine examinations were performed on these children in-cluding fiberoptic bronchoscopy BALF cytology counts lungfunction tests and lung CT examinations In addition theywere followed up through telephone consultation and outpa-tient clinics Perform a retrospective analysis of the collecteddata

33 Data Sources +e data in this article are mainly derivedfrom the clinical data of the inpatient diagnosis of theChildrenrsquos Hospital of the province from 2015 to 2019 as

well as the statistics of on-site understanding of patients andtelephone interviews After that the statistical data areclassified and analyzed and simulated by computer softwareWe conducted investigations on doctors and patients andasked them to evaluate the effectiveness of the rehabilitationof lower limb function in children with cerebral palsy basedon virtual reality technology +e evaluation method wasbased on the entropy method and comprehensive quanti-tative and qualitative analysis

+e entropy method is a relatively objective evaluationindex weight assignment method which can effectivelyavoid the subjectivity of artificial scoring and has high ac-curacy However at the same time this study also realizesthat the entropy method has the defect that it cannot directlyreflect the knowledge opinions and empirical judgments ofexperts and scholars and the weighted results obtained maybe contrary to reality +erefore this article uses a combi-nation of analytic hierarchy process and entropy method todetermine the weight coefficient of each evaluation index ofregional higher education

Quantitative analysis is to analyze the data of the problemusing the intuition and clear essence of mathematics to reflectthe existence of the problem qualitative is to collect readorganize and systematically relate the theoretical results ofrelevant domestic and foreign research documents Somestandards cannot be directly analyzed in a quantitative way butcan only be evaluated using a qualitative analysis method +eassessment standard system is constructed using a combinationof quantitative and qualitative analysis methods and formulasrelated to standard calculations are also given

4 Experimental Analysis of Rehabilitation ofLower Limb Function in Children withCerebral Palsy

41 Changes in Children with Cerebral Palsy in Recent YearsWe made relevant statistics on all children with cerebralpalsy who had been admitted to the hospital from 2010 to2019 in five hospitals in the province and discussed the trendof changes in children with cerebral palsy in the province+e specific data are shown in Table 1

From Figure 2 we can see that the number of childrenwith cerebral palsy in our province has shown an upward

Treatment of children

Grouping Active movement Training intention

Figure 1 Principles of physical education teaching


trend and then a downward trend It was at the peak of thenumber of children in 2014 and 2015 but with the continuousimprovement of medical technology in recent years thenumber of children is declining year by year We conductedrelated surveys on hospital doctors and hospital medicalrecords and conducted relevant statistics on the treatment ofthese children +e specific data are shown in Table 2

It can be seen from Figure 3 that with the change of timethe number of cured children has increased year by year andthe percentage of cured children has increased from less than60 in 2010 to about 75 +ere may be some factors thatthe sample size is too small However as a whole the level ofmedical care and technology is constantly rising and thelevel of medical technology and doctors is constantly rising+e cure rate of children with cerebral palsy is increasingyear by year

42 Age of Children with Cerebral Palsy We have classifiedthe age of children with cerebral palsy in order to facilitatethe classification and formulation of later treatment plansand facilitate rehabilitation treatment +e specific data areshown in Table 3

From Figure 4 we can see that among the childrenadmitted to the hospital there are children of all ages but theage of the main children is between 3 and 10 years old

reaching about 60 which shows the treatment of childrenwith cerebral palsy At this time wemust pay attention to themethods and methods of treatment and rehabilitation andfully consider the acceptance level of children of this age toachieve better treatment results

43 Changes before and after Treatment in Children withCerebral Palsy We treat the children and compare theirphysical functions before and after treatment such as upperand lower limb functions living ability and balance makestatistics and use templates to digitize them for easycomparison +e values before treatment are shown inTable 4

From Figure 5 we can see that the parameters of childrenwith cerebral palsy are very low before treatment the upperand lower limb function is averaged at about 05 and theliving ability and balance do not exceed 05 At themaximumwalking speed of 10m it is also far behind a normal childwhose walking speed of 10 meters is about 6 seconds Inorder to facilitate comparison we have made statistics onvarious parameters of children who have undergone tra-ditional treatment +e specific data are shown in Table 5

From Figure 6 we can see that after the traditionaltreatment the physical function indicators of children withcerebral palsy have improved significantly For example in

Table 1 Changes in the number of children

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019First hospital 23 25 19 23 18 19 21 22 21 19First Affiliated Hospital 20 18 21 19 21 24 22 26 23 17Provincial University Hospital 19 23 24 25 20 21 20 22 16 18City Peoplersquos Hospital 20 23 24 27 24 21 19 17 18 16Provincial Hospital 21 24 25 26 29 27 23 21 21 18

2325

19

23

18 1921 22 21

1920

23 24

27

24

2119

17 1816

21

24 25 26

2927

2321 21

18

0

5

10

15

20

25

30

35

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Num

ber o

f chi

ldre

n

Years

First Affiliated HospitalCity Peoplersquos Hospital

First hospitalProvincial University HospitalProvincial Hospital

Figure 2 Changes in the child


12

1413

17

12

16 16

1819

16

11

1314

17

10

1516

17

9

13

11

14

12

1413

17

1516

13

15

5430 5660 5840

6670

5350

68707140

75 7370 75

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

0

2

4

6

8

10

12

14

16

18

20

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Cure

rate

()

Num

ber o

f peo

ple c

ured

Years


First Affiliated HospitalCity Peoplersquos HospitalCure rate

Figure 3 Cure of children in recent years

Table 3 Age of child

0ndash2 3ndash6 7ndash10 11ndash12 13ndash15First hospital 3 5 2 4 7First Affiliated Hospital 2 4 3 3 6Provincial University Hospital 1 6 4 5 7City Peoplersquos Hospital 4 9 11 2 5Provincial Hospital 6 3 5 9 4

City Peoplersquos HospitalFirst Affiliated Hospital

First hospitalProvincial HospitalProvincial UniversityHospital

3

5

2

4

7

4

9

11

2

56

3

5

9

4

2

43 3

6

1

6

45

7

ndash2

0

2

4

6

8

10

12

14

Num

ber o

f chi

ld


Table 2 Number of children cured



the function of the upper and lower limbs after the treat-ment the functions of the upper and lower limbs of thechildren are equally divided It can reach about 058 and thebalance ability is also about 06 which has reached a goodlevel and the time for the child to walk at the maximumspeed of 10m has also been reduced reaching about 45 Forthe children based on virtual reality technology we alsoconducted 8 weeks of treatment under the virtual tech-nology and statistics on their various parameters as shownin Table 6

From Figure 7 we can see that after 8 weeks of virtualreality technology and treatment the data of the child haveincreased a lot compared with the traditional treatment Interms of upper and lower limb function the average scorecan reach more than 06 In terms of balance the score isabout 07 and in terms of childrenrsquos exercise it has basicallyreached the level of ordinary people which shows that withthe cooperation of virtual reality technology the lower limbexercise ability of children with cerebral palsy can basicallybe restored

043 049 044 052 059

041 046 053 058 062037 035 051

051061047 038

047044

058

034048 039 047 049

577612

672621 634

0

1

2

3

4

5

6

7

8

0

05

1

15

2

25

3

Firsthospital

First AffiliatedHospital

ProvincialUniversityHospital

City PeoplersquosHospital

ProvincialHospital

Wal

king

spee

d

Child

par

amet

ers

Different hospitals

Upper limb abilityDaily lifeFunctional walking classification

Lower limb functionBalance10m maximum walking speed (s)


Table 5 Parameters of children after traditional treatment

Upper limb ability Lower limbfunction Daily life Balance Functional walking

classification10m maximumwalking speed (s)

First hospital 052 058 051 056 052 447First Affiliated Hospital 059 062 054 061 058 434Provincial University Hospital 069 064 068 064 066 421City Peoplersquos Hospital 075 078 075 076 074 459Provincial Hospital 079 076 081 073 069 473

Table 4 Value before treatment

Upper limbability Lower limb function Daily life Balance Functional walking




Table 6 Virtual reality treatment of children

Upper limb ability Lower limb function Daily life Balance Functional walkingclassification

10m maximumwalking speed (s)


065 062069 074

087

058

067 065

075 078

062 061068

077082

068 067074

067

086

069 072078

072

089

357

334

342

349

373

3

31

32

33

34

35

36

37

38

39

0

01

02

03

04

05

06

07

08

09

1

First hospital First AffiliatedHospital



ProvincialHospital

Functional walking classificationLower limb functionBalance

Upper limb abilityDaily life10m maximum walking speed (s)

Figure 7 Parameters after virtual reality technology treatment

052

059

069

075

079

058

062

064

078

076

051

054

068

075

081

056

061

064

076

073

052

058

066

074

069

447

434

421

459

473

0 02 04 06 08 1




ProvincialHospital

Hospital

Functional walking classificationBalance

Daily lifeLower limb function

Figure 6 Children after treatment


5 Conclusions

+e traditional treatment of children with cerebral palsymainly relies on one-on-one training by the therapist +etherapistrsquos work intensity is high and the physical strengthrequirements of the therapist are high It is difficult to ensurethe continuity and stability of the training the level of thetherapist has a greater impact on the rehabilitation treatmenteffect+e overall professional quality level of the therapist isrelatively high Rehabilitation training requires one or morerehabilitation therapists to perform rehabilitation trainingfor the patient However it is difficult for each therapist toachieve the same method and strength In the rehabilitationtraining for the patient no objective effect evaluation can beobtained professional venues and equipment are required+erefore conventional rehabilitation treatment not onlyconsumes a lot of manpower and time but the training effectcannot be guaranteed

+ere are large differences in the line function statustreatment duration treatment frequency duration trainingactions and forms of the existing children with cerebralpalsy Further research is needed to determine the optimaltreatment dose frequency duration and interventional in-tervention and optimal stage so as to provide patients withthe best treatment strategy to achieve the best results Atpresent virtual reality technology is mostly used as anauxiliary means of conventional rehabilitation training forresearch

At present there are few studies on children with ce-rebral palsy in the application of the central nervous systemespecially lower limb rehabilitation but they have improvedsignificantly in the past three years However the sample sizeof many studies is too small and long-term follow-up islacking +ey may affect the experiment persuasiveness ofthe result Moreover virtual reality technology has onlyappeared in recent years and has not yet reached the stage oftechnological maturity +ese will affect the results of ex-periments especially the clinical experience of most relyingon therapists which is difficult to quantify and brings in-convenience to clinical applications +is is also the focus ofour future research

Data Availability

No data were used to support this study

Conflicts of Interest

+e authors declare that they have no conflicts of interest

References

[1] J Chen ldquoDiscuss the motor function and rehabilitation effectsof children with cerebral palsy after applying rehabilitationnursing measuresrdquo Frontiers of Health vol 28 no 5pp 70-71 2019

[2] X Ma and X Ma ldquoAnalysis of the effect of traditional Chinesemedicine acupuncture and pediatric massage on the MDI andPDI indexes of children with cerebral palsyrdquo Dietetics vol 6no 7 pp 90ndash92 2019

[3] Z Lv D Chen R Lou and H Song ldquoIndustrial securitysolution for virtual realityrdquo IEEE Internet of 2ings Journal2020

[4] Z Yan and Z Lv ldquo+e influence of immersive virtual realitysystems on online social applicationrdquoApplied Sciences vol 10no 15 p 5058 2020

[5] Y Xu W Xie and F He ldquoEffect of feedforward controlcombined with trunk training on motor development re-covery and follow-up of children with cerebral palsyrdquo ChineseJournal of Child Health Care vol 27 no 8 pp 83ndash86 2019

[6] Y Wang and J Liu ldquo+e effect of combined intervention ofrehabilitation nursing and hyperbaric oxygen on motorfunction and self-care ability in children with cerebral palsyrdquoShanxi Medical Journal vol 49 no 03 pp 113ndash115 2020

[7] L Jiang ldquoObservation on motor function and rehabilitationeffect of children with cerebral palsy after applying rehabil-itation nursing measuresrdquo Digest of World Latest MedicalInformation vol 18 no 75 pp 217ndash223 2018

[8] N Yang ldquoApplication effect of rehabilitation nursing in thenursing of children with cerebral palsyrdquo World Clinic Med-icine vol 11 no 5 p 195 2017

[9] X Zhao Y Zhang S Du et al ldquo+e effect of motion ob-servation training based on somatosensory games on themotor function of children with spastic cerebral palsyrdquoChinese Journal of Physical Medicine and Rehabilitationvol 40 no 12 pp 916ndash918 2018

[10] W Pei and M Wang ldquoStudy on the effect of auxiliary acu-puncture treatment on motor function of children with ce-rebral palsyrdquo Guangming Traditional Chinese Medicinevol 33 no 10 pp 96ndash98 2018

[11] Li Rong and Na Wan ldquo+e value analysis of the effect ofrehabilitation nursing intervention on the motor function andrehabilitation effect of children with cerebral palsyrdquo Chineseand ForeignMedical Research vol 17 no 6 pp 106-107 2019

[12] H Liu ldquoApplication of comprehensive treatment combinedwith hyperbaric oxygen in improving motor function ofchildren with cerebral palsyrdquo Clinical Research vol 026no 006 pp 145-146 2018

[13] S Yang ldquoObservation on the effect of rehabilitation nursingmeasures on the motor function and rehabilitation effect ofchildren with cerebral palsyrdquo Health for All vol 479 no 18p 163 2018

[14] S Li ldquo+e effect of rehabilitation nursing measures on themotor function and rehabilitation effect of children withcerebral palsyrdquo Medicine amp Health Care vol 26 no 2pp 127-128 2018

[15] P Jiang ldquoDiscussion on the effect of evidence-based nursingfor children with cerebral palsyrdquo Contemporary MedicalEssays vol 17 no 4 pp 29-30 2019

[16] S Zhao ldquoAnalysis of the rehabilitation effect of modern re-habilitation concept combined with acupuncture andmassage on children with cerebral palsyrdquo Electronic Journal ofIntegrated Traditional Chinese and Western MedicineCardiovascular Diseases vol 6 no 14 pp 135-136 2018

[17] Q Sun ldquoApplication of rehabilitation nursing in the treat-ment of salivation in children with cerebral palsyrdquo ChineseTrauma and Disability Medicine vol 24 no 8 pp 125-1262016

[18] S Zhang ldquoEvaluation of the effect of differences in clinicaltypes and intervention modes of children with cerebral palsyon the self-care ability of childrenrdquo Chinese Traumatology andDisability Medicine vol 24 no 5 pp 129-130 2016

[19] M Wang Fei Wang J Ye et al ldquo+e effect of Wushenacupuncture on children with cerebral palsy and its influence


on cerebral hemodynamicsrdquo Journal of Nanjing University ofTraditional ChineseMedicine vol 34 no 2 pp 132ndash135 2018

[20] B Song and Z Wei ldquoA clinical study on mental trainingcombined with acupuncture in the treatment of children withcerebral palsyrdquo Journal of Chinese Medicine vol 31 no 3pp 459ndash462 2016

[21] B X Batu and G Qing ldquoExperience of Mongolian medicinenursing in children with cerebral palsyrdquo Chinese Journal ofMinority Medicine vol 25 no 6 pp 76-77 2019

[22] N Liu J Zhu and S Zhang ldquo+e application value ofbrainstem auditory evoked potentials in the diagnosis ofchildren with cerebral palsyrdquo Heilongjiang Medicine vol 041no 7 pp 651-652 2017

[23] HWang ldquo+e clinical application value of exercise therapy inthe treatment of children with cerebral palsyrdquo Diet HealthCare vol 4 no 22 pp 49ndash52 2017

[24] Z Shu ldquoResearch on the application effect of evidence-basednursing in rehabilitation nursing of children with cerebralpalsyrdquoModern Health Care vol 8 no 296 pp 191-192 2017

[25] Fei Huang ldquoEffect of acupuncture and massage combinedwith rehabilitation measures on the prognosis of functionalrecovery in children with cerebral palsyrdquo World Journal ofIntegrated Traditional Chinese and Western Medicine vol 14no 4 pp 119ndash122 2019

[26] X Lan ldquo+e effect of club-style health education for childrenwith cerebral palsy on the quality of life of parents of chil-drenrdquo Journal of Nurses Training vol 6 no 33 pp 56ndash582018

[27] N Liu J Zhu and S Zhang ldquo+e application value ofbrainstem auditory evoked potentials in the diagnosis ofcerebral palsy in childrenrdquo Heilongjiang Medicine vol 41no 393 pp 60-61 2017


constructed in a way to save materials and reduce energyconsumption It can use graphical or animated drawings toexpress the rapid process of manufacturing individualproducts and to show people in the future its tendency thesearch for differentiated and individualised products It canbe used in the form of graphical cases to show the functionsand functions of integrated design and optimised design andconstruction [6] +ere are also many domestic and foreignresearch studies on the role of virtual reality technology inthe rehabilitation of lower limb function of children withcerebral palsy

In order to evaluate the effect of virtual reality tech-nology on the rehabilitation of upper and lower limbs ofstroke patients Yang Yujie used computers to search majordatabases such as HowNet and Wanfang to research therelated literature and to systematically analyze literature datausing computer software He concluded that virtual realitytechnology has a significant effect on the rehabilitation ofupper limbs of stroke patients but it is not obvious for therehabilitation of patientsrsquo lower limbs [7] Cheng Xiuyananalyzed the application of virtual reality technology inmedical treatment especially in stroke patients and the useof virtual reality technology can allow patients to bettermaintain their recovery function It has designed experi-ments on the clinical data of the hospital in recent years andperformed virtual reality technology treatments on patientsfor several weeks Comparing the parameters of these skillswith patients undergoing traditional treatment methods it isconcluded that virtual reality technology can effectivelyimprove the patientrsquos lower extremity balance and is con-ducive to patient rehabilitation [8] Xu Lei in order toevaluate the impact of virtual reality technology on patientswith cerebral palsy created a three-dimensional gait analysissystem divided patients into groups and performed dif-ferent treatments on patients [9] After a certain treatmenttime the patientrsquos stride length stride frequency and otherimportant indicators for cerebral palsy patients are testedExperimental results prove that virtual reality technologyhas a good effect on the patientrsquos walking ability [10] +esestudies have improved the relevant reference role for thisarticle However due to insufficient samples of these studiestoo much emphasis on theories and unreasonable practicalschemes the research has too many variables and theconclusions are unconvincing

+is article analyzes the advantages and disadvantagesof the previous research and then proposes a model of therehabilitation efficacy of lower limb function in childrenwith cerebral palsy based on virtual reality technology+is article mainly describes the basic characteristics ofthe impairment of the ability of the lower limbs in chil-dren with cerebral palsy and the composition is describedin four aspects grid individual definition status andaction definition and interaction between individuals +esystem objectively assessed the clinical relevance of re-storing the function of the lower limbs in children withcerebral palsy explained the damage of children withcerebral palsy in patients and verified the role of virtualreality technology in the treatment of children with ce-rebral palsy

2 Rehabilitation Treatment Methods of LowerLimb Function in Children withCerebral Palsy

21 Virtual Reality Technology +e continuous develop-ment of virtual reality technology has deepened the con-notation of virtual practice In essence the practice of virtualreality technology is still transforming things in objectivereality into digital image symbols through photoelectric andother means and then expressing them in virtual space comeout [11] However difference from the usual virtual practiceis that the practice in virtual reality makes the practicesubject completely immersed in a virtual environment thatcan get real feelings and through sophisticated sensingtechnology people can obtain vision hearing touch andsmell that are the same as reality And the comprehensivefeeling of kinesthesia and then the motion tracker of variousparts of the human body will feedback the subjectrsquos feedbackinto the virtual space and cyclically interact [12]

Virtual reality technology has brought about changes inhuman working life entertainment and practical methodsAt the same time it also caused social problems such asexcessive leniency health effects violence and value ori-entation and the development of the field of philosophy wasborn +e traditional philosophy of technology tends tostudy the various social effects of technology but at the sametime the development of technology will also have an impacton the philosophy system Affected by virtual reality tech-nology branches of philosophical fields such as artificialintelligence philosophy virtual reality philosophy and ar-tificial life philosophy continue to appear +e philosophicalissues generated by virtual reality technology involve manyfields such as practical theory media theory epistemologyethics and sociology Its unique technical characteristics andpractical methods have produced different depths of utilityin multiple disciplines [13]

+e characteristics of virtual reality technology makephilosophers pay more attention to some traditional phil-osophical theories such as the study of ontology andthinking about the nature of the world Some brand-newphilosophical ideas have emerged at the historic moment Inview of the technical characteristics of virtual reality that canconstruct a brand-new virtual environment some scholarshave put forward the idea that ldquocomputingrdquo is the essence ofthe world For example the American philosopher Steinhartproposed digital metaphysics Zhai Zhenming a philosophyprofessor at Sun Yat-sen University in my country proposeda new ethics ldquoworld-making ethicsrdquo and so on Facing thecontinuous innovation of technology philosophical think-ing cannot stop but should lead and correct the newtechnology [14]

Since the advent of the Internet virtual practice hasattracted much attention+rough virtual practice mankindhas broken through material production practice socialpractice and scientific practice expanded the scope ofpractice increased the objects of knowledge and improvedthe practical ability +e development of virtual realitytechnology has added new vitality to virtual practice If



x(k + 1) Ix(k) + Jv(k) k 1 2 (1)


K 1113944infin

k1x

i(k)Jx(k) + r

i(k)cJ1113960 1113961 (2)


Q 1

2a2r

minus 12b2


minus 1

a2r

minus 1t2

+ 2 1 minus b2

1113872 1113873t1113960 1113961

Q 1

2a2r

minus 12b2


minus 1

a2r

minus 1L2

+ 2 1 minus a2

1113872 1113873L1113960 1113961

(3)


2b2

a2r


t2

+1 minus b

2

a2r

minus1 t (4)


Q2

+2 1 + b

21113872 1113873

a2r

minus1 Q +1 + b

21113872 1113873

2

a2r

minus11113872 1113873


a2rminus1 Ix1113888 1113889

2

(5)












Ua plowast bj


m

m1t (6)


t 1

ln x1113944

1

n1fnm lowast ln fnm

r 1 minus 1113936

xn1 znm



1113936xn1 znm

1113944

x

m1wm 1

(7)


d

1113944

x


2

11139741113972

wn 1

1 + d rn uq( 1113857

(8)


Qδ rn d cos rn uq( 11138571113868111386811138681113868

1113868111386811138681113868ge δ1113966 1113967 (9)




1113944

m

n1δij (10)



1113936nn1 qr minus quq1113872 1113873

2

1113936 ququqm minus quq1113872 11138732

1113970 (11)

























2325

19

23

18 1921 22 21

1920

23 24

27

24

2119

17 1816

21

24 25 26

2927

2321 21

18

0

5

10

15

20

25

30

35

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Num

ber o

f chi

ldre

n

Years





12

1413

17

12

16 16

1819

16

11

1314

17

10

1516

17

9

13

11

14

12

1413

17

1516

13

15

5430 5660 5840

6670

5350

68707140

75 7370 75

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

0

2

4

6

8

10

12

14

16

18

20

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Cure

rate

()

Num

ber o

f peo

ple c

ured

Years








3

5

2

4

7

4

9

11

2

56

3

5

9

4

2

43 3

6

1

6

45

7

ndash2

0

2

4

6

8

10

12

14

Num

ber o

f chi

ld







043 049 044 052 059

041 046 053 058 062037 035 051

051061047 038

047044

058

034048 039 047 049

577612

672621 634

0

1

2

3

4

5

6

7

8

0

05

1

15

2

25

3

Firsthospital




ProvincialHospital

Wal

king

spee

d

Child

par

amet

ers

Different hospitals

















065 062069 074

087

058

067 065

075 078

062 061068

077082

068 067074

067

086

069 072078

072

089

357

334

342

349

373

3

31

32

33

34

35

36

37

38

39

0

01

02

03

04

05

06

07

08

09

1




ProvincialHospital




052

059

069

075

079

058

062

064

078

076

051

054

068

075

081

056

061

064

076

073

052

058

066

074

069

447

434

421

459

473

0 02 04 06 08 1




ProvincialHospital

Hospital





5 Conclusions




Data Availability




References
































x(k + 1) Ix(k) + Jv(k) k 1 2 (1)


K 1113944infin

k1x

i(k)Jx(k) + r

i(k)cJ1113960 1113961 (2)


Q 1

2a2r

minus 12b2


minus 1

a2r

minus 1t2

+ 2 1 minus b2

1113872 1113873t1113960 1113961

Q 1

2a2r

minus 12b2


minus 1

a2r

minus 1L2

+ 2 1 minus a2

1113872 1113873L1113960 1113961

(3)


2b2

a2r


t2

+1 minus b

2

a2r

minus1 t (4)


Q2

+2 1 + b

21113872 1113873

a2r

minus1 Q +1 + b

21113872 1113873

2

a2r

minus11113872 1113873


a2rminus1 Ix1113888 1113889

2

(5)












Ua plowast bj


m

m1t (6)


t 1

ln x1113944

1

n1fnm lowast ln fnm

r 1 minus 1113936

xn1 znm



1113936xn1 znm

1113944

x

m1wm 1

(7)


d

1113944

x


2

11139741113972

wn 1

1 + d rn uq( 1113857

(8)


Qδ rn d cos rn uq( 11138571113868111386811138681113868

1113868111386811138681113868ge δ1113966 1113967 (9)




1113944

m

n1δij (10)



1113936nn1 qr minus quq1113872 1113873

2

1113936 ququqm minus quq1113872 11138732

1113970 (11)

























2325

19

23

18 1921 22 21

1920

23 24

27

24

2119

17 1816

21

24 25 26

2927

2321 21

18

0

5

10

15

20

25

30

35

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Num

ber o

f chi

ldre

n

Years





12

1413

17

12

16 16

1819

16

11

1314

17

10

1516

17

9

13

11

14

12

1413

17

1516

13

15

5430 5660 5840

6670

5350

68707140

75 7370 75

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

0

2

4

6

8

10

12

14

16

18

20

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Cure

rate

()

Num

ber o

f peo

ple c

ured

Years








3

5

2

4

7

4

9

11

2

56

3

5

9

4

2

43 3

6

1

6

45

7

ndash2

0

2

4

6

8

10

12

14

Num

ber o

f chi

ld







043 049 044 052 059

041 046 053 058 062037 035 051

051061047 038

047044

058

034048 039 047 049

577612

672621 634

0

1

2

3

4

5

6

7

8

0

05

1

15

2

25

3

Firsthospital




ProvincialHospital

Wal

king

spee

d

Child

par

amet

ers

Different hospitals

















065 062069 074

087

058

067 065

075 078

062 061068

077082

068 067074

067

086

069 072078

072

089

357

334

342

349

373

3

31

32

33

34

35

36

37

38

39

0

01

02

03

04

05

06

07

08

09

1




ProvincialHospital




052

059

069

075

079

058

062

064

078

076

051

054

068

075

081

056

061

064

076

073

052

058

066

074

069

447

434

421

459

473

0 02 04 06 08 1




ProvincialHospital

Hospital





5 Conclusions




Data Availability




References




































Ua plowast bj


m

m1t (6)


t 1

ln x1113944

1

n1fnm lowast ln fnm

r 1 minus 1113936

xn1 znm



1113936xn1 znm

1113944

x

m1wm 1

(7)


d

1113944

x


2

11139741113972

wn 1

1 + d rn uq( 1113857

(8)


Qδ rn d cos rn uq( 11138571113868111386811138681113868

1113868111386811138681113868ge δ1113966 1113967 (9)




1113944

m

n1δij (10)



1113936nn1 qr minus quq1113872 1113873

2

1113936 ququqm minus quq1113872 11138732

1113970 (11)

























2325

19

23

18 1921 22 21

1920

23 24

27

24

2119

17 1816

21

24 25 26

2927

2321 21

18

0

5

10

15

20

25

30

35

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Num

ber o

f chi

ldre

n

Years





12

1413

17

12

16 16

1819

16

11

1314

17

10

1516

17

9

13

11

14

12

1413

17

1516

13

15

5430 5660 5840

6670

5350

68707140

75 7370 75

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

0

2

4

6

8

10

12

14

16

18

20

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Cure

rate

()

Num

ber o

f peo

ple c

ured

Years








3

5

2

4

7

4

9

11

2

56

3

5

9

4

2

43 3

6

1

6

45

7

ndash2

0

2

4

6

8

10

12

14

Num

ber o

f chi

ld







043 049 044 052 059

041 046 053 058 062037 035 051

051061047 038

047044

058

034048 039 047 049

577612

672621 634

0

1

2

3

4

5

6

7

8

0

05

1

15

2

25

3

Firsthospital




ProvincialHospital

Wal

king

spee

d

Child

par

amet

ers

Different hospitals

















065 062069 074

087

058

067 065

075 078

062 061068

077082

068 067074

067

086

069 072078

072

089

357

334

342

349

373

3

31

32

33

34

35

36

37

38

39

0

01

02

03

04

05

06

07

08

09

1




ProvincialHospital




052

059

069

075

079

058

062

064

078

076

051

054

068

075

081

056

061

064

076

073

052

058

066

074

069

447

434

421

459

473

0 02 04 06 08 1




ProvincialHospital

Hospital





5 Conclusions




Data Availability




References

































1113944

m

n1δij (10)



1113936nn1 qr minus quq1113872 1113873

2

1113936 ququqm minus quq1113872 11138732

1113970 (11)

























2325

19

23

18 1921 22 21

1920

23 24

27

24

2119

17 1816

21

24 25 26

2927

2321 21

18

0

5

10

15

20

25

30

35

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Num

ber o

f chi

ldre

n

Years





12

1413

17

12

16 16

1819

16

11

1314

17

10

1516

17

9

13

11

14

12

1413

17

1516

13

15

5430 5660 5840

6670

5350

68707140

75 7370 75

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

0

2

4

6

8

10

12

14

16

18

20

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Cure

rate

()

Num

ber o

f peo

ple c

ured

Years








3

5

2

4

7

4

9

11

2

56

3

5

9

4

2

43 3

6

1

6

45

7

ndash2

0

2

4

6

8

10

12

14

Num

ber o

f chi

ld







043 049 044 052 059

041 046 053 058 062037 035 051

051061047 038

047044

058

034048 039 047 049

577612

672621 634

0

1

2

3

4

5

6

7

8

0

05

1

15

2

25

3

Firsthospital




ProvincialHospital

Wal

king

spee

d

Child

par

amet

ers

Different hospitals

















065 062069 074

087

058

067 065

075 078

062 061068

077082

068 067074

067

086

069 072078

072

089

357

334

342

349

373

3

31

32

33

34

35

36

37

38

39

0

01

02

03

04

05

06

07

08

09

1




ProvincialHospital




052

059

069

075

079

058

062

064

078

076

051

054

068

075

081

056

061

064

076

073

052

058

066

074

069

447

434

421

459

473

0 02 04 06 08 1




ProvincialHospital

Hospital





5 Conclusions




Data Availability




References









































2325

19

23

18 1921 22 21

1920

23 24

27

24

2119

17 1816

21

24 25 26

2927

2321 21

18

0

5

10

15

20

25

30

35

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Num

ber o

f chi

ldre

n

Years





12

1413

17

12

16 16

1819

16

11

1314

17

10

1516

17

9

13

11

14

12

1413

17

1516

13

15

5430 5660 5840

6670

5350

68707140

75 7370 75

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

0

2

4

6

8

10

12

14

16

18

20

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Cure

rate

()

Num

ber o

f peo

ple c

ured

Years








3

5

2

4

7

4

9

11

2

56

3

5

9

4

2

43 3

6

1

6

45

7

ndash2

0

2

4

6

8

10

12

14

Num

ber o

f chi

ld







043 049 044 052 059

041 046 053 058 062037 035 051

051061047 038

047044

058

034048 039 047 049

577612

672621 634

0

1

2

3

4

5

6

7

8

0

05

1

15

2

25

3

Firsthospital




ProvincialHospital

Wal

king

spee

d

Child

par

amet

ers

Different hospitals

















065 062069 074

087

058

067 065

075 078

062 061068

077082

068 067074

067

086

069 072078

072

089

357

334

342

349

373

3

31

32

33

34

35

36

37

38

39

0

01

02

03

04

05

06

07

08

09

1




ProvincialHospital




052

059

069

075

079

058

062

064

078

076

051

054

068

075

081

056

061

064

076

073

052

058

066

074

069

447

434

421

459

473

0 02 04 06 08 1




ProvincialHospital

Hospital





5 Conclusions




Data Availability




References































12

1413

17

12

16 16

1819

16

11

1314

17

10

1516

17

9

13

11

14

12

1413

17

1516

13

15

5430 5660 5840

6670

5350

68707140

75 7370 75

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

0

2

4

6

8

10

12

14

16

18

20

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Cure

rate

()

Num

ber o

f peo

ple c

ured

Years








3

5

2

4

7

4

9

11

2

56

3

5

9

4

2

43 3

6

1

6

45

7

ndash2

0

2

4

6

8

10

12

14

Num

ber o

f chi

ld







043 049 044 052 059

041 046 053 058 062037 035 051

051061047 038

047044

058

034048 039 047 049

577612

672621 634

0

1

2

3

4

5

6

7

8

0

05

1

15

2

25

3

Firsthospital




ProvincialHospital

Wal

king

spee

d

Child

par

amet

ers

Different hospitals

















065 062069 074

087

058

067 065

075 078

062 061068

077082

068 067074

067

086

069 072078

072

089

357

334

342

349

373

3

31

32

33

34

35

36

37

38

39

0

01

02

03

04

05

06

07

08

09

1




ProvincialHospital




052

059

069

075

079

058

062

064

078

076

051

054

068

075

081

056

061

064

076

073

052

058

066

074

069

447

434

421

459

473

0 02 04 06 08 1




ProvincialHospital

Hospital





5 Conclusions




Data Availability




References

































043 049 044 052 059

041 046 053 058 062037 035 051

051061047 038

047044

058

034048 039 047 049

577612

672621 634

0

1

2

3

4

5

6

7

8

0

05

1

15

2

25

3

Firsthospital




ProvincialHospital

Wal

king

spee

d

Child

par

amet

ers

Different hospitals

















065 062069 074

087

058

067 065

075 078

062 061068

077082

068 067074

067

086

069 072078

072

089

357

334

342

349

373

3

31

32

33

34

35

36

37

38

39

0

01

02

03

04

05

06

07

08

09

1




ProvincialHospital




052

059

069

075

079

058

062

064

078

076

051

054

068

075

081

056

061

064

076

073

052

058

066

074

069

447

434

421

459

473

0 02 04 06 08 1




ProvincialHospital

Hospital





5 Conclusions




Data Availability




References



































065 062069 074

087

058

067 065

075 078

062 061068

077082

068 067074

067

086

069 072078

072

089

357

334

342

349

373

3

31

32

33

34

35

36

37

38

39

0

01

02

03

04

05

06

07

08

09

1




ProvincialHospital




052

059

069

075

079

058

062

064

078

076

051

054

068

075

081

056

061

064

076

073

052

058

066

074

069

447

434

421

459

473

0 02 04 06 08 1




ProvincialHospital

Hospital





5 Conclusions




Data Availability




References































5 Conclusions




Data Availability




References































systematic evaluation of the effect of rehabilitation of

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