Non-immersive virtual reality telerehabilitation for motor accuracy and precision in individuals with Cerebral Palsy: A non-randomized clinical trial

This study aimed to describe motor performance, accuracy and precision, in individuals with Cerebral Palsy (CP) compared to typically developing individuals (controls), and to examine longitudinal changes during a non-immersive virtual reality (VR) telerehabilitation protocol. Methods: The final sample included, 38 with CP and 21 controls. Controls completed a single practice session, while 29 participants with CP completed the 10-day home-based protocol, and 20 returned for a follow-up session to assess retention. Analyses followed the intention-to-treat principle, including all 38 CP participants. The intervention used the MoveHero game, performed two to three times per week, with sessions lasting at least 9 minutes under remote therapist supervision. Motor performance was assessed in a coincident timing task using absolute error (AE, accuracy), variable error (VE, precision), and percentage of hits. The study was registered in the Brazilian Clinical Trials Registry (ReBec: RBR-4kf52bv). Results: The CP group had higher mean AE and VE values than controls but showed progressive improvements across practice days. Mean accuracy improved across most target positions (p 0.05). Conclusion: Home-based non-immersive VR telerehabilitation using MoveHero effectively enhanced upper-limb motor performance in individuals with CP, regardless of functional level. These findings support VR as an accessible, motivating, and adaptable tool for promoting motor learning and continuity of care in home-based rehabilitation.