A serious game for assessing upper-limb visuomotor adaptation in children with cerebral palsy during reaching tasks in virtual reality

Cerebral palsy (CP) is the most common non-progressive neurodevelopmental disorder, associated with impairments in motor control, posture, and adaptability. Understanding how patients with CP adapt to different task demands is essential to design effective assessment and rehabilitation tools. The aim of this study is to provide a detailed characterization of the movement patterns observed between a group of patients with CP and a Control Group, with the goal of identifying specific motor control features that may influence adaptability in several mapping conditions of the game. A cohort of 15 individuals with CP and 10 controls performed game-based tasks under varying mapping conditions. Kinematic and performance metrics were extracted and analyzed to quantify differences in motor strategies, variability, and adaptability across groups. Patients with CP showed distinct movement patterns compared to controls, particularly in adaptability metrics. The adaptability of motor control was influenced by the mapping condition, revealing group-specific limitations. This study highlights characteristic motor control features in CP that influence adaptability to task constraints. These findings may inform the development of personalized rehabilitation protocols and adaptive game-based interventions for motor training.