Abstract Background Performance-based dexterity is often limited in children with Cerebral Palsy (CP), affecting independence in daily activities. This study aimed to investigate the effectiveness of fine motor grasping exercises in a virtual reality (VR) environment using the Leap Motion Controller (LMC) on performance-based dexterity. Methods A total of 32 children with CP ( n = 16 per group), classified as Levels I or II according to the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS), were randomly assigned to either the Leap Motion Group (LMG) or the Control Group (CG). Both groups received 45-minute therapy sessions, twice weekly for 8 weeks. While both groups underwent Neurodevelopmental Therapy (NDT), the intervention doses were specified as follows: the CG received 45 min of conventional NDT, whereas the LMG received 30 min of NDT integrated with 15 min of Leap Motion-based virtual reality training (including Object Catching, Firefly, and Bee-batting games). The primary outcome was performance-based dexterity, assessed using the ABILHAND-Kids questionnaire, while secondary outcomes included the Box and Block Test (BBT), Nine-Hole Peg Test (NHPT), and the Montessori-based Pink Tower Timed Performance Test (PTPT). Results Significant improvements were observed within both two groups ( n = 16 per group) across all measured parameters ( p < 0.05). The results also indicated a borderline significant improvement in the VR group ( p = 0.050); this finding should be interpreted with caution, as it lies exactly at the threshold of statistical significance. However, the LMG demonstrated significantly greater improvements compared to the CG in BBT, NHPT, PTPT, and ABILHAND-Kids scores ( p < 0.05). Furthermore, the Leap Motion Group exhibited high motivation and engagement, as reflected by strong user satisfaction scores (mean: 4.38 ± 0.82 out of 5), supporting the feasibility of VR-based training. Conclusion Preliminary results indicate that Leap Motion-based VR exercises could serve as a beneficial adjunct to NDT for enhancing performance-based dexterity; however, further evidence is needed to definitively conclude its effects on long-term functional independence. Trial Registration ClinicalTrials.gov, NCT04954144.
ERGEN et al. (2026) studied this question.