Effects of Virtual Reality Use on Children with Cerebral Palsy and Its Applications in Health: A Systematic Review.

Background/Objectives: This study evaluated the effects of virtual reality (VR) on functionality, quality of life, and motivation in children with cerebral palsy (CP). Methods: The systematic review was registered in PROSPERO (CRD42022321170) and conducted using the keywords physical therapy OR physiotherapy AND "Virtual Reality". Studies were screened based on title, abstract, and full-text review. The PEDro scale was used to assess methodological quality, and the GRADE system was applied to determine the level of certainty of the evidence. Results: A total of 10 studies showed improvements in balance, 6 in gross motor function, and 8 in upper limb coordination. Additional gains were found in daily functioning (6), gait (4), motivation (3), and spasticity (1-2). Overall, virtual reality enhanced motor abilities and engagement compared with conventional therapy, underscoring its value as a playful and motivating tool in rehabilitation. All outcome measures showed positive changes, particularly in functionality and quality of life. The primary outcomes with the most favorable responses to intervention were gross motor function and balance, followed by motivation and adherence. However, the generalities of the findings are limited due to variabilities in outcome reporting and measurement tools. Conclusions: The findings indicated clinical improvements in key outcome measures following VR interventions. Nonetheless, there were significant variabilities in the evaluation instruments used across studies. Despite this, the clinical evidence supported the integration of VR into neurorehabilitation processes for children with CP.