Comparison of action observation therapy and virtual reality combined with conventional therapy for upper extremity rehabilitation in children with unilateral cerebral palsy.

BACKGROUND: This study aims to evaluate and compare the effects of two neurorehabilitation methods-action observation therapy (AOT) and XBOX 360 Kinect™ (XBOX) on upper extremity body structure functions, activity, and functional participation levels in children with Unilateral Cerebral Palsy (UCP). METHODS: Forty-five children with UCP (aged 5-15 years) were randomly divided into three groups: AOT, XBOX, and Conventional (CNV). All groups received conventional physiotherapy (45 minutes, twice weekly for 3 weeks). The AOT group had additional 30-minute daily telerehabilitation sessions, while the XBOX group used XBOX 360 Kinect for the same duration. Evaluations included the Modified Ashworth Scale (MAS), Jamar Hand Dynamometer, Baseline Mechanical Grip Meter, Selective Control of the Upper Extremity Scale (SCUES), Jebsen Taylor Hand Function Test (JTHFT), Abilhand-Kids, and Pediatric Quality of Life Inventory (PedsQL). Statistical significance was set at p<0.017. RESULTS: Both AOT and XBOX groups showed greater improvements than CNV(p<0.017). AOT achieved clinically meaningful gains in all grasp types and selectivity, while XBOX mainly improved pinch, lateral grip, and forearm selectivity. Both groups improved in ABILHAND-Kids and PedsQL, with broader gains in AOT. CONCLUSION: AOT and XBOX are effective supplementary therapies for upper extremity rehabilitation in children with UCP, complementing conventional physiotherapy. CLINICAL TRIAL NUMBER: NCT05327179.