Effectiveness of Video-Game-Based Therapy to Improve Hand Function in Children with Cerebral Palsy: A Systematic Review and Meta-Analysis.

Advances in technology have led to the emergence of new therapeutic methods such as video-game-based therapy (VGBT). This may be a promising new method for improving upper limb function, but the role and proposed uses still need to be clarified. This study aims to investigate the effectiveness of VGBT in children with cerebral palsy (CP) compared to conventional therapy (CT). A systematic search of five databases was conducted (Cochrane, Embase, Pubmed, Scopus, Web of Science) in January 2024 to identify randomized controlled trials that compared VGBT interventions with CT for children with CP. Our primary outcomes focused on tests on hand functions (HFs) (grip strength, grasp function, manual dexterity tests, hand function questionnaires tests, and upper limb fine motor function tests). A random effects meta-analysis was performed, and ROB2 and GRADE tools were used. Of 2882 articles reviewed, 22 were selected, involving a total of 785 children. Three outcomes were statistically significant in favor of the intervention group: for grasp function, the standardized mean difference (SMD) was 0.80 (95% confidence intervals 0.06, 1.55); for HF questionnaires, the SMD was 0.36 (95% CI 0.04, 0.68); and for HF tests, the SMD was 0.42 (95% CI 0.03, 0.81). The ROB was high risk in two, some concerns for four and low risk in the other cases. The GRADE was moderate in two, while the remaining were low and very low in half of the papers. VGBT has the potential to be an effective tool for rehabilitation of disabled upper limb function in CP as an adjunct to other traditional forms of therapy by integrating it into everyday rehabilitation.