Non-immersive virtual reality telerehabilitation for motor accuracy and precision in individuals with Cerebral Palsy: A non-randomized clinical trial
Paula Lumy da Silva, Elisa de Jesus Valenzuela, Mariana Giovanelli de Carvalho, Anne Michelli Gomes Gonçalves Fontes, Juliana Perez Weingartner, Talita Dias da Silva-Magalhães, Íbis Ariana Peña de Moraes, Helen Dawes, Eduardo Dati Dias, Carlos Bandeira de Mello Monteiro
Abstract
This study aimed to describe motor performance, accuracy and precision, in individuals with Cerebral Palsy (CP) compared to typically developing individuals (controls), and to examine longitudinal changes during a non-immersive virtual reality (VR) telerehabilitation protocol. Methods: The final sample included, 38 with CP and 21 controls.
Introduction
Cerebral Palsy (CP) refers to a group of permanent disturbances of movement and postural development, causing activity limitations attributed to non-progressive disturbances which occurred during fetal or infant brain development. In addition to motor disorders, CP is often accompanied by disturbances in sensation, perception, cognition, communication, behavior, epilepsy, and secondary musculoskeletal problems [1].
Materials and method
Study design
This study was approved by the Research Ethics Committee of the Hospital das Clínicas, School of Medicine, University of São Paulo (protocol: 38563420.0.0000.0068), and registered in the Brazilian Clinical Trials Registry (ReBEC) under the number RBR-4kf52bv. This is a non-randomized controlled clinical trial conducted between January 20, 2021, and March 30, 2024.
Results
The study initially recruited 82 participants, including 58 individuals in the CP group and 24 in the control group. Following the application of exclusion criteria, 24 participants were excluded, resulting in a final sample of 59 participants: 38 in the CP group and 21 in the control group. All control participants performed a single practice session of the experimental task.
Discussion
The main objective of the present study was to analyze the motor performance of individuals with CP who participated in a long-term protocol of home telerehabilitation using a virtual reality game. As we hypothesized, the CP group presented more difficulty in practicing the task than the controls.
Acknowledgments
We would like to thank all participants and their families for their time and commitment, and the staff who assisted with data collection and technical support.
Citation: Silva PLd, Valenzuela EdJ, Carvalho MGd, Fontes AMGG, Weingartner JP, Silva-Magalhães TDd, et al. (2026) Non-immersive virtual reality telerehabilitation for motor accuracy and precision in individuals with Cerebral Palsy: A non-randomized clinical trial. PLoS One 21(3): e0343934. https://doi.org/10.1371/journal.pone.0343934
Editor: Imre Cikajlo, University rehabilitation institute, SLOVENIA
Received: May 20, 2025; Accepted: February 8, 2026; Published: March 13, 2026
Copyright: © 2026 Silva et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All data from this research are publicly available. Silva PL, Valenzuela EJ, Martinez JP, Silva-Magalhães TD, Moraes IAP, Dawes H, Dias ED, Monteiro CBM. Dataset for Non-immersive virtual reality as a telerehabilitation protocol on precision and accuracy performance in individuals with cerebral palsy: a non-randomized controlled clinical trial, Zenodo.2025; V1. https://doi.org/10.5281/zenodo.17468973.
Funding: The study was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) – Finance Code 406029/2023-7 and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior do Ministério da Educação (CAPES): Finance Code 001. Dawes is supported by NIHR Exeter BRC.
Competing interests: The authors have declared that no competing interests exist.
