Effects of video-based games on upper extremity function and activity participation in children with hemiparetic cerebral palsy

Aim: The aim of this study was to systematically evaluate the effects of video-based gaming on upper extremity motor function and activity participation in children with hemiparetic cerebral palsy (CP). Materials and Methods: Twenty-four children aged 7–13 years with hemiparetic CP, classified as Level I–III on the Gross Motor Function Classification System (GMFCS) and Level 1–3 on the Manual Ability Classification System (MACS), were recruited. Participants were randomized into intervention (n=12) and control (n=12) groups. The control group received Neurodevelopmental Therapy (NDT) four times per week (45-minute sessions) over a 12-week period. The intervention group received two NGT sessions and two Xbox Kinect gameplay sessions per week, each lasting 45 minutes, over the same duration. Baseline and post-intervention assessments included the Nine-Hole Peg Test (9HPT) to measure timed performance-based hand function, the Duruöz Hand Index (DHI) for skill-based hand function, and the Assistance to Participation Scale (APS) to assess participation in daily activities. All assessments were conducted by a blinded expert physiotherapist. Results: Baseline characteristics (age, sex, GMFCS, MACS levels) were comparable between groups (p>0.05), confirming group homogeneity. Both groups exhibited statistically significant improvements in DHI and APS scores after 12 weeks (p<0.05). However, neither group showed a significant change in 9HPT performance between pre- and post-tests (p>0.05). Comparative analysis demonstrated that the intervention group's gains in both DHI and APS scores were significantly greater than those of the control group (p<0.05). Conclusion: Incorporating Kinect-based video games into conventional NGT enhanced upper extremity function and daily activity participation more effectively than NGT alone in children with hemiparetic CP. The interactive, real-time feedback provided by the gaming intervention likely facilitated motor learning and increased motivation and adherence.